Acute Attack Case Study Essay

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o General measure : patients education about disease, counselling
• Acute attack : give IV methylprednisolone, if poor response to corticosteroid consider plasma exchange
• Disease modifying theraphy: o Goals : to reduce relapse rate, decrease progression of disability, slow accumulation of MRI lesions o First line : interferon B, glatiramer acetate o Second line : natalizumab o New oral agent : fingolimod and cladbirine

• Symptomatic treatment o Spasticity : baclofen, tizanidine, dantrolene, benzodiazepine, botulinum toxin o Bladder dysfunction : oxybutynin o Pain : carbamezepine, gabapentin o Fatigue : amantidine, modafinil, methylphenidate o Depression : alprazolam, lithium o Constipation : fiber, stool softener, laxatives

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