Multiple sclerosis

Leading Medicine Guide Editors
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Leading Medicine Guide Editors
Multiple sclerosis (MS) is a disease that damages the insulating covers of nerve cells in the brain and spinal cord. As a result, the different parts of the nervous system may sometimes find it hard to communicate, and this causes a broad range of symptoms.
ICD codes for this diseases: G35

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Article overview

In most cases, a multiple sclerosis specialist is a qualified neurologist, whose focus is on diseases of the nervous system. However, since multiple sclerosis can potentially affect different regions of the body, a multiple sclerosis specialist will usually work with a multidisciplinary team of specialist doctors and healthcare professionals.

Which symptoms do multiple sclerosis specialists treat?

Some specific symptoms of multiple sclerosis may include:

  • double vision
  • blindness (in one eye)
  • muscle weakness
  • sensation difficulties
  • coordination difficulties

Symptoms may disappear between attacks. However, permanent neurological problems may tend to persist, especially as the disease progresses.

Symptoms of multiple sclerosis

What treatment methods are used by multiple sclerosis specialists?

Multiple sclerosis is not curable, and treatment typically aims to speed recovery from attacks, slow the progression of the disease and manage its symptoms. Some people with very mild symptoms will not need to resort to treatment.

Treatments for MS attacks

  • corticosteroids are recommended to reduce inflammation of the nerves.
  • plasmapheresis (blood plasma exchange) involves mixing blood cells with a protein solution.

Treatments to slow the advance of MS

MS can take two major forms:

  • a continuously progressive type of MS
  • a relapsing-remitting type of MS, with periods when symptoms may (temporarily) disappear

The immuno-suppressive drug ocrelizumab is the only recommended medication for slowing the advance of progressive forms of MS. For relapsing-remitting types of MS, there are several disease-modifying therapies available.

Treatment options for relapsing-remitting MS include:

  • beta interferons, which are some of the most common medications prescribed for the treatment of MS. When injected underneath the skin or directly into a muscle, they can help to lower the frequency and severity of MS relapses.
  • ocrelizumab is also approved for the relapse-remitting type of MS, because it has been shown to both cut the relapse rate of MS and slow the advance of disabling symptoms in the two main forms of the disease.

Other drugs that are used to slow the development of symptoms in relapsing-remitting MS include:

  • glatiramer acetate
  • dimethyl fumarate
  • fingolimod
  • teriflunomide
  • natalizumab
  • alemtuzumab
  • mitoxantrone

Much of the immune system response associated with multiple sclerosis happens during the first phases of the disease. Early and aggressive medication treatments can reduce the relapse rate and slow down the formation of any new lesions.

Treatments for MS symptoms

  • physiotherapy involves stretching and strengthening exercises to enhance daily functions.
  • muscle relaxants may help to control painful muscle stiffness and spasms.
  • medications may also help to minimise fatigue, as well as to combat other symptoms, such as pain, depression, and bowel or bladder control.

Alternative medicine

Many people with MS also use a number of alternative remedies to alleviate symptoms such as weakness and muscular pain. Activities such as acupuncture, exercise, massage, meditation, yoga, and relaxation techniques can play a part in increasing overall mental and physical wellbeing.

What additional qualifications are required by multiple sclerosis specialists?

A neurologist’s training includes four years of study at medical school, followed by one year basic clinical training and four years of residency (one year of internal medicine, then three years of neurology training). Some neurologists then undertake a two-year fellowship, during which they receive additional training focusing on their chosen specialist area of neurology. A multiple sclerosis fellowship is a recognised neurological subspecialty.

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