Relapse management in multiple sclerosis.
Relapses, exacerbations, and attacks are synonymous for new or worsened neurologic symptoms that are the hallmark of relapsing-remitting multiple sclerosis. Management of relapses is not always straightforward. The clinician must distinguish between true relapses, symptom fluctuation, and pseudo-relapses. Risks and benefits of treating a relapse must be considered. Once the decision to treat is made, most clinicians would pursue a course of corticosteroids. Consensus may end there, as there is no clear-cut "best" route of administration or dosing schedule. The patient presenting with their first relapse or clinically isolated syndrome may be at risk for the development of multiple sclerosis. Clinical presentation, CSF findings, and MRI may all give clues as to the risk for future demyelinating events.
Thrower
Ben W
BW
Shepherd MS Institute, Atlanta, Georgia 30309, USA. ckernich2@sbcglobal.net
D000324:Adrenocorticotropic Hormone / Q000627:therapeutic use; D002985:Clinical Protocols; D003711:Demyelinating Diseases / Q000188:drug therapy / Q000628:therapy; D019468:Disease Management; D005260:Female; D005938:Glucocorticoids / Q000627:therapeutic use; D006801:Humans; D016756:Immunoglobulins, Intravenous / Q000627:therapeutic use; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D020529:Multiple Sclerosis, Relapsing-Remitting / Q000188:drug therapy / Q000534:rehabilitation / Q000628:therapy*; D011239:Prednisolone / Q000008:administration & dosage / Q000627:therapeutic use; D011247:Pregnancy; D011248:Pregnancy Complications / Q000188:drug therapy / Q000628:therapy; D012008:Recurrence; D013315:Stress, Psychological; D014611:Vaccination
D005938:Glucocorticoids; D016756:Immunoglobulins, Intravenous; D007166:Immunosuppressive Agents; D000324:Adrenocorticotropic Hormone; D011239:Prednisolone