There is no known cure for multiple sclerosis at this time. However, there are promising therapies that may decrease exacerbations and delay progression of the disease. Treatment is aimed at controlling symptoms and maintaining function to give the maximum quality of life.

Patients with a relapsing-remitting course are placed on immune modulating therapy that requires injection under the skin or in the muscle once or several times a week. This may be in the form of interferon (such as Avonex or Betaseron) or another medicine called glatiramer acetate (Copaxone). They are all similar in their effectiveness and the decision on which to use depends on concerns about particular side-effects.

Other than protective therapies, steroids are given to decrease the severity of attacks when they occur. These shut the immune system down to stop cells from causing inflammation. Other medicines such as Baclofen, Tizanidine or Diazepam may be used to reduce muscle spasticity. Cholinergic medications may be helpful to reduce urinary problems. Antidepressant medications can also help with mood or behavior symptoms. Amantadine may be given for fatigue.

Physical therapy, speech therapy, occupational therapy, and support groups (see below) may also be useful. These can help improve the person's outlook, reduce depression, maximize function, and improve coping skills. A planned exercise program early in the course of the disorder can help with maintaining muscle tone.

A healthy lifestyle is encouraged, including good general nutrition. Adequate rest and relaxation can help maintain energy levels. Attempts should be made to avoid fatigue, stress, temperature extremes, and illness to reduce factors that may trigger an MS attack.

The expected outcome is variable and unpredictable. Although the disorder is chronic and incurable, life expectancy can be normal or nearly so, with a life span of 35 or more years after diagnosis being common. Most people with MS continue to walk and function at work with minimal disability for 20 or more years. The factors felt to best predict a relatively benign course are female gender, young age at onset (less than 30 years), infrequent attacks, a relapsing-remitting pattern, and low burden of disease on the imaging studies.

The amount of disability and discomfort varies with the severity and frequency of attacks and the part of the central nervous system affected by each attack. Commonly, there is initially a return to normal or near-normal function between attacks. As the disorder progresses, there is progressive loss of function with less improvement between attacks.

• progressive disability
• urinary tract infections
• side effects of medications used to treat the disorder