In the past, only symptomatic treatment at the time of acute neurological exacerbation was available. There are now additional forms of therapy aimed at modulating or changing the response of the immune system to better control the disease. Some of these treatments have been studied in clinical trials, while others are used when other options have failed or are inappropriate but may not have been studied in an organized trial. Each patient requires a careful evaluation and a determination as to what subtype of MS he or she most likely has. This form of treatment is given at the onset of new symptoms, with hope of shortening the course of the exacerbation.
Corticosteroids are usually the treatment of choice.
It is usually given daily, intravenously for 3 to 5 days for a total dose of approximately 3 grams. It is usually tolerated well, although some patients may complain of insomnia or change in mood. Some patients may notice a change even after one dose. It is often given with a tapering dose of the oral steroid prednisone to follow. Some patients may be hospitalized during the treatment, while others can remain home with nursing services.