Treatment for multiple sclerosis (MS) is as varied as the condition. As a National Multiple Sclerosis Society Center for Comprehensive MS Care, the Norton Neuroscience Institute Hussung Family Multiple Sclerosis Center provides a comprehensive range of treatment options, rehabilitation, outpatient therapies and home treatment. As part of the comprehensive care, patients can access the full range of educational and support services of Norton Neuroscience Institute Resource Centers.

Neuroimmunologists like those at the Hussung Family Multiple Sclerosis Center specialize in treating conditions like MS that involve both the nervous and immune systems.

Treatment for MS falls into three broad categories: recovery from MS attacks, slowing the disease’s progression and relief from symptoms.

Treatment for MS Relapses

Many MS relapses gradually will improve and don’t require treatment. When relapse symptoms affect your ability to function, including seeing and walking, your specialist may prescribe high doses of steroids to help ease symptoms.

Steroids often are prescribed as daily tablets for about a week or daily infusions for a shorter course. Steroids suppress the immune system and ease the inflammation at the site of nerve damage.

For patients whose relapse symptoms don’t respond sufficiently to steroids, plasmapheresis may be an option. Plasmapheresis, completed while the patient is admitted to a hospital, separates the red and white blood cells from the plasma and replaces the cells back into the bloodstream with a plasma exchange fluid.

Plasmapheresis has been found to successfully treat some autoimmune diseases by removing certain antibodies. While the procedure has not been found to be effective for modifying MS, it has been found to help relieve MS relapse symptoms.

Treatment to Slow the Progression of MS

The development of new medications to slow the progression of MS has been rapid in recent years.

Ocrelizumab is the only medication approved by the Food and Drug Administration (FDA) for primary progressive MS, which affects about 15% of MS patients. But overall, there are more than 20 medications approved by the FDA for various types of MS.

The complexity of the disease and the ever-expanding options of drugs for MS require the care of MS specialists who are experienced with the newest treatments as well as established options to find a personalized match of therapy and your unique case of MS.

Factors that your neuroimmunologist will consider when matching your condition with a treatment include:

• The type of MS — primary progressive, clinically isolated syndrome, relapsing-remitting or secondary progressive
• Your age
• Aggressiveness of your disease
• Whether you are planning to become pregnant
• Medical history, such as cardiac conditions, infections and cancer
• Method of administration (self-injectables, oral medications and intravenous infusions)
• History of adherence to treatment
  • Some medications need to be taken daily.
  • For those who tend to miss daily dosages, less-frequent options are available.
• Risk of progressive multifocal leukoencephalopathy — a potentially fatal brain infection — based on whether a blood test shows a specific virus (known as JC virus) in your system
• Insurance requirements (Some insurance providers require first-line, traditional or standard treatments to fail before escalating to other medications.)

Drugs for MS

Lower-efficacy medications: interferons, glatiramer acetate and teriflunomide

Moderate efficacy: Dimethyl fumarate and diroximel fumarate, sphingosine-1 phosphate receptor modulators fingolimod and zonisamide

Higher efficacy: natalizumab, alemtuzumab, cladribine; and the B-cell therapies ocrelizumab, ofatumumab and rituximab

MS Symptom Treatment

In addition to clinical treatments, many activities that promote symptom management are available through Norton Neuroscience Institute Resource Centers.

Integrative symptom management – Norton Neuroscience Institute MS providers pursue a combination of approaches to address MS symptoms. Conventional treatments include medication, physical therapy, occupational therapy, speech therapy, water therapy and assistive devices. Unconventional therapies include exercise, tai chi, yoga, guided imagery, meditation, mindfulness, lifestyle changes and mind-body strategies that can improve bladder symptoms, fatigue, gait issues and pain.

Behavioral medicine – MS can shift your life in ways that can make it unrecognizable. It can affect your work, your role in the family and your independence. The result can be anxiety, depression, grief, stress and other mental health conditions. Mental health intervention can help prevent overall MS symptoms as well as mental health symptoms from worsening.

Medication – Various drugs are available to reduce fatigue, improve walking speed and spasticity. Baclofen is a frequently used spasticity medication, and Botox injections can provide short-term relaxation of targeted muscles.

Rehabilitation – Guided exercise can promote overall conditioning, reducing fatigue and improving overall function at home and at work. Rehabilitation can help with mobility, personal care, driving and daily functioning. Norton Neurosciences & Spine Rehabilitation Center and its gait lab provide comprehensive, personalized care.

Clinical Trials – New treatments for MS are constantly on the horizon. As principal investigators on MS-related clinical trials, our physicians often have some of the deepest experience with newly approved discoveries and can provide access to potentially breakthrough experimental treatments.

What to Expect at the Norton Neuroscience Institute Hussung Family Multiple Sclerosis Center

• A full range of multiple sclerosis support options are available, including remote and in-person classes and on-demand patient education videos from your providers.
• An MS patient navigator is dedicated to helping you and caregivers work with your medical treatment team. The patient navigator also can help you with arranging transportation, insurance approvals, financial assistance and accessing clinical trials, and can steer you toward other assistance to get you the best care possible.
• We have a social worker, psychologist, pharmacist and a dietitian dedicated to supporting MS patients.
• The Hussung Family Multiple Sclerosis Center is on the Norton Healthcare – St. Matthews campus, along with an infusion center. Other infusion center locations include downtown Louisville and on the campus of Norton Brownsboro Hospital.
• Our clinic is recognized as a Center for Comprehensive MS Care by the National Multiple Sclerosis Society.
• We accept Medicare, Medicaid, and most major commercial insurance plans. Patients with income equal to or less than 35% of the federal poverty level may be eligible for financial assistance.
• Book appointments, get alerts when an earlier appointment becomes available, communicate with your medical provider, refill prescriptions and more through your free Norton MyChart account.