multiple sclerosis

Treatment of acute multiple sclerosis (MS) exacerbation is indicated when disabling symptoms are present. Oral and intravenous (IV) corticosteroids are considered equally efficacious in hastening recovery. However, this patient has optic neuritis and should initially receive IV corticosteroids as oral corticosteroids are associated with an increased risk of recurrent optic neuritis (Choice D). An oral corticosteroid taper can be considered after IV therapy. Plasmapheresis should be considered in glucocorticoid-refractory patients (Choice A).

Disease-modifying drugs (eg, beta-interferon, glatiramer acetate) are indicated for chronic maintenance therapy in patients with relapsing-remitting multiple sclerosis (MS) as they can decrease the frequency of relapses and reduce the development of brain lesions.