MS treatment and prevention
A range of treatment and prevention options may be recommended:
- Plasmapheresis
- Speech therapy to assist with swallowing disorders and speech
difficulties
- Physical and occupational therapy to help increase stability,
mobility and coordination
- Urology services to address bladder problems
- Thalamotomy or thalamic stimulation to address chronic cerebellar
tremor
- Pain management services for the treatment of chronic pain
- Medication management
- Dietary consultation
- Exercise program development
- Stress management programs
- Access to clinical trials
- Behavioral health services
- Support groups
The Regional MS Center offers the latest treatment techniques and technologies. Treating MS symptoms may involve intravenous or oral steroids, anti-cancer drugs that suppress the immune system, plasma exchange therapy (plasmapheresis), as well as newer therapies that are only available in a clinical research setting.
For the management of severe spasticity, the MS center offers the intrathecal baclofen pump. For movement disorders and muscle spasms related to MS, the center offers botulinum toxin. Intravenous immunomodulating therapies are used to treat autoimmune neurological disorders like MS by stabilizing the patient and helping to prevent an episode from worsening.
Plasmapheresis
Plasma exchange therapy involves removing and separating plasma from red and white blood cells. Plasma is the fluid portion of the blood in which these cells are suspended. The plasma also contains antibodies, which may be destroying certain tissues and causing a flare-up of MS. The plasma is replaced with a mixture of the protein substance albumin and saline solution, and the red and white blood cells are returned to the body.
Two IV lines are inserted into the patient's veins for the procedure. About
1/2 to 1 cup of blood is out of the body at any given time. Medications may be given during the procedure. Treatments take 2-3 hours each, typically occurring once a week, and total treatments may range from
5 to 15. It usually takes several weeks before a change in symptoms is noticed, but plasmapheresis can relieve symptoms in many MS patients.
Intrathecal baclofen therapy
MS patients who experience severe spasticity -- involuntary tightening of muscles -- may experience reduced spasticity with ITB therapy and fewer side effects associated with oral baclofen. ITB treatment involves surgically implanting a pump just beneath the skin of the abdomen. The pump directly injects medication into the fluid surrounding the spinal cord. In this way, only small amounts of medication are required compared to oral medications which circulate throughout the entire body. ITB dosage can be easily adjusted for each patient. Refills of medication are injected into the pump every
2-3 months. The pump can be removed at any time.
Other medications
Four medications are currently approved for use to modulate the immune system in an effort to prevent multiple sclerosis attacks. The MS type may determine which drug is most appropriate. The newest medication, Rebif, was approved in
March 2002, by the US Food & Drug Administration. Avonex, Betaseron and Copaxone are the other approved immunomodulating medications. The four drugs may reduce future disability and improve quality of life for many people with MS, no matter what the level of disability, age or frequency of relapse. These medications are usually continued indefinitely unless there is a clear lack of benefit or intolerable side effects.
Medications that suppress the immune system's attacks on nerve fibers in MS include azathioprine, cyclophosphamide, immunoglobin, methotrexate and
mitoxantrone.
The Regional MS Center at St. Luke's is the only place in Wisconsin currently involved in a study of Antegren, a medication that works as an antibody to block T-cells from crossing from the bloodstream to the brain and causing an MS attack. As another preventive measure against MS episodes, the MS center is also testing high-dose Betasoren therapy.
For more information, visit our
Clinical Research
site.
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