What is sclerosis

There may be periods where symptoms are stable, but the overall course is one of worsening over time. Often an individual will describe a change in their abilities when comparing current function to past function but without identifying an episode that led to the worsening. Sometimes, after the onset of secondary progressive MS an individual may experience a relapse. The course would then be considered secondary progressive MS with relapses.

This is referred to as primary progressive MS. People with primary-progressive MS describe a gradual change in mobility; often walking, over time. They often describe heaviness and stiffness in the lower limbs.

People with primary-progressive MS almost never have an exacerbation relapse. If a relapse occurs after a primary progressive course is well established, the pattern is known as Progressive-Relapsing MS. Benign MS is a mild course where an individual will have mild disease after having MS for about 15 years.

There is no good way of predicting which patients will follow this course. Benign MS cannot be predicted at the time of diagnosis or even after a few years with MS. For more information about MS, request an appointment with our doctors.

To request an appointment or refer a patient, please contact the Johns Hopkins Multiple Sclerosis Center at Request an Appointment. A doctor will monitor how well a drug is working, as there may be adverse effects and the same drugs do not suit everyone.

New drug options coming onto the market are proving to be safer and more effective than some existing ones. Adverse effects of immunosuppressant drugs include a higher risk of infections. Some medications may also harm the liver.

If a person notices adverse effects or if their symptoms get worse, they should seek medical advice. Other drugs are useful when a person experiences a worsening of symptoms during a flare. They will not need these drugs all the time. These medications include corticosteroids, which reduce inflammation and suppress the immune system.

They can treat an acute flare-up of symptoms in certain types of MS. Examples include Solu-Medrol methylprednisolone and Deltasone prednisone. Steroids can have adverse effects if a person uses them too often, and they are not likely to provide any long-term benefit.

Behavioral changes: If a person has vision problems, a doctor may recommend they rest their eyes from time to time or limit screen time. A person with MS may need to learn to rest when fatigue sets in and to pace themselves so they can complete activities.

Problems with mobility and balance: Physical therapy and walking devices, such as a cane, may help. The drug dalfampridine Ampyra may also prove useful. Tremor: A person may use assistive devices or attach weights to their limbs to reduce shaking. Medications may also help with tremors.

Fatigue: Getting enough rest and avoiding heat can help. Physical and occupational therapy can help teach people more comfortable ways to do things. Assistive devices, such as a mobility scooter, can help conserve energy. Medication or counseling may help boost energy by improving sleep. Pain: A doctor may prescribe anticonvulsant or antispasmodic drugs or alcohol injections to relieve trigeminal neuralgia , a sharp pain that affects the face.

Pain relief medication, such as gabapentin, may help with body pain. There are also medications to relieve muscle pain and cramping in MS. Bladder and bowel problems: Some medications and dietary changes can help resolve these issues. Depression: A doctor may prescribe a selective serotonin reuptake inhibitor SSRI or other antidepressant drugs. Learn more here about how to manage an exacerbation of MS.

What is a healthful diet for a person with MS? Find out here. Studies have suggested that cannabis may help relieve pain, muscle stiffness, and insomnia.

However, there is not enough evidence to confirm this. People considering this approach should note that there is a difference between using street cannabis and medical cannabis.

Also, not all forms of cannabis are legal in all states. A person should ask their doctor for advice before using cannabis, as some forms can have adverse effects. Smoking cannabis is unlikely to be beneficial, and it may make symptoms worse.

Some people have suggested that biotin may help. Find out more here. Physical therapy: This aims to provide the skills to maintain and restore maximum movement and functional ability. Occupational therapy: The therapeutic use of work, self-care, and play may help maintain mental and physical function. Speech and swallowing therapy: A speech and language therapist will carry out specialized training for those who need it.

Cognitive rehabilitation: This helps people manage specific problems in thinking and perception. Vocational rehabilitation: This helps a person whose life has changed with MS make career plans, learn job skills, and get and keep a job.

Plasma exchange involves withdrawing blood from a person, removing the plasma, replacing it with new plasma, and transfusing it back into the person.

Studies have produced mixed results. Scientists are looking into the use of stem cell therapy to regenerate various body cells and restore function to people who have lost it due to a health condition. Researchers hope that one day, stem cell therapy techniques may be able to reverse the damage done by MS and restore functionality in the nervous system.

MS is challenging to live with but is rarely fatal. Some severe complications such as bladder infections, chest infections, and difficulty swallowing could lead to death. A multiple sclerosis prognosis does not always result in severe paralysis. Two-thirds of people with MS are able to walk. However, many of them will require assistance such as a cane, wheelchair, crutches, or a scooter.

The average life expectancy for a person with MS is 5 to 10 years lower than the average person. MS is a potentially severe health condition that affects the nervous system. Seminars in Neurology. Goldman L, et al. Multiple sclerosis and demyelinating conditions of the central nervous system. In: Goldman-Cecil Medicine. Lotze TE. Pathogenesis, clinical features, and diagnosis of pediatric multiple sclerosis. Kantarci OH, et al. Novel immunomodulatory approaches for the management of multiple sclerosis.

Disease-modifying treatment of relapsing-remitting multiple sclerosis in adults. Olek MJ, et al. Treatment of acute exacerbations of multiple sclerosis in adults. Wingerchuk DM. Multiple sclerosis: Current and emerging disease-modifying therapies and treatment strategies. Mayo Clinic Proceedings. Pizzorno JE, et al. In: Textbook of Natural Medicine. Louis, Mo. Evaluation and diagnosis of multiple sclerosis in adults.

Gaetani L, et al. Journal of Neurology. Pathogenesis and epidemiology of multiple sclerosis. Symptom management of multiple sclerosis in adults. Yadav Y, et al. Summary of evidence-based guideline: Complementary and alternative medicine in multiple sclerosis. Riggin EA. Allscripts EPSi. Mayo Clinic. March 4, National MS Society. Network of Pediatric MS Centers.

Accessed March 5, Rodriguez M. Plasmapheresis in acute episodes of fulminant CNS inflammatory demyelination. Deb C. PLoS One. FDA approves new drug to treat multiple sclerosis. Accessed Feb. Keegan BM expert opinion. Mayo Clinic, Rochester, Minn.