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Multiple Sclerosis. Incidence. 85,000 patient in UK Cases present between 20-40yrs of age Twice as many females Not a fatal condition, most patients have a normal life span 2/3rds of patients don’t get a major disability and are able to walk with the use of an aid. Characteristics.
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Incidence • 85,000 patient in UK • Cases present between 20-40yrs of age • Twice as many females • Not a fatal condition, most patients have a normal life span • 2/3rds of patients don’t get a major disability and are able to walk with the use of an aid
Characteristics • Relapsing remitting (85% of cases)…acute flare ups with partial or complete remissions • Primary progressive: progressive disease with no remissions (10%) • Secondary progressive: start as relapsing remitting followed by steady progression (50% of RR followed this pattern before DMDs • Progressive relapsing:steady worsening from outset with acute relapses with or without recovery, continuous progression between relapses
Treatment • Disease modifying drugs decrease relapse rate in RR by up to 1/3rd and some trials have shown decreased severity of relapses. • Beta interferon is indicated for SP when relapses are the cause of increasing disability • Beta interferon doesn’t help those with severe disabilities • No treatment for PP
Treatment contd. • Beta interferon can cause flu like symptoms in first 3/12 • Neutralising antibodies can be provoked by beta interferon thereby blocking the effect of the drug • Copaxone can cause chest tightness, flushing and sweating • When to start Rx ??