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Early Treatment for Multiple Sclerosis

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WebMD Feature

Michael Williamson was 16 years old when he noticed a few odd cramps one day at a cross-country track meet. His coach told him to run them out. A day or so later, he woke up paralyzed from the waist down.

After a lot of testing and poking and prodding, Williamson was told he had something called transverse myelitis. "I saw a lot of specialists, but no one mentioned MS," says Williamson, now 27 and the owner of an adventure travel company in Colorado.

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Push for Earlier Treatment

If Williamson had his first symptoms today, he would likely start a disease-modifying drug right away. Doctors tend to diagnose MS more quickly than before.

Each time you have symptoms, it’s called a flare-up, relapse, or attack. Doctors used to wait for a second bout to be sure you have MS. Since 2010, though, doctors may diagnose MS after the first flare if both of these are true:

  • Symptoms of MS last for at least 24 hours. They could be as dramatic as Williamson’s paralysis, or more subtle, like an arm or leg with numbness that doesn't go away when you shake it out. A sudden blind spot or blurry vision in one eye can be a symptom, too. (Within 1 to 2 weeks, vision often returns to normal.)
  • An MRI shows changes in the brain. In MS, your system goes awry and attacks the tough sheath around the nerves of your brain and spine, called myelin. An MRI scan can show early damage here.

That means you and your doctor can start fighting MS sooner than in the past.

Hopes and Benefits of Prompt Treatment

Researchers aren’t sure yet whether MS drugs will change the ups and downs of the illness over the long run. Most people do not become severely disabled. In a smaller group who may face a disability, could early use of drugs keep someone out of a wheelchair 10 years from now?

"That's still uncertain," says Mark Keegan, MD, a Mayo Clinic neurologist. "There are some ongoing studies that might tell us more, but it's a hard question to answer."

However, research does suggest two benefits from prompt treatment:

  • Taking medicine soon after your first symptoms cuts down on how many times those symptoms come back.
  • People who take MS medicines early are less likely to have a disability -- at least over the short term -- compared with people who don't take MS meds. That means that within 6 months to 2 years after diagnosis, people who started medicine early were less disabled than those who began medicine later.

What if you've already had MS symptoms for a while? Maybe it took some time to get a diagnosis. Your doctor is likely to suggest that you start taking a disease-modifying drug. Even if you don't start the medicine at your earliest symptoms, you may still have fewer relapses.

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