Medical and PT Management in MS

Question 1

What are the goals of pharmacological treatment of MS?

Answer 1

Minimizing inflammatory response associated w/ an acute exacerbation of MS

Disease modification: slowing down the progression to move toward a state of remission

Management of symptoms

Reduction of motor symptoms

Question 2

How is pharmacological treatment used to treat MS?

Answer 2

Acute exacerbations
Chronic conditions
Depression
Fatigue
Gait limitations
Spasticity
Sexual and Urinary dysfunction

Question 3

How is acute exacerbations of MS medically managed?

Answer 3

Methylprednisolone therapy via Solu-medrol

Question 4

What are the side effects of Methylprednisolone therapy?

Answer 4

Fluid retention, immunosuppression, and mood swings

Question 5

What is the protocol for Methylprednisolone therapy in days 3-5?

Answer 5

High dose via IV

Question 6

What is the protocol for Methylprednisolone therapy in days 10 to 6 weeks?

Answer 6

Tapered orally

Question 7

How is chronic conditions of MS medically managed?

Answer 7

Via disease-modifying agents

Question 8

What is the mechanism behind disease modifying agents?

Answer 8

Decreases the immune response

Question 9

What are the effects of disease-modifying agents

Answer 9

Decreases about 30% of relapses
Decreases severity
Slows progression

Question 10

What are the limitations of disease-modifying agents?

Answer 10

Cannot reverse existing damage or impairments

Question 11

What are reasons for depression in those with MS?

Answer 11

Psychosocial effects of MS disability
Direct effects of lesions on brain structure involved in regulating mood state
Side effect of mood change from the first=line medical treatment (interferon)
Immune dysfunction