Fast Five Quiz: Key Aspects of Multiple Sclerosis Treatment

Michelle H. Cameron, MD, PT, MCR; Kerstin Hellwig, MD

Disclosures

June 30, 2022

Intrathecal pumps for delivery of antispasticity medications (eg, baclofen) can be implanted surgically. Caution should be used with baclofen pumps because of the risk for malfunction and baclofen overdose. Autologous hematopoietic stem cell transplantation (aHSCT) may be effective for slowing the course of MS and for repairing damage to the nervous system. A study exploring long-term outcomes with aHSCT in a large cohort of MS patients concluded that aHSCT prevents disability worsening in the majority of patients and induces durable improvement in disability in patients with RRMS. Among those with RRMS, disability worsening-free survival was 85.5% at 5 years and 71.3% at 10 years. In patients with progressive MS, disability worsening-free survival was 71.0% at 5 years and 57.2% at 10 years.

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 compared with 39 relapses in drug-therapy recipients. In addition, 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.

Learn more about the surgical treatment of MS.

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