Multiple sclerosis: diagnosis and the management of acute relapses

S M Leary, B Porter, A J Thompson, S M Leary, B Porter, A J Thompson

Abstract

Multiple sclerosis is an inflammatory demyelinating disease of the central nervous system that may result in a wide range of neurological symptoms and accumulating disability. Its course is unpredictable resulting in a changing pattern of clinical need. Diagnostic criteria for multiple sclerosis require objective evidence for dissemination in space and time. The diagnostic and management process should follow good practice guidelines with the person at the centre of the process. Appropriate support and information should be available from the time of diagnosis. Continuing education is key in enabling the person to actively participate in their management. In the event of an acute relapse the person should have direct access to the most appropriate local service. Provided medical causes have been excluded, corticosteroid treatment to hasten the recovery from the relapse should be considered. Management of an acute relapse should be comprehensive addressing any medical, functional, or psychosocial sequelae.

References

    1. N Engl J Med. 1993 Dec 9;329(24):1764-9
    1. J Neurol Neurosurg Psychiatry. 1993 Nov;56(11):1219-20
    1. CMAJ. 1995 May 1;152(9):1423-33
    1. Neurology. 1996 Apr;46(4):907-11
    1. Neurology. 1997 Feb;48(2):312-4
    1. Lancet. 1997 Mar 29;349(9056):902-6
    1. Brain. 1997 Jun;120 ( Pt 6):1085-96
    1. J Neurol Neurosurg Psychiatry. 1998 Apr;64(4):451-4
    1. N Engl J Med. 1998 Jul 30;339(5):285-91
    1. Can J Neurol Sci. 1998 Aug;25(3):222-9
    1. J Neurol Neurosurg Psychiatry. 1998 Sep;65(3):362-5
    1. Neurology. 1999 Mar 10;52(4):839-45
    1. J Neurosci Nurs. 1999 Feb;31(1):17-26
    1. Neurology. 1999 Jun 10;52(9):1737-45
    1. Arch Neurol. 1999 Sep;56(9):1138-42
    1. Brain. 1999 Oct;122 ( Pt 10):1941-50
    1. Ann N Y Acad Sci. 1965 Mar 31;122:552-68
    1. Ann Neurol. 1999 Dec;46(6):878-86
    1. Ann Neurol. 2000 Jun;47(6):831-5
    1. Neurology. 2000 Jul 12;55(1):55-61
    1. N Engl J Med. 2001 Feb 1;344(5):319-26
    1. J Neuroimmunol. 2001 Jul 2;117(1-2):1-8
    1. Ann Neurol. 2001 Jul;50(1):121-7
    1. Brain. 2002 May;125(Pt 5):952-60
    1. CNS Drugs. 2002;16(8):563-78
    1. Neurology. 2002 Dec 24;59(12):1837-43
    1. Postgrad Med J. 2003 Jan;79(927):11-7
    1. Ann Behav Med. 2003 Aug;26(1):1-7
    1. Semin Neurol. 2003 Jun;23(2):133-46
    1. J Neurol Neurosurg Psychiatry. 2003 Sep;74(9):1225-30
    1. BMJ. 2003 Sep 20;327(7416):646
    1. Mult Scler. 2003 Oct;9(5):431-9
    1. J Neurol. 2003 Oct;250(10):1214-8
    1. Neurology. 2003 Dec 9;61(11):1528-32
    1. BMJ. 2004 Mar 27;328(7442):731
    1. Ann Neurol. 2004 Aug;56(2):303-6
    1. Br Med J. 1971 Sep 25;3(5777):725-9
    1. J Neurol Neurosurg Psychiatry. 1982 Feb;45(2):179-80
    1. Ann Neurol. 1983 Mar;13(3):227-31
    1. J Neurol Neurosurg Psychiatry. 1985 Feb;48(2):157-9
    1. Lancet. 1985 Jun 8;1(8441):1313-5
    1. Lancet. 1985 Jul 6;2(8445):27-8
    1. Q J Med. 1986 Jan;58(225):69-80
    1. J Neurol Neurosurg Psychiatry. 1987 May;50(5):511-6
    1. J Neurol Neurosurg Psychiatry. 1988 Feb;51(2):285-7
    1. Brain. 1989 Feb;112 ( Pt 1):133-46
    1. Neurology. 1989 Jul;39(7):969-71
    1. Brain. 1990 Apr;113 ( Pt 2):291-302
    1. Neurology. 1992 May;42(5):991-4
    1. Brain. 1993 Feb;116 ( Pt 1):117-34
    1. Can J Neurol Sci. 1993 Feb;20(1):17-29
    1. J Neurol. 1993 Jul;240(7):417-22
    1. Arch Ophthalmol. 1995 Feb;113(2):136-7

Source: PubMed

Sponsor e collaboratori

Condizioni mediche

Interventi farmacologici

3
Sottoscrivi