I'm 22, and I have some of the symptoms of MS, and I still didn't do anything in life…. I think I'm doomed to never amount to anything if I get MS now… how long before I'll be mentally disabled???

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Although there is no known cure for multiple sclerosis, several therapies have proven helpful. the primary aims of therapy are returning function after an attack, preventing new attacks, and preventing disability. As with any medical treatment, medications used in the management of MS have several adverse effects. at the same time different alternative treatments are pursued by some patients, despite the paucity of supporting, comparable, replicated scientific study.

Management of acute attacks

During symptomatic attacks administration of high doses of intravenous corticosteroids, such as methylprednisolone,[83][84] is the routine therapy for acute relapses. the aim of this kind of treatment is to end the attack sooner and leave fewer lasting deficits in the patient. although generally effective in the short term for relieving symptoms, corticosteroid treatments do not appear to have a significant impact on long-term recovery.[85] Potential side effects include osteoporosis[86] and impaired memory, the latter being reversible.[87]

Disease modifying treatments
Disease-modifying treatments are expensive and most of these require frequent (up-to-daily) injections. Others require IV infusions at 1-3 month intervals.
Disease-modifying treatments are expensive and most of these require frequent (up-to-daily) injections. Others require IV infusions at 1-3 month intervals.

The earliest clinical presentation of relapsing-remitting MS (RRMS) is the clinically isolated syndrome (CIS). several studies have shown that treatment with interferons during an initial attack can decrease the chance that a patient will develop clinical MS.

As of 2007, six disease-modifying treatments have been approved by regulatory agencies of different countries for relapsing-remitting MS. three are interferons: two formulations of interferon beta-1a (trade names Avonex and Rebif) and one of interferon beta-1b (U.S. trade name Betaseron, in Europe and Japan Betaferon). a fourth medication is glatiramer acetate (Copaxone). the fifth medication, mitoxantrone, is an immunosuppressant also used in cancer chemotherapy, is approved only in the USA and largely for SPMS. Finally, the sixth is natalizumab (marketed as Tysabri). all six medications are modestly effective at decreasing the number of attacks and slowing progression to disability, although they differ in their efficacy rate and studies of their long-term effects are still lacking.[91][92][93][94] Comparisons between immunomodulators (all but mitoxantrone) show that the most effective is natalizumab, both in terms of relapse rate reduction and halting disability progression;[95] it has also been shown to reduce the severity of MS.[96] Mitoxantrone may be the most effective of them all;[97] however, it is generally considered not as a long-term therapy as its use is limited by severe cardiotoxicity.

The interferons and glatiramer acetate are delivered by frequent injections, varying from once-per-day for glatiramer acetate to once-per-week (but intra-muscular) for Avonex. Natalizumab and mitoxantrone are given by IV infusion at monthly intervals.

Treatment of progressive MS is more difficult than relapsing-remitting MS. Mitoxantrone has shown positive effects in patients with a secondary progressive and progressive relapsing courses. it is moderately effective in reducing the progression of the disease and the frequency of relapses in patients in short-term follow-up.[94] On the other hand no treatment has been proven to modify the course of primary progressive MS.[99]

As with any medical treatment, these treatments have several adverse effects. One of the most common is irritation at the injection site for glatiramer acetate and the Interferon treatments. Over time, a visible dent at the injection site due to the local destruction of fat tissue, known as lipoatrophy, may develop. Interferons also produce symptoms similar to influenza;[100] while some patients taking glatiramer experience a post-injection reaction manifested by flushing, chest tightness, heart palpitations, breathlessness, and anxiety, which usually lasts less than thirty minutes.[92] More dangerous are liver damage of interferons and mitoxantrone,[ the immunosuppressive effects and cardiac toxicity of the latter;[105] or the putative link between natalizumab and some cases of progressive multifocal leukoencephalopathy.

Management of the effects of MS

Disease-modifying treatments only reduce the progression rate of the disease but do not stop it. As multiple sclerosis progresses, the symptomatology tends to increase. the disease is associated with a variety of symptoms and functional deficits that result in a range of progressive impairments and handicap. Management of these deficits is therefore very important. both dr