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Multiple Sclerosis

Patient Education

Learn more about conditions which affect the brain and nervous system.

Conditions Treated

We want to help you keep living the life you want.  We partner with you on this journey with our specialists, who focus on inflammatory and autoimmune conditions affecting the brain and nervous system. These include:

Multiple Sclerosis (MS)

The cause of MS is unknown and MS is different for each person.  Although there is no cure yet, there are disease modifying therapies (DMTs) that can help. DMTs are treatments to delay, change, or interrupt the natural course of the disease. For MS, this means taking medicine over a long period of time to reduce the number of attacks and how bad they are. It is also important to follow a healthy lifestyle.

Research

ChristianaCare MS Comprehensive Center of Excellence is committed to better understanding multiple sclerosis. This includes causes, triggers, and related disorders. We are involved in clinical trials that will improve quality of life for those living with these disorders.  Currently, we have 3 types of trials:

  • Studies evaluating best treatment approaches 
  • Studies evaluating the safety of existing therapies
  • Trials evaluating new MS treatments
Diagnosis

There are nearly 1 million people with MS in living in the United States and it can appear at any age. It’s one of the most common health problems affecting the brain and nervous system.  

Confirming an MS diagnosis involves a review of medical problems, imaging studies, and laboratory testing. Other health problems that can also look like MS must be excluded. Laboratory, imaging, and studies that may be done to help diagnose and manage MS include:

  • Blood tests
  • Lumbar puncture (spinal tap)
  • MRI of the brain and spinal cord
  • Optical coherence tomography (OCT)
  • Visual field testing
  • Electrical conduction studies
  • Other studies as needed
Treatment

ChristianaCare MS Comprehensive Center of Excellence includes highly trained clinicians who are experts in the care of MS.  Different treatments are available to delay, change, or interrupt the natural course of the disease.  Using a team approach, we guide patients through different treatment options during all stages of life. Our team teaches patients and their families about medicines and how to best manage symptoms.

There is no known cure for Multiple Sclerosis.  However, there are treatments that may limit new disease activity that may help, control, or prevent symptoms of MS.  Different types of medicines can be used as a part of the treatment plan and to help manage your symptoms.  We also offer rehabilitation services to improve the overall well-being for people living with MS.

Disease Modifying Treatments (DMTs)

The goal of Injectable or infused therapy treatment for MS is to limit new injury by preventing relapses and slowing the process that worsens disability. Commonly used DMTs for MS include:

  • Injectable medicines
  • Medicines taken by mouth
  • Infused medications such as monoclonal antibodies
Treatment for Acute Relapses

A new and sudden attack can be called an acute relapse. The goal in treating an acute relapse is to promote faster recovery. While treatments for acute relapses can help the patient recover faster, they may not make as much a difference in the overall recovery. Therefore, not all MS relapses are treated right away.

Steroid medicines are commonly used during new attacks. Sometimes, infusions such as plasmapheresis or IV immunogloblulins (IVIG) are also used.

Symptomatic Treatments

The goal of symptomatic treatments for MS is to stop or control symptoms. Treatments include:

  • Bowel management.
  • Medicines for walking.
  • Botox injections for muscle spasticity.
  • Medicines that relieve muscle spasms, urinary problems, sexual dysfunction, fatigue, or depression.
Rehabilitation

An important part of treatment is rehabilitation that improves a person's ability to do their normal daily activities. This type of care includes:  

  • Exercise Programs.
  • Energy Management.
  • Nutrition Programs.
  • Physical Therapy.
  • Speech Therapy.
  • Occupational Therapy.

Brain & Nervous System Conditions

Neuromyelitis Optica (NMO) Spectrum Disorder

Neuromyelitis optica spectrum disorder is a group of central nervous system (CNS) diseases. Similar to multiple sclerosis (MS), NMO is an inflammatory disorder of the brain and nervous system. NMO affects more women than men and it can occur at any age.  However, if often begins in the 30s or 40s. NMO is considered rarer than MS.

NMO relapses are more severe than MS relapses and people could experience disability if relapses occur.  The purpose of treatment for NMO is to prevent further relapses and disability.

NMO Spectrum Disorder Symptoms

Symptoms of NMO include vision problems and eye pain. One of the criteria for a diagnosis of NMO spectrum disorder is transverse myelitis.  

Transverse myelitis is a spinal condition that causes:

  • Weakness in one or more limbs
  • Numbness and tingling
  • Bladder and/or bowel problems
  • Pain
NMO Spectrum Disorder Treatment

At ChristianaCare, the main goals of NMO therapy are to prevent future relapses and help you feel as well as possible. Therapy options for NMO are different from MS. Some MS therapy may actually make NMO worse. There are currently 3 medications that are FDA approved to treat NMO spectrum disorder. Currently, there are three FDA- approved medications for those with the aquaporin-4 antibody.

  • Soliris (Eculizumab), an intravenous infusion that is approved for those with the aquaporin-4 antibody.
  • Uplinza (Inebilzumab), an intravenous infusion that is approved for those with the aquaporin-4 antibody.
  • Enspryng (Satralizumab), an injection you give yourself that is approved for those with the aquaporin-4 antibody.

These immune therapies have shown in clinical trials to dramatically lower the likelihood of an NMO relapse. ChristianaCare team specialists will help patients throughout the process and explain all available options.


Myelin Oligodendrocyte Glycoprotein (MOG)-Antibody Associated Disease

Myelin Oligodendrocyte Glycoprotein Antibody Disease (MOGAD) is an inflammatory disease of the brain and nervous system, though it is different from MS.  It is very common in pediatrics but can occur in adults.

Unlike other neuroinflammatory disorders. MOG disorders affect men and women almost equally but are more common in children than adults. Compared to similar disorders, MOG disorders can be less aggressive and may come back, or you could only experience one MOG episode. These types of relapses could have long-term effects on the central nervous system (CNS), including walking and vision challenges.

MOG Antibody Associated Disease Symptoms

MOG could manifest is through a condition called acute disseminated encephalomyelitis (ADEM). It affects children under 10, ADEM is more common in pediatrics than adults. In many cases, ADEM could occur just one time, but it can occur more than once. ADEM can cause:

  • Seizures
  • Headache
  • Behavioral changes and confusion
  • Changes in alertness or consciousness
  • Visual changes, numbness and weakness
Diagnosis of MOG Antibody Associated Disease

MOG disorders are diagnosed with a blood test, a review of symptoms, and MRI features. Spinal Fluid Tap could also be required at times. It is very important to correctly diagnose a MOG antibody disorder.

MOG Antibody Associated Disease Treatment

Not all patients need ongoing treatment, as many will only have one episode. Treatment often includes medications that change the immune system to prevent further relapses.

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