Treatment Plan , Prognosis & Key Information
Treatment Plan
Relapse management:
- Methylprednisolone 0.5mg x5/day for 5 days (within 14 days of onset)
- Confirm absence of infection in last 24 hours
- New/worsening symptoms required for diagnosis Symptom management:
Fatigue:
- Yoga
- CBT
- Exercise programme
- Medications: amantadine, modafinil, SSRIs Spasticity:
- First line: baclofen
- Second line: gabapentin
Oscillopsia
- First line: gabapentin
- Second line: memantine Mobility:
- Supervised exercise programmes
- Vestibular rehabilitation
- Mobility aids
- Physiotherapy Mental health:
- CBT
- Amitriptyline for emotional lability Pain:
- Follow standard MSK/neuropathic pain pathways
Prognosis
Progressive disability development over time
Key Information
- Treatment aims: prevent relapses, prolong life/comfort, reduce relapse frequency
- Prompt referral is essential for diagnosis