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Title: Multiple sclerosis- diagnosis, management and prognosis.
Austin Authors: Tsang, Benjamin K-T;Macdonell, Richard A L 
Affiliation: Department of Neurology, Austin Hospital, Melbourne, Victoria, Australia
Issue Date: 1-Dec-2011
Publication information: Australian Family Physician; 40(12): 948-55
Abstract: Multiple sclerosis is the most common chronic disabling disease of the central nervous system in young adults.This article summarises the diagnosis, management and prognosis of multiple sclerosis.Multiple sclerosis usually starts with an acute episode of neurological disturbance, termed a 'clinically isolated syndrome', followed by an illness phase punctuated by relapses and remissions which may transition after 10 years to a phase of progressive accumulation of disability without relapses. Fifteen to 20% of patients will have a progressive course from the onset. There is significant interpatient variability in prognosis. The main diagnostic criteria are clinical, supported by investigations including magnetic resonance imaging and lumbar puncture and evoked potentials. First line disease modifying agents for relapsing remitting multiple sclerosis include interferon-ß and glatiramer. First line treatment for relapses is usually intravenous methylprednisolone for 3 days. Troublesome symptoms may include spasticity, parasthesias, tremor, erectile dysfunction, depression and anxiety, fatigue and pain. After excluding differential diagnoses, symptomatic management includes pharmacological agents, allied health consultation and continence strategies. Although pregnancy reduces disease activity, there is a higher risk of relapse in the postpartum period.
Gov't Doc #: 22146321
Journal: Australian Family Physician
Type: Journal Article
Subjects: Adjuvants, Immunologic.administration & dosage
Antineoplastic Agents.administration & dosage
Diagnosis, Differential
Disease Progression
Family Practice.statistics & numerical data
Health Status
Immunoglobulins, Intravenous.administration & dosage
Immunologic Factors.administration & dosage
Interferon-beta.administration & dosage
Middle Aged
Mitoxantrone.administration & dosage
Multiple Sclerosis.diagnosis.drug therapy.epidemiology
Physician's Practice Patterns.statistics & numerical data
Young Adult
Appears in Collections:Journal articles

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