jueves, 1 de febrero de 2018

Relapsing-Remitting Multiple Sclerosis Treatment

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By Cashmere Lashkari

There is no cure for multiple sclerosis. The only way to manage the disorder is to make major lifestyle changes and adhere to a strict medication regime. Disease-modifying therapies have proved to be the most effective way to deal with MS.

Credit: Matthew Ennis/ Shutterstock.com

Multiple sclerosis is a disorder of the immune system, where the myelin coating the nerve cells is damaged by antibodies formed by the defence system of the body. This affects the functioning of the central nervous system, comprising the brain and the spinal cord. The two main types of multiple sclerosis or MS are relapsing-remitting multiple sclerosis and primary progressive multiple sclerosis.

Individuals suffering from MS may present with a wide range of symptoms. These may be divided into two categories, namely, physical symptoms and mental symptoms. Among the physical symptoms are a difficulty in walking because of loss of coordination of the limbs, problems with urgency of urination, a feeling of tingling or numbness, as well as a slew of vision problems.

The mental symptoms can include a loss of memory, a problem with learning new things, trouble with thinking and planning the day’s activities, inability to multitask, trouble with concentrating and focusing on issues. More severe symptoms may include an inability to recognise common objects around the house or being unable to judge distances between objects accurately. The individual may find it difficult to manage simple cognitive activities.

Modifying the course of multiple sclerosis

The three-pronged approach to managing MS includes:

1. Managing the symptoms: The idea is to keep the individual as comfortable as possible during the relapses. Relieving pain and achieving comfort is the main goal. Controlling inflammation and encouraging the patient to keep a positive attitude are vital to help deal with the relapses with dignity.

2. Rehabilitation of the individual: Here the endeavour is to keep the patient as productive as possible by ensuring mobility and independence. It’s about teaching the individual that they can still lead a fruitful life with MS.

3. Adopting a healthy lifestyle: By changing the lifestyle of an individual, it is possible to remove a number of triggers that could potentially lead to a relapse. Change is never easy, but making these healthy changes may help slow down the progress of MS.

What is the course of treatment for relapsing-remitting multiple sclerosis?

The earlier the condition is diagnosed, the faster some potentially effective treatments may be applied. MS is treated differently in most cases as symptoms are different from person to person. The following are the generally accepted treatments

Medication for symptoms experienced: Since there is no outright cure, a range of medications may be used to reduce the inflammation of the nerves and try to slow down the progress of the disease. These medicines include beta-interferon, glatiramer acetate, monoclonal antibodies, dimethyl fumarate, and fingolimod.

Additional medication may be required for symptoms such as muscle spasm, depression, fatigue, bladder inconsistency, and erectile dysfunction. Medications should always be prescribed by the attending doctor according to the symptoms experienced by the individual patient. Self-medication using the drugs prescribed during the last relapse should be strictly avoided.

Disease-modifying therapies: These are used to treat relapsing-remitting multiple sclerosis in order to reduce the number of relapses, and to slow down the rate of progression of disability. While they cannot achieve a permanent cure, they can reduce the risk of irreversible damage to the central nervous system.

These medicines should be initiated as soon as a formal diagnosis of MS has been made. Some people may suffer from side-effects when they start these medicines. However, since they do inhibit the progress of the illness, it may be worth enduring the side-effects to continue with these drugs.

Enhancing mobility and independence: Since being able to look after oneself is important, individuals with relapsing-remitting multiple sclerosis should be rehabilitated to be able to live independently. They should be able to function at optimal level without having to depend upon a caregiver.

This ability will help their self-confidence and enhance the quality of their lives, despite being afflicted with MS. By allowing them to live their daily lives on their own, appropriate rehabilitation effects a huge change in the mindset of these patients.

Healthy lifestyle changes: None of us are living our lives in the healthiest way possible. Even when an individual is well aware that there is a healthier alternative to an activity, inertia sets in encouraging one to go with the easiest activities rather than the healthier ones. A diagnosis of multiple sclerosis will take away this option.

If the individual wishes to lead a comfortable and productive life, he will need to make serious lifestyle changes. Simple changes include quitting smoking, not consuming alcohol, ensuring daily exercise, eating healthier foods that help keep relapses at bay and of course getting enough sleep and rest each night.

Reviewed by Liji Thomas, MD.