Multiple Sclerosis Treatment from Drexel Neurosciences Institute
Multiple sclerosis affects every person differently, and each patient has unique treatment needs. The specialists at the Drexel Neurosciences Institute are committed to helping patients in the Greater Philadelphia area with multiple sclerosis through individualized care and support. Learn more about multiple sclerosis.
By combining patient care services, education, and research into one comprehensive neurology program, the Drexel multiple sclerosis center improves the quality of life for multiple sclerosis patients. Referrals to physicians in other specialties, such as internal medicine, gynecology, and urology, can be made when necessary.
Diagnosing Multiple Sclerosis
The following tests are commonly used in the diagnosis of multiple sclerosis. Drexel neurologists can provide your initial diagnosis, or offer you a second opinion.
Magnetic Resonance Imaging (MRI)
MRI is an imaging test that uses powerful magnets and radio waves to create pictures of the brain and surrounding nerve tissues. A brain MRI provides detailed pictures of these tissues. It also provides clear pictures of parts of the brain that are difficult to see clearly on CT scans.
A neuropsychological evaluation consists of paper-and-pencil or computerized tests that are used to determine brain function. Intelligence, memory, language function, and overall function are usually evaluated to see if there is an indication of loss of ability due multiple sclerosis.
Neuropsychological tests are administered privately with an examiner in a quiet office environment, free from distractions. This allows for an evaluation of a person at their highest level of concentration.
Evoked potential tests are a way to measure electrical conduction through the central nervous system. We can measure conduction through the optical system (visual evoked potential or VEP), sensory system (somato-sensory evoked potential or SSEP), and hearing system (brainstem auditory evoked potential or BAEP). Evoked potential testing is used to diagnose multiple sclerosis. It can also be used to study abnormal conduction through the spinal cord in compression and tumors. Auditory testing is helpful with tumors of the auditory nerve.
Balance testing analyzes six different aspects of balance. This unique evaluation tool is appropriate for patients of any age with any severity of balance problems.
Lumbar Puncture (spinal tap or LP)
A lumbar puncture, or spinal tap, is the collection of cerebrospinal fluid (CSF) for testing. CSF is normally clear and colorless. It surrounds the brain and spinal cord and acts as a buffer. Any changes in the fluid's color, consistency or quantity may indicate a neurological disease or disorder such as multiple sclerosis.
During a spinal tap, anesthetic is injected into the skin of the lower back, followed by a long, thin needle that will measure the CSF pressure and collect fluid for testing. After the sample is collected, the needle is removed. The patient remains flat for an hour after the test.
Treatments for Patients with Multiple Sclerosis
Once a patient has been diagnosed with multiple sclerosis, the Drexel Neurosciences Institute offers the following services and treatments:
- Ongoing neurological care
- Nursing care
- Social services
- Disease modifying therapies
- Bowel/bladder management
Medical Therapies for Multiple Sclerosis
Baclofen therapy reduces muscle spasticity related to multiple sclerosis by correcting the imbalance of electrical signals originating at the spinal cord. Bacolofen can be taken orally or delivered directly into the spinal fluid, reducing the undesired side effects common with oral Baclofen therapy.
The Baclofen pump is placed surgically, allowing the patient to receive the drug at the correct dosage and timing without being required to stay in the hospital. Patients will return to their doctor for refills and dosage adjustments as needed.
Intravenous Infusion of Natalizumab (Tysabri)
Tysabri is an FDA-approved medication for adult patients with relapsing forms of multiple sclerosis (MS) used to slow the worsening of physical disability and to decrease the number of flare-ups (relapses).
Tysabri is an antibody, which is unlike other multiple sclerosis (MS) treatments. It is thought to inhibit white blood cells (T cells) from getting into the brain and attacking the myelin covering nerve fibers in the brain and spinal cord. This is believed to result in fewer of the brain lesions that cause MS symptoms.
Infusions are once a month. They last an hour and there is a one hour observation period afterward.
Because Tysabri increases the risk of progressive multifocal leukoencephalopathy (PML), a rare brain infection that can cause severe disability or death, it is generally recommended for patients who have not been helped enough by, or cannot tolerate, other treatments for MS.
Tysabri does not cure multiple sclerosis (MS) and has not been studied for longer than two years or in patients with chronic progressive MS.
Intravenous Immune Globulin (IVIG)
Immunoglobulins are antibody proteins that are secreted by the white blood cells called B-lymphocytes and by plasma cells, in response to the presence of a substance (antigen) that provokes an immune response. Intravenous immunoglobulin G (IVIG) is a pooled human immunoglobulin G (IgG) that is presumed to regulate the immune system.
There are some data that suggest that monthly administration of intravenous immunoglobulin G (IVIG) may be beneficial in reducing relapses and/or inflammatory lesions on MRI in some persons with relapsing-remitting MS.
A meta-analysis of the various studies that have been done with intravenous immunoglobulin G (IVIG) concluded that it may be a valuable alternative for the treatment of relapsing-remitting MS (e.g., for those individuals who cannot or will not take one of the approved medications), but cannot presently be considered a first-line treatment.
Methylprednisolone is a synthetic corticosteroid. Steroids are hormones normally produced in the human body by the adrenal glands. They have a number of physiologic effects on different organ systems, but are most widely used for their anti-inflammatory actions. These steroids are different from the anabolic steroids used by athletes and others to enhance muscle development and strength.
Steroids were among the first agents used to treat MS and remain the treatment of choice for managing acute exacerbations (relapses or attacks).
A 3- to 5-day course of methylprednisolone can be used to treat any attack that is significantly affecting a person's ability to function at home or at work.
Data from clinical studies suggest that "pulse" dosing provides maximum benefit with the fewest side effects for MS patients. The IV steroids may be followed by a 1- to 2-week tapering dose of oral steroids.
Botox® Injection for Spasticity
Spasticity is a state of increased tone of a muscle (and an increase in the deep tendon reflexes) that can occur in patients with multiple sclerosis. For example, with spasticity of the arms there is an increase in tone of the related muscles, making them feel tight and rigid.
Botox is approved by the FDA to treat increased muscle stiffness in elbow, wrist, and finger muscles in people 18 years and older with upper limb spasticity. Botox received FDA approval for the treatment of upper limb spasticity based on efficacy and safety demonstrated in three well-controlled clinical trials.
Balance-Based Torso-Weighting (BBTW)
Balance-based torso-weighting is an evaluation and treatment system. This therapy uses in a custom-weighted patient garment. A therapist assesses an individual's balance to find problem areas. Once the balance dysfunction is identified, small non-obtrusive weights are strategically placed on the torso (trunk) to improve balance control. Patients frequently report improvement during their first visit.
Clinical Trials for Patients With Multiple Sclerosis
The Drexel Neurosciences Institute participates in a number of ongoing clinical trials for patients with multiple sclerosis. Learn more about these trials to find out if you are eligible to participate.
Multiple Sclerosis Specialists
The information on these pages is provided for general information only and should not be used for diagnosis or treatment, or as a substitute for consultation with a physician or health care professional. If you have specific questions or concerns about your health, you should consult your health care professional.
The images being used are for illustrative purposes only; any person depicted is a model.
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