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Multiple Sclerosis Treatment Guidelines

The National Institute for Health and Clinical Excellence (NICE) provides multiple sclerosis treatment guidelines.  According to NICE, multiple sclerosis (MS) is a disease of the central nervous system, which consists of the brain and the spinal cord.  It occurs when white matter within the brain or spinal cord becomes inflamed and then destroyed by the person’s own immune system.  Eventually these areas become scarred, which gives the disease its name: multiple (areas of the brain or spinal cord) sclerosis (hardening).

There are three different patterns of multiple sclerosis, which include:

Relapsing/remitting MS – In this patter periods of good health are followed by the sudden onset of symptoms or relapses.

Secondary progression of MS – Symptoms gradually worsen with fewer remissions (about 50% of people with relapsing/remitting MS develop secondary progressive MS within 10 years of having the disease).

Primary progressive MS – Symptoms gradually worsen over time, only about 10-15% of people with MS have this form at onset.

According to NICE’s multiple sclerosis treatment guidelines, any individual who is suspected of having MS should be referred to a neurologist and seen in a short amount of time.  The individual should then be seen and examined in order to confirm or refute the diagnosis.  The service should give the impressionof being seamless from the individual’s perspective, with every health organization sharing and transferring the information about people with MS.

 

Upon the Diagnosis of MS

 

NICE’s multiple sclerosis treatment guidelines state that a physician should systematically rule out any other possible problems which could be contributing to the patient’s fatigue, cognitive impairment, impaired sexual function, and/or reduced bladder control.  After a thorough assessment and diagnosis, multiple sclerosis should be treated in the following manner, according to NICE’s multiple sclerosis guidelines:

  • Any person who experiences an acute episode should be offered high-dose corticosteroids such as 500 mg- 1g of intravenous methylprednisolone for 3-5 days or a dosage of 500 mg – 2 g of oral methylprednisolone for 3-5 days.
  • Prior to administering these dosages, a person with MS should have the risks and benefits of taking corticosteroids explained to them.
  • An individual should be given support and referred to a specialist neurological rehabilitation service.
  • People with MS should be advised that taking 17-23 grams of linoleic acid a day may reduce the progression of MS.  Linoleic acid can be found in sunflower, corn, soya, and safflower oils.
  • People with MS should be offered an immunization against influenza and are able to have any other immunizations that they need since there is no known cause of immunizations leading to relapses in MS.