Abstract
Within last 15 years the treatment approach to multiple sclerosis (MS) has been substantially changed in accordance with the recent knowledge about its etiopatogenesis. Intravenous administration of high-dose methylprednisolone still remains the first choice in the treatment of MS relapses.
Between relapses immune system modifying therapy should be started early in the course of the disease as the major axonal loss appears in this period and early treatment can protect patients from subsequent disability. Since 2009, some of interferon-beta products are indicated even in cases of clinically isolated syndrome when the risk of MS development is deemed to be high.
When the disease activity is not effectively suppressed by interferon-beta the treatment should be switched to either monoclonal antibody natalizumab, or to pulse-therapy with immune suppressive and cytostatic agents. When these approaches fail immune ablative autologous haemopoetic stem cell transplant is an option in some well selected cases.
Symptomatic treatment and continuing physiotherapy are still an important and inevitable part of comprehensive approach. mitoxantrone.