Multiple sclerosis: diagnosis and the management of acute relapses

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.

[1]  John Noseworthy,et al.  Clinical implications of benign multiple sclerosis: A 20‐year population‐based follow‐up study , 2004, Annals of neurology.

[2]  D. Mohr,et al.  Association between stressful life events and exacerbation in multiple sclerosis: a meta-analysis , 2004, BMJ : British Medical Journal.

[3]  F. Lublin,et al.  Effect of relapses on development of residual deficit in multiple sclerosis , 2003, Neurology.

[4]  A. Thompson,et al.  Diagnosis of MS: a comparison of three different clinical settings , 2003, Multiple sclerosis.

[5]  Alan J. Thompson,et al.  Does neurorehabilitation have a role in relapsing-remitting multiple sclerosis? , 2003, Journal of Neurology.

[6]  W. Hop,et al.  Self reported stressful life events and exacerbations in multiple sclerosis:prospective study , 2003, BMJ : British Medical Journal.

[7]  G. Baker,et al.  A randomised controlled trial comparing rehabilitation against standard therapy in multiple sclerosis patients receiving intravenous steroid treatment , 2003, Journal of neurology, neurosurgery, and psychiatry.

[8]  K. Lorig,et al.  Self-management education: History, definition, outcomes, and mechanisms , 2003, Annals of behavioral medicine : a publication of the Society of Behavioral Medicine.

[9]  H. Hartung,et al.  Current disease-modifying therapies in multiple sclerosis. , 2003, Seminars in neurology.

[10]  D. Matchar,et al.  Immunization and MS: A summary of published evidence and recommendations , 2002, Neurology.

[11]  W. Hop,et al.  Prospective study on the relationship between infections and multiple sclerosis exacerbations. , 2002, Brain : a journal of neurology.

[12]  A J Thompson,et al.  SYMPTOMATIC MANAGEMENT AND REHABILITATION IN MULTIPLE SCLEROSIS , 2001, Journal of neurology, neurosurgery, and psychiatry.

[13]  R. Gold,et al.  Mechanism of action of glucocorticosteroid hormones: possible implications for therapy of neuroimmunological disorders , 2001, Journal of Neuroimmunology.

[14]  A. Compston,et al.  Recommended diagnostic criteria for multiple sclerosis: Guidelines from the international panel on the diagnosis of multiple sclerosis , 2001, Annals of neurology.

[15]  S Suissa,et al.  Vaccinations and the risk of relapse in multiple sclerosis. Vaccines in Multiple Sclerosis Study Group. , 2001, The New England journal of medicine.

[16]  G. Ebers The natural history of multiple sclerosis , 2000, Neurological Sciences.

[17]  D. Goodkin,et al.  Psychological stress and the subsequent appearance of new brain MRI lesions in MS , 2000, Neurology.

[18]  S. Bernasconi,et al.  Long-Term Results with Growth Hormone Therapy in Idiopathic Hypopituitarism , 2000, Hormone Research in Paediatrics.

[19]  A J Thompson,et al.  Diagnostic criteria for primary progressive multiple sclerosis: A position paper , 2000, Annals of neurology.

[20]  B. Weinshenker,et al.  A randomized trial of plasma exchange in acute central nervous system inflammatory demyelinating disease , 1999, Annals of neurology.

[21]  J. Baskerville,et al.  The natural history of multiple sclerosis: a geographically based study. 7. Progressive-relapsing and relapsing-progressive multiple sclerosis: a re-evaluation. , 1999, Brain : a journal of neurology.

[22]  E. Waubant,et al.  Multiple sclerosis that is progressive from the time of onset: clinical characteristics and progression of disability. , 1999, Archives of neurology.

[23]  D. Goodin,et al.  The relationship of MS to physical trauma and psychological stress , 1999, Neurology.

[24]  J. Baskerville,et al.  The natural history of multiple sclerosis: a geographically based study. 5. The clinical features and natural history of primary progressive multiple sclerosis. , 1999, Brain : a journal of neurology.

[25]  F. Barkhof,et al.  Primary and transitional progressive MS , 1999, Neurology.

[26]  W. Koopman,et al.  The journey to multiple sclerosis: a qualitative study. , 1999, The Journal of neuroscience nursing : journal of the American Association of Neuroscience Nurses.

[27]  M. Hutchinson,et al.  Rate of pregnancy-related relapse in multiple sclerosis. Pregnancy in Multiple Sclerosis Group. , 1999, The New England journal of medicine.

[28]  D. Luscombe,et al.  Use of corticosteroids in multiple sclerosis by consultant neurologists in the United Kingdom , 1998, Journal of neurology, neurosurgery, and psychiatry.

[29]  P. Coyte,et al.  Cost Analysis of Methylprednisolone Treatment of Multiple Sclerosis Patients , 1998, Canadian Journal of Neurological Sciences / Journal Canadien des Sciences Neurologiques.

[30]  M. Hutchinson,et al.  Rate of Pregnancy-Related Relapse in Multiple Sclerosis , 1998 .

[31]  G. McDonnell,et al.  Clinical study of primary progressive multiple sclerosis in Northern Ireland, UK , 1998, Journal of neurology, neurosurgery, and psychiatry.

[32]  S. Farmer,et al.  Randomised trial of oral and intravenous methylprednisolone in acute relapses of multiple sclerosis , 1997, The Lancet.

[33]  R. Knobler,et al.  A multicenter, randomized, double-blind, placebo-controlled trial of influenza immunization in multiple sclerosis , 1997, Neurology.

[34]  S. Reingold,et al.  Defining the clinical course of multiple sclerosis , 1996, Neurology.

[35]  R. Beck The optic neuritis treatment trial: three-year follow-up results. , 1996, Archives of ophthalmology.

[36]  M. Stewart Effective physician-patient communication and health outcomes: a review. , 1995, CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne.

[37]  R. Beck The Optic Neuritis Treatment Trial: Three-Year Follow-up Results , 1995 .

[38]  R. Beck,et al.  The effect of corticosteroids for acute optic neuritis on the subsequent development of multiple sclerosis. The Optic Neuritis Study Group. , 1993, The New England journal of medicine.

[39]  M. Lawden,et al.  Methylprednisolone in multiple sclerosis: a comparison of oral with intravenous therapy at equivalent high dose. , 1993, Journal of neurology, neurosurgery, and psychiatry.

[40]  T. Bergström,et al.  Viral infections trigger multiple sclerosis relapses: a prospective seroepidemiological study , 1993, Journal of Neurology.

[41]  A. Sadovnick,et al.  Epidemiology of Multiple Sclerosis: A Critical Overview , 1993, Canadian Journal of Neurological Sciences / Journal Canadien des Sciences Neurologiques.

[42]  O. Andersen,et al.  Prognostic factors in a multiple sclerosis incidence cohort with twenty-five years of follow-up. , 1993, Brain : a journal of neurology.

[43]  D. Paty,et al.  Life expectancy in patients attending multiple sclerosis clinics , 1992, Neurology.

[44]  I. Moseley,et al.  Acute disseminated encephalomyelitis , 2016, Neurology.

[45]  C. Kennard,et al.  Relative efficacy of intravenous methylprednisolone and ACTH in the treatment of acute relapse in MS , 1989, Neurology.

[46]  B Bass,et al.  The natural history of multiple sclerosis: a geographically based study. I. Clinical course and disability. , 1989, Brain : a journal of neurology.

[47]  P. Newman,et al.  Methylprednisolone therapy in multiple sclerosis: a profile of adverse effects. , 1988, Journal of neurology, neurosurgery, and psychiatry.

[48]  R. Newcombe,et al.  A double-blind controlled trial of high dose methylprednisolone in patients with multiple sclerosis: 1. Clinical effects. , 1987, Journal of neurology, neurosurgery, and psychiatry.

[49]  A. Alpérovitch,et al.  CLINICAL VIRAL INFECTIONS AND MULTIPLE SCLEROSIS , 1985, The Lancet.

[50]  G. Dean,et al.  TO TELL OR NOT TO TELL THE DIAGNOSIS OF MULTIPLE SCLEROSIS , 1985, The Lancet.

[51]  D. Dick,et al.  Intravenous methylprednisolone for multiple sclerosis in relapse. , 1985, Journal of neurology, neurosurgery, and psychiatry.

[52]  D. Silberberg,et al.  New diagnostic criteria for multiple sclerosis: Guidelines for research protocols , 1983, Annals of neurology.

[53]  C. Kennard,et al.  Treatment of acute exacerbations of multiple sclerosis with intravenous methyl-prednisolone. , 1982, Journal of neurology, neurosurgery, and psychiatry.

[54]  J. Kurtzke,et al.  On the Risk of Multiple Sclerosis According to Age at Immigration to South Africa* , 1971, British medical journal.

[55]  F. Mcdowell,et al.  PROBLEMS OF EXPERIMENTAL TRIALS OF THERAPY IN MULTIPLE SCLEROSIS: REPORT BY THE PANEL ON THE EVALUATION OF EXPERIMENTAL TRIALS OF THERAPY IN MULTIPLE SCLEROSIS , 1965, Annals of the New York Academy of Sciences.

[56]  Alastair Compston,et al.  McAlpine's Multiple Sclerosis , 2005 .

[57]  Alan J. Thompson,et al.  Developing a measure of patients' experiences of relapse management in multiple sclerosis. , 2003 .

[58]  O. Khan,et al.  Comparative Assessment of Immunomodulating Therapies for Relapsing-Remitting Multiple Sclerosis , 2002, CNS drugs.

[59]  M. Filippi,et al.  Primary Progressive Multiple Sclerosis , 2002, Topics in Neuroscience.

[60]  Specialist nursing in MS - the way forward: key elements for developing MS specialist nurse services in the UK. , 2001, Nursing management.

[61]  C. Poser The relationship of MS to physical trauma and psychological stress: report of the Therapeutics and Technology Assessment Subcommittee of the American Academy of Neurology. , 2000, Neurology.

[62]  A. Thompson,et al.  A clinical and laboratory study of benign multiple sclerosis. , 1986, The Quarterly journal of medicine.