Multiple Sclerosis: A Guide to Treatment and Management

by Polman, Chris H.; Thompson, Alan J.; Murray, T. Jock; McDonald, W. Ian

• ISBN13: 9781888799545
• ISBN10: 1888799544
• Edition: 5th
• Format: Paperback
• Copyright: 2001-06-10
• Publisher: Demos Health

Summary

Free Univ., Amsterdam. Offers a detailed discussion of various therapies currently used for multiple sclerosis, with opinions on their efficacy from the Medical Management Committee of the International Federation of Multiple Sclerosis Societies. Previous edition titled Therapeutic Claims in Multiple Sclerosis, c1996. Softcover.

Author Biography

Chris H. Polman, MD, PhD: Professor of Neurology, Free University Medical Centre, Amsterdam Alan J. Thompson, MD, FRCP, FRCPI: Garfield Weston Professor of Clinical Neurology and Neurorehabilitation, Institute of Neurology, Queen Square, University College, London T. Jock Murray, OC, MD, FRCPC, MACP, FRCP: Professor of Medicine (Neurology) Professor of Medical Humanities, Dalhousie University, Halifax, Nova Scotia W. Ian McDonald, MB, PhD, FRCP, FMedSci: Professor of Clinical Neurology (Emeritus) Institute of Neurology, Queen Square, London

Table of Contents

Introduction	1	(6)
Evidence of Effectiveness and the Selection of Treatment	3	(4)
Treatment for an Acute Exacerbation	7	(8)
Overview	7	(2)
Specific Agents	9	(6)
Intravenous Methylprednisolone	9	(1)
Intravenous Dexamethasone	10	(1)
Intramuscular Adrenocorticotropic Hormone	10	(1)
Oral Steroids	10	(2)
Intrathecal Steroids	12	(1)
Aspirin and Nonsteroidal Antiinflammatory Drugs	12	(1)
Plasmapheresis	12	(3)
Treatments That Affect the Long-Term Course of the Disease (``Disease-Modifying Therapy'')	15	(28)
From Better Understanding to Better Treatment	16	(3)
Drugs Approved for Use in MS	19	(7)
Interferon Beta	19	(6)
Glatiramer Acetate	25	(1)
Treatments That Are Not Specifically Approved for MS But Are Being Used in Certain Parts of the World	26	(8)
Intravenous Immunoglobulin	26	(2)
Azathioprine	28	(1)
Cyclophosphamide	28	(1)
Cyclosporin-A	29	(1)
Methotrexate	29	(1)
Cladribine	30	(1)
Mitoxantrone	30	(1)
Sulfasalazine	31	(1)
Interferon Alpha	32	(1)
Corticosteroids	32	(1)
Interferon Gamma	33	(1)
Plasmapheresis	33	(1)
Total Lymphoid Irradiation	33	(1)
Acyclovir and Other Antiviral Agents	33	(1)
Bone Marrow Transplantation and Hemopoietic Stem Cell Transplantation	34	(1)
Treatments Under Development	34	(9)
Monoclonal Antibodies to Lymphocytes	35	(1)
Agents That Interfere with Cytokine Production/Activity	36	(1)
Other Cytokines	36	(1)
Agents That Induce Specific Immunosuppression	37	(1)
Oral Myelin	37	(1)
Administration of MBP and Other Peptides	38	(1)
T Cell (Receptor) Vaccination	38	(1)
Agents That Reduce Blood-Brain Barrier Injury	38	(5)
Symptomatic Treatment and Rehabilitation	43	(36)
Symptomatic Treatment of MS	44	(18)
Spasticity	45	(1)
Oral Agents	46	(1)
Baclofen	46	(1)
Tizanidine	46	(1)
Dantrolene and Benzodiazepines	47	(1)
Other Oral Agents	47	(1)
Other Routes	48	(1)
Ataxia	49	(1)
Medical Treatment	50	(1)
Surgical Intervention	50	(1)
Fatigue	51	(1)
Medication	52	(1)
Bladder Dysfunction	53	(2)
Bowel Dysfunction	55	(1)
Sexual Dysfunction	56	(1)
Management of Sexual Dysfunction in Women	56	(1)
Management of Sexual Dysfunction in Men	56	(2)
Pain	58	(1)
Other Paroxysmal Symptoms	59	(1)
Cognition	60	(1)
Other Symptoms	60	(1)
Visual Dysfunction	60	(1)
Vertigo	61	(1)
Swallowing, Speech, and Respiratory Dysfunction	61	(1)
Temperature Sensitivity	61	(1)
Psychiatric and Psychological Dysfunction	62	(1)
Neurologic Rehabilitation	62	(17)
Evaluating Outcomes	63	(1)
Evaluating Neurorehabilitation in MS	64	(1)
Evaluating Comprehensive Packages of Rehabilitation	65	(1)
Do Benefits of Rehabilitation Carry Over in Medium Term?	66	(1)
Evaluating Components of the Rehabilitation Package	67	(1)
Evaluating Service Delivery	68	(11)
Alternative Therapies Used by People with MS	79	(48)
Definition of Alternative or Complementary Medicine	80	(1)
The Popularity of Alternative Medicine	81	(1)
Informing Your Doctor	82	(3)
Miscellaneous Empirical Treatments	85	(42)
Injected Materials	85	(13)
Injected Materials and Oral Administration	98	(1)
Oral Administration	99	(5)
Physical and Surgical Manipulations	104	(22)
Diet	126	(1)
Index	127