WHY IS IT IMPORTANT TO START TREATMENT EARLY?

Before one begins to experience any symptoms of MS, early damage in the central nervous system can occur. Studies have shown that one of the best chances of reducing long-term disability is during the early relapsing phase of the disease that’s characterized by inflammation – MS often causes more damage in the first year itself than in years five to 10.
Further, given that all currently available medications primarily target inflammation, starting the treatment early helps to minimize this inflammation thereby reducing damage to nerve fibres and loss of brain tissue.

HOW IS MULTIPLE SCLEROSIS TREATED?

Unfortunately, there is no cure for MS, however, medicines and certain lifestyle changes can help manage the condition.

A good MS Treatment Plan must focus on four key areas: disease management, relapse management, symptom management and general health. The patient needs to work very closely with the doctor to find the treatment plan that is not only the best but also causes the fewest side eects.


Disease Management:

Unfortunately there is currently no cure for MS, however there are some disease-modifying treatments (DMTs) that can help decrease the number of attacks, slow the progression of the condition and decrease the number of lesions on the brain. Currently, there are a wide variety of DMTs with dierent dosing and delivery methods available – injections, infusions and oral medications – however finding the most eective treatment may involve trial and error as it might be dicult to predict individual response to a particular medication. The patient would need to discuss the available options with the team of doctors so that an informed decision based on potential benefits and risks can be taken.



Relapse Management:

An MS relapse is a sudden onset of new symptoms or a worsening of old symptoms that were earlier stable. The new symptoms or changed symptoms must last for at least 24 hours and must be separated from a previous relapse by at least 30 days to be considered as a relapse. The doctors, however, do not treat every relapse and often the symptoms pass on their own.

One of the most common method of treat- ing a relapse is the administration of a brief course of intravenous, high-dosage corticosteroids that shorten the duration of acute attacks and decrease the inflammation in lesions. However, it’s important to note that steroids do not alter disease progression or relapse rate.

Another method of treating a relapse is Adrenocorticotropic Hormone (ACTH) and is recommended for patients who have not responded positively to, or cannot tolerate, corticosteroids, as well as for patients whose veins cannot handle infusions. ACTH is administered by intramuscular injection and the treatment usually lasts for a few weeks.


Symptom Management:

New symptoms vary from person to person and they adversely aect a patient’s quality of life. While these may be frightening, appropriate planning and management of symptoms can help alleviate fear, minimize negative eects and also help maintain a
good quality of life. A good symptom management plan might include medical, reha- bilitative, psychological and lifestyle approaches and choosing the right approach or approaches depend on the type of symptoms, the severity of the symptom and several other factors such as physical ability and support system.

For example, treatment of chronic fatigue might involve medication, learning energy conservation techniques and making certain lifestyle changes to introduce healthier sleep habits.

It is advised that the patient discusses each new symptom with the team of doctors as some symptoms are best treated with early intervention so that the worsening of the symptoms can be controlled, while some other symptoms would need to be monitored for changes over time.


General Health Management: An MS patient’s ability to maintain his/her quality of life depends on his/her overall health. For example, lack of exercise in combination with an MS symptom such as weakness, could contribute to a loss of mobility; poor sleep habits and poor nutrition can worsen a symptom such as fatigue; or, fever and infection can cause temporary worsening of the symptoms.
A body with good general health and a healthy daily routine, the body is more prepared to handle symptoms as and when they flare up. This is the reason routine medical care, exercise, nutrition and proper rest are important aspects to consider in an eective MS treatment plan.

While there is no treatment available for MS, a relatively old treatment protocol has given MS patients a new hope in halting the disease progression – Haematopoietic Stem Cell Transplant or HSCT. Currently, HSCT is the only existing, scientifically proven treatment that completely halts disease progression of MS.