Acute treatments

Most patients with multiple sclerosis (MS) experience relapses characterized by acute or subacute neurological dysfunction lasting days to several weeks followed by a remission with partial or complete resolution of neurological dysfunction. Attacks may occur as part of diverse demyelinating syndromes: clinically isolated syndromes [e.g., isolated optic neuritis (ON), myelitis, or brainstem syndromes], relapsingremitting MS (RRMS) or secondary progressive MS, or one of the atypical demyelinating disease variants (Marburg variant, tumefactive MS, severe monophasic disorders such as complete transverse myelitis and neuromyelitis optica). The goals of acute treatment are reversal of neurological disability sustained from an attack, arrest of rapidly deteriorating neurological dysfunction, and restoration of function. This may be distinguished from the goals of long-term therapies, such as interferon beta and glatiramer acetate, which are not known to alter the course of an individual attack and its sequelae, but rather to reduce the probability of subsequent clinical and subclinical attacks.