Reviewed by Arefa Cassoobhoy on December 19, 2018
Douglas Stuart, MD, neurologist; Tiffany Curwen, Richard Cordell.
© 2014 WebMD, LLC. All rights reserved.
NARRATOR: With a diagnosis of multiple sclerosis, symptoms and circumstances can be different for each patient, so what should you be aware of?
There are four types of MS, the most common is relapsing-remitting, where a patient has clearly defined random attacks to their neurological function.
Attacks are completely unpredictable, as is the disease. With treatment, the possibility for recovery or remission from an attack is very good.
Dr. Douglas Stuart: MS patients will find that they have lots of symptoms almost everyday, and these symptoms can fluctuate and stay or they can fluctuate and leave.
So we like to tell our patients that there are going to be good days and there are going to bad days with this disease. Not every bad day, means that you’re having a new attack of multiple sclerosis.
So, generally speaking, we only consider something an exacerbation or flare of MS, if it lasts longer than 24 hours and is sustained.
If you talk to your average MS patient, they may have several hours of numbness or weakness that fluctuate with their body temperature or with their level of fatigue or whether they’re stressed.
Tiffany Curwen: MS is a funny disease. You have to battle it from the inside out. You really do, because the physical things that people may or may not be able to see will dissipate if you’re healthy inside.
And I think that’s what’s happened for me. I’ve made every effort to keep myself as strong and rested as possible so that I’m not limping, and I’m not wobbly, and I’m not tired as much.
Richard Cordell: think I felt absolutely useless when I got that diagnosis. Because you just absolutely do not know what it means, what direction you’re going in, how it’s going to affect you, your family, your job, your surroundings.
The key to the relapse and remitting is not to relapse. When you exacerbate the disease, that’s when it causes the damage.
So if you can stay away from that part of it, and many of these drugs are designed to do that, your chances of having a healthy and mobile life are excellent.
Dr. Douglas Stuart: There are different kinds of treatments for MS. There's treatments that you give patients before they have an attack.
These are the disease modifying drugs that you take everyday or several times a weak or once a month to prevent an attack from coming.
These treatments are maintenance therapies and they’re designed to try to make the immune system less autoreactive. On the other hand, there are some treatments that we use only when a patient is having symptoms ...
Whether they be bladder symptoms or pain symptoms or fatigue symptoms, we have a number of different medications that we have in our toolkit
and we pull those out intermittently sometimes to treat the symptom when it comes or to prevent the symptom from coming.
Tiffany Curwen: I think I’ve been able to really ward off a lot of its unfortunate effects by taking my medication daily and consistently like I was supposed to in following my doctor’s directions.
Dr. Douglas Stuart: Everybody can have some sort of treatment for their multiple sclerosis. It is true that certain patients with what we call chronic progressive disease do not have as many treatment options as your typical patient with relapsing remitting disease.
We have lots of good medications for relapsing remitting MS and they’re well-proven in numerous controlled clinical trials.
Richard Cordell: I’ve always had a great relationship with my doctor and when he suggested a change up on drugs or trying something that’s not approved or going into some kind of test group,
I would be right there with my hand up volunteering because I knew something really good could come out of it for me as well as everybody else who has MS.
Dr. Douglas Stuart: Your average patient will treat approximately one exacerbation per year, actually we’re finding that we’re having to treat patients less often because their disease modifying drugs are working so well.
If you’re having more than one relapse per year, it’s probably time to think about a different disease modifying therapy.