1. Multiple Sclerosis

2. Incidence 85,000 patient in UK Cases present between 20-40yrs of age Twice as many females Not a fatal condition, most patients have a normal life span 2/3rds of patients don’t get a major disability and are able to walk with the use of an aid

3. Characteristics Relapsing remitting (85% of cases)…acute flare ups with partial or complete remissions Primary progressive: progressive disease with no remissions (10%) Secondary progressive: start as relapsing remitting followed by steady progression (50% of RR followed this pattern before DMDs Progressive relapsing:steady worsening from outset with acute relapses with or without recovery, continuous progression between relapses

4. Treatment Disease modifying drugs decrease relapse rate in RR by up to 1/3 rd and some trials have shown decreased severity of relapses. Beta interferon is indicated for SP when relapses are the cause of increasing disability Beta interferon doesn’t help those with severe disabilities No treatment for PP

5. Treatment contd. Beta interferon can cause flu like symptoms in first 3/12 Neutralising antibodies can be provoked by beta interferon thereby blocking the effect of the drug Copaxone can cause chest tightness, flushing and sweating When to start Rx ??