Multiple Sclerosis Treatment and Management

Corticosteroids

When a significant flare-up occurs that interferes with daily function (e.g., loss of vision or inability to walk), high-dose steroids are the first line of defense.

• Administration: Usually given intravenously (IV methylprednisolone) for 3 to 5 days, sometimes followed by an oral taper.
• Mechanism: They powerfully reduce inflammation and close the blood-brain barrier, shortening the duration of the relapse.
• Limitations: They do not repair existing damage or alter the long-term progression of the disease; they only accelerate recovery from the current attack.

Plasmapheresis (Plasma Exchange)

For severe relapses that do not respond to steroids, plasma exchange is an option.

• Process: Blood is removed from the body, the plasma (containing the attacking antibodies) is separated and discarded, and the blood cells are returned with replacement fluid.
• Indication: Used as a rescue therapy for sudden, severe attacks.