Fast Five Quiz: Key Aspects of Multiple Sclerosis Treatment

Michelle H. Cameron, MD, PT, MCR

Disclosures

December 06, 2018

Intrathecal pumps for delivery of antispasticity medications (eg, baclofen) can be implanted surgically. Caution should be used with baclofen pumps due to the risk for malfunction and baclofen overdose.

AHSCT may be effective for slowing the course of MS and for repairing damage to the nervous system. One retrospective study evaluated 281 patients with MS who underwent AHSCT between 1995 and 2006. Almost half of the patients (46%) remained free from neurologic progression for 5 years after transplant. However, eight deaths (2.8%; 95% confidence interval, 1.0%-4.9%) were reported within 100 days of transplant and were considered transplant-related mortality. Patients with a relapsing form of MS fared better than those with progressive MS. This suggests that AHSCT may not necessarily treat a neurodegenerative component of the disease that is operative in the later stages of the disease.

In a trial of 110 patients with relapsing-remitting disease, stem cell therapy helped control MS. After 1 year, just one stem cell recipient had experienced a relapse, versus 39 relapses in drug-therapy recipients. Additionally, during a mean follow-up of 3 years, treatment failure occurred in just 6% of stem cell patients, compared with 60% of those on drug therapy.

Surgical procedures that relate to MS are directed primarily at alleviating symptoms such as dysphagia, significant limb spasticity or contractures, and severe neuropathic pain. Measures include gastrojejunal tube placement, adductor leg muscle tendon release, and rhizotomy, respectively.

For more on the surgical treatment of MS, read here.

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