Multiple Sclerosis

Author: Fionn Bellis / Editor: Yasmin Sultan / Reviewer: Rasheed Kaja Mohammad, Mohamed Elwakil / Code: A5 / Published: 25/04/2023

This session describes the presentations, pathophysiology, management and treatment options for multiple sclerosis relevant to emergency medicine.

After completing this session you will be able to:

  • Describe the basic pathophysiology, disease progression and prognostic features of multiple sclerosis
  • Recognise the wide range of acute presentations of multiple sclerosis in previously-well patients
  • Explain how to manage the acute exacerbations of established multiple sclerosis to minimise complications
  • Evaluate treatment options in acute multiple sclerosis
  • Compare and contrast the features of acute multiple sclerosis with optic neuritis, acute transverse myelitis and acute disseminated encephalitis
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References

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  4. Compston A, Coles A. Multiple sclerosis. Lancet. 2008 Oct 25;372(9648):1502-17.
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  7. Dahl AA. Adult Optic Neuritis Treatment & Management. Medscape, 2022.
  8. Thompson, et al. National multiple sclerosis society. 2017. McDonald MS Diagnostic Criteria. [Accessed April 2023].
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  10. National Clinical Guideline Centre (UK). Multiple Sclerosis: Management of Multiple Sclerosis in Primary and Secondary Care. London: National Institute for Health and Care Excellence (UK); 2014 Oct.
  11. Lavy C, James A, Wilson-MacDonald J, Fairbank J. Cauda equina syndrome. BMJ. 2009 Mar 31;338:b936.
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  13. Ciccone A, Beretta S, Brusaferri F, Galea I, Protti A, Spreafico C. Corticosteroids for the long-term treatment in multiple sclerosis. Cochrane Database Syst Rev. 2008 Jan 23;(1):CD006264.
  14. National Institute for Health and Care Excellence. Multiple sclerosis in adults: management. NICE guideline [NG220] 2022.
  15. Whiting PF, Wolff RF, Deshpande S, et al. Cannabinoids for Medical Use: A Systematic Review and Meta-analysis. JAMA. 2015;313(24):24562473. doi:10.1001/jama.2015.6358.
  16. Langford RM, Mares J, Novotna A, et al. A double-blind, randomized, placebo-controlled, parallel-group study of THC/CBD oromucosal spray in combination with the existing treatment regimen, in the relief of central neuropathic pain in patients with multiple sclerosis. J Neurol. 2013 Apr;260(4):984-97.

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