The thinking used to be that MS progressed more quickly in people diagnosed at an older age. But the study authors note that those diagnosed as children hit disability milestones at a younger age and therefore could be considered to have a poorer prognosis. Tremlett participated in a study published in April in the European Journal of Neurology , which investigated whether the use of the widely prescribed MS drugs known as beta interferons delays the onset of secondary-progressive MS; it found that they do not.
However, a study published in January in the Journal of the American Medical Association suggests otherwise. When researchers compared MS medications including beta interferons, glatiramer Copaxone, Glatopa , fingolimod Gilenya , natalizumab Tysabri , and alemtuzumab Campath, Lemtrada versus no treatment at all, they found that treatment with any of these medications was associated with a lower risk of transition to SPMS.
In particular, fingolimod , natalizumab , and alemtuzumab were associated with the lowest risk of progression to SPMS, and treatment was especially beneficial when started sooner — less than five years after disease onset — rather than later. Tremlett also coauthored a systematic review of MS research published in July in the journal Neurotoxicology that looked at risk factors associated with onset, relapses, and progression in MS.
The review focused on factors that are modifiable, and among these, smoking appeared to accelerate disease progression. A more recent study, published in April in the journal Neurology , also identified smoking, along with older age, greater disability, motor and brain stem dysfunction, and spinal lesions at the time of diagnosis, as risk factors for transitioning from relapsing-remitting MS to secondary-progressive MS.
Although MS in children is generally understood to be the same disease as MS in adults, there are some key differences. A study published in June in Neurology further confirmed a higher relapse rate in children with MS than in adults and showed that children are more likely to be diagnosed with relapsing forms of the disease and often experience longer diagnostic delays than adults.
Chitnis adds, "There is a slower course of progression, and kids have less disability early on in their disease course. In rare cases, the condition progresses to advanced MS. This will present with increasingly severe symptoms, including muscle weakness, a loss of mobility, and, in some cases, serious cognitive difficulties. The symptoms of MS can include:. In time, these symptoms can lead to secondary complications, including a loss of bone density, bladder and bowel issues , and pressure sores.
There is currently no cure for MS, but medical advances have opened new treatment routes. The following sections look at these in more detail. Treatment for MS typically involves disease-modifying therapy , which can reduce the number of relapses a person experiences and slow the progression of MS. The doctor may also order other prescriptions for MS, including corticosteroid injections to relieve inflammation and symptoms during a relapse.
Physical therapy can help a person maintain and improve physical strength and the ability to function in everyday life. Plasma exchange may help a person manage severe symptoms of an MS episode if medication has not proven effective.
It involves removing blood from the body and extracting substances from it that may be harmful. A doctor then returns the treated blood to the body. Some complementary therapies may also help some people deal with their symptoms.
These options include:. Although these practices are not clinically proven remedies, they may help some people with MS manage their symptoms alongside a broader treatment plan.
Regular light exercise may also help keep the body moving. A physical therapist is likely to recommend stretching after light exercise each day to help keep the muscles strong and flexible. Understanding what to expect with each type of MS can help people get a better idea of how the condition is progressing so that they can seek the best treatment. Treatment involves managing the symptoms and slowing down the progression of the condition. Ongoing scientific research aims to find new ways to treat MS.
There are no specific treatment guidelines for RIS and additional research is needed to further define what factors increase the likelihood that someone with RIS will develop MS. Monitoring of MRI and neurological symptoms, and neurological examination are generally recommended to quickly identify changes. If the diagnosis is MS, treatment can be started early. Research interest in RIS is high and several studies are ongoing , which could provide more guidance for monitoring and treatment.
CIS is a first episode of neurologic symptoms caused by inflammation and demyelination in the central nervous system. The episode, which by definition must last for at least 24 hours, is characteristic of multiple sclerosis but does not yet meet the criteria for a diagnosis of MS because people who experience a CIS may or may not go on to develop MS.
When CIS is accompanied by lesions on a brain MRI magnetic resonance imaging that are similar to those seen in MS, the person has a high likelihood of a second episode of neurologic symptoms and diagnosis of relapsing-remitting MS. The diagnostic criteria for MS make it possible to diagnose MS in a person with CIS who also has specific findings on brain MRI that provide evidence of an earlier episode of damage in a different location and indicate active inflammation in a region other than the one causing the current symptoms.
In the meantime, individuals with CIS who are considered at high risk for developing MS may now be treated with a disease-modifying therapy that has been approved by the U. RRMS — the most common disease course — is characterized by clearly defined attacks of new or increasing neurologic symptoms. These attacks — also called relapses or exacerbations — are followed by periods of partial or complete recovery remissions. Your doctor and medical team can help you find the best combination of treatments to manage your symptoms and improve your quality of life.
While there are not many medications approved by the Food and Drug Administration to treat pediatric MS, medications used to treat adult MS have been studied in children. Some prescription treatments and medical interventions include:. For some people with MS, their condition will never get to the advanced stage. For instance, it may become very difficult to walk, write, or speak. A caregiver may become needed to help with everyday tasks. Researchers continue to make strides in their understanding of the disease.
Improved therapeutic advances, new technologies, and FDA-approved medications are having an impact on the underlying course of MS. Using your knowledge and working closely with your doctor can make MS easier to manage throughout the course of the disease.
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