MS Acute Treatment

Posted On July 24, 2021

Multiple Sclerosis review

Acute exacerbation

  • IV methylprednisolone: 1000 mg iv daily for 5 days (3 to 7 days)
    • with or without short taper
  • Oral prednisone: 50 mg tab x 20 tab daily for 5 days
    • without taper
    • some previous study suggested iv more effective for optic neuritis
  • ACTH (corticotropin) more expensive
    • Without taper: 80-120 mg sq or im daily for 7 days
    • With taper: 80 mg sq or im daily for 7 days, 40 units daily for 4 days, 20 units daily for 3 days

Acute exacerbation with poor response

  • or very severe deficit, or refractory relapses
  • Plasma exchange (PLEX)
    • daily treatment for 5 to 7 days
    • or every other day for 3 to 7 treatments

References