Multiple sclerosis: management

Anthony T Reder MD (

Dr. Reder of the University of Chicago served on advisory boards and as a consultant for Bayer, Biogen Idec, Caremark Rx, Genentech, Genzyme, Novartis, Mallinckrodt, Mylan, Serono, and Teva-Marion.

Originally released October 23, 2014; last updated January 29, 2019; expires January 29, 2022


Multiple sclerosis affects every part of the neuraxis and has replaced syphilis as the great mimicker in neurology. In this article, author discusses treatment of multiple sclerosis symptoms and the underlying disease as well as successes and failures in therapeutic trials and critical issues regarding multiple sclerosis therapy. This revision includes new comments on environment and vitamin D and the immunology, benefits, and dangers of treatments.

Key points


• Multiple sclerosis symptoms arise from lesions in all parts of the CNS; most symptoms can be treated.


• New therapies have dramatically changed the course of multiple sclerosis and survival. There are fewer exacerbations and hospitalizations and less progression of the disease compared to the 1993 pre-therapy era.


• The best therapy and best compliance to therapy is based on a decision by doctor and patient that incorporate disease characteristics, dangers from other medical conditions, patient s preference for form of administration, and life style. Delay and switch of therapy by insurance companies and other decision makers who are not familiar with the patient or with the disease often lead to permanent brain damage.


• On average, all therapies are still only partially effective.


• There is intense research to find the cause and cure of multiple sclerosis.

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