Multiple Sclerosis Treatment

How is Multiple Sclerosis Diagnosed?

People exhibiting symptoms of multiple sclerosis should consult a neurologist for assessment and diagnosis of the condition. Since multiple sclerosis is an autoimmune disease of the central nervous system, its diagnosis requires a combination of clinical and diagnostic procedures.

The diagnosis is made according to the McDonald diagnostic criteria, in conjunction with MRI, cerebrospinal fluid analysis (oligoclonal bands), and evoked potential studies, where necessary.

How is Multiple Sclerosis Treated Based on Severity?

The treatment of multiple sclerosis based on its severity is shown below:

Types of Multiple Sclerosis and Its Treatment

The treatment approaches for multiple sclerosis, based on its types, are mentioned below:

Topical Treatments for Multiple Sclerosis

There is no specific topical treatment for multiple sclerosis. However, topical medications may be prescribed for localised neuropathic pain in selected patients. These can include:

Other Treatments for Multiple Sclerosis

Other treatment options for multiple sclerosis include the following:

• Intravenous Corticosteroids: Acute MS relapses are usually treated with high-dose intravenous methylprednisolone.

• Plasma Exchange: Plasma exchange may be recommended for severe attacks when corticosteroid therapy is ineffective.

• Disease-Modifying Therapies (DMTs): Certain DMTs (for example, monoclonal antibody therapies like ocrelizumab, natalizumab, and alemtuzumab) may decrease relapses and slow down disease progression.

• Physiotherapy: Physiotherapy helps people with multiple sclerosis to keep their mobility and muscle strength.

• Occupational Therapy: Occupational therapy helps to preserve independence in everyday activities.

• Speech and Swallowing Therapy: Speech therapy can be useful for patients who have problems with speech or swallowing.

Oral Medications for Multiple Sclerosis Treatment

Oral medications for multiple sclerosis include disease-modifying therapies and medications to help relieve symptoms, such as spasticity and neuropathic pain. Some of the medicines are:

• Fingolimod: Decreases relapse rates and disease progression by suppressing the function of immune cells.

• Dimethyl fumarate: Decreases inflammation and reduces relapse rates.

• Teriflunomide: Reduces immune system activity that leads to nerve damage.

• Siponimod: Helps to slow disability progression and decrease relapse rate in certain types of MS.

• Ozanimod: Suppresses immune cell migration into the brain and spinal cord to control disease activity.

• Cladribine: Decreases the number of immune cells destroying the nervous system.

• Dalfampridine: Assists with improving walking in some patients with multiple sclerosis.

• Baclofen: Aids in easing muscle stiffness and spasms.

• Tizanidine: Helps to decrease muscle tension and spasticity.

• Gabapentin: Assists in treating nerve pain in multiple sclerosis.

• Pregabalin: Helps to alleviate nerve pain and abnormal sensations such as burning and tingling.

Ayurvedic and Alternative Treatments for Multiple Sclerosis

Some MS patients may opt for supportive disease management through Ayurvedic or other alternative methods, which can include:

• Abhyanga or medicated oil massage may help relieve muscle stiffness and increase flexibility.

• Sudation (swedana) can help ease tension in muscles.

• Yoga and meditation can assist with achieving balance and flexibility.

• Acupuncture may help with pain and muscle spasticity in certain cases.

Note: Ayurvedic and alternative therapies should only be used as complementary treatments under qualified supervision and after consultation with your neurologist.

Home Care for Managing Multiple Sclerosis

Multiple sclerosis patients can follow the suggestions below to improve their quality of life:

• Take your medications just as directed by your doctor.

• Engage in regular physiotherapy and stretching exercises.

• Eat a balanced and healthy diet.

• Get sufficient rest and sleep.

• Use mobility aids when advised by your healthcare practitioner.

• Visit for regular checkups to track disease progress.

• Stay physically active as per your comfort and within your ability.

How Long Does Multiple Sclerosis Treatment Take?

The approximate treatment durations for different multiple sclerosis treatment methods are listed below:

Multiple Sclerosis Treatment Side Effects

Treatments for multiple sclerosis may have some side effects that depend on the drug or treatment modality administered. These side effects usually include:

• Injection site reactions

• Flu-like symptoms

• Test results indicating abnormal liver function

• Higher risk of infection

• Reactions related to infusion

• Hair thinning due to some medicines

• Nausea

• Fatigue

People undergoing treatment for multiple sclerosis should contact their neurologist if they experience recurring or serious side effects from the treatment.

Lifestyle Changes for Managing Multiple Sclerosis

Some lifestyle changes might be considered for enhancing the condition and quality of life of people suffering from multiple sclerosis, which include the following:

• Perform low-impact physical exercises regularly to keep your body healthy and flexible.

• Maintain a nutritious diet to support overall neurological health.

• Get enough sleep to manage fatigue.

• Manage your stress levels to reduce the risk of symptom flare-ups.

• Quit smoking to prevent the progression of the disease.

Triggers That Can Worsen Symptoms of Multiple Sclerosis

Some triggers that can worsen multiple sclerosis symptoms include:

• Infections, such as UTIs or respiratory infections.

• Exposure to heat or hot weather can temporarily aggravate neurological symptoms.

• Physical and psychological stress, leading to flare-ups of symptoms.

• Sleep deprivation and fatigue worsen weakness and cognitive issues.

• Smoking contributes to more rapid disease progression.

• Overheating (Uhthoff phenomenon), where the core body temperature increases.

• Emotional stress caused by long-term treatment and disease progression.

Multiple Sclerosis Treatment Cost

The cost of multiple sclerosis treatment in India depends on the prescribed medicines, the frequency of follow-up, rehabilitation, and hospitalisation. The average cost of multiple sclerosis treatment in India ranges from ₹10 lakh to ₹21 lakh. Oral disease-modifying therapies are usually more affordable than biologic or infusion therapies. MRI scans, cerebrospinal fluid analysis and rehabilitation add to the overall cost of treatment.

Does Health Insurance Cover Multiple Sclerosis Treatment in India?

Yes. All health insurance plans cover medically necessary hospitalisation, investigations, and treatments of multiple sclerosis in India, subject to policy terms and conditions and applicable waiting periods. Besides, it is also covered under most critical illness insurance plans, subject to a waiting period and a survival period. However, the coverage for expensive disease-modifying drugs may vary from one plan to another.

Eligible patients may also receive treatment benefits under certain government schemes (such as the Ayushman Bharat Pradhan Mantri-Jan Arogya Yojana), where applicable.