Multiple Sclerosis

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About 350,000 people have multiple sclerosis in the United States, about one in 1,000. It is also more prevalent in females and Caucasians, with three times more women having MS than men. 

Neurologists at Cleveland Clinic Florida, part of the Mellen Center at Cleveland Clinic in Ohio, are experts in the treatment and medical management of multiple sclerosis (MS) and other demyelinating disorders. Our physicians use a team approach when developing a comprehensive care plan that meets each patient’s physical, emotional, cognitive, and rehabilitation needs. Care plans can also include additional components requested by the patient, their family members or primary physician. Opportunities to participate in research studies are available. 

Cleveland’s Mellen Center for Multiple Sclerosis Treatment and Research encompasses physicians at Cleveland Clinic Florida. Established in 1984, the Mellen Center has grown to become one of the largest and most comprehensive programs for multiple sclerosis (MS) treatment and research in the world. The physicians conducting basic and clinical research at the Mellen Center have made important contributions toward the development of medications to control MS symptoms and disease progression. They also offer consultative services to other neurologists and patients world-wide while providing ongoing care for a large number of MS patients annually.

In addition to serving patients with MS, doctors at Cleveland Clinic Florida also see patients with other disorders such as acute disseminated encephalomyelitis, neuromyelitis optica, optic neuritis and transverse myelitis, among others. Our aim is to provide accurate diagnosis and treatment in order to alleviate symptoms and control the underlying disease. 

Treatment options for multiple sclerosis may include self-injectable, oral, or intravenous immune modulating therapies. Symptomatic treatments may include lifestyle modifications, oral medications, or various types of therapy. Procedures such as botulinum toxin injections or insertion of a baclofen pump may be offered to manage spasticity. 

Appointments

The team of neurologists at Cleveland Clinic Florida is dedicated to providing the most advanced treatment options to individuals with multiple sclerosis and other demyelinating disorders.  Part of the world-renowned Mellen Center for Multiple Sclerosis, our physicians are highly trained in the diagnosis of neuroimmunological conditions and often provide consultative services to both neurologists and patients. We see a broad range of patients with conditions such as:

Multiple sclerosis is not easy to diagnose and can vary from person to person. Most patients with MS have a history of neurological symptoms that come and go over the course of their lives. Recently, a panel of international MS experts created new diagnostic criteria (The Revised McDonald criteria) to allow for an earlier diagnosis of MS, if MRI scanning shows new lesions forming over time. Confirming a diagnosis of MS is still a complex process that involves many different components, including a neurological examination and other diagnostic testing such as: 

  • Magnetic Resonance Imaging (MRI)
    Uses powerful magnets and radio waves to generate detailed images of the brain. This test helps to detect disease related changes in the brain or spinal cord of more than 90 percent of individuals suspected of having multiple sclerosis. 
  • Evoked Potential Study
    A test that measures the electrical activity in the brain in response to stimulation of sight, sound, or touch. This test can help to confirm whether multiple sclerosis has affected the auditory, visual or sensory pathways of the nerves. 
  • Laboratory Tests
    Multiple sclerosis cannot be detected in the blood, however, your doctor may order a blood test to rule out other conditions that can mimic MS. 
  • Lumbar Puncture
    A procedure that removes spinal fluid to test for the presence of immunoglobulins as well as oligoclonal bands or certain proteins that are the breakdown products of myelin. 
  • Urology Testing
    Tests used to determine if bladder symptoms are being caused by multiple sclerosis.

Even though a cure has not yet been found for multiple sclerosis, there are many treatment strategies that can help improve the quality of life for people living with MS. Some of these therapies can help manage symptoms, reduce exacerbations of MS, and modify the course of the disease.  Cleveland Clinic Florida specialists use a multi-disciplinary approach to develop comprehensive treatment plans that can address the issues and needs of patients diagnosed with MS.  Some of these therapies are outlined below:

Medication Management 
Many medications are FDA approved for use in the treatment of multiple sclerosis, all of which may modify the course of the disease. Currently, these medications are available as injections, oral medications, or intravenous infusions. Overall, these drugs can help decrease the incidence of exacerbations of MS, reduce the amount of new lesions on MRI scans, and slow down disease progression. Additional information on each of the medications listed below can be found on the National Multiple Sclerosis Society website.

  • Copolymer-1 (Copaxone®)
  • Dalfampridine (Ampyra*) 
  • Dimethyl fumarate (Tecfidera*)
  • Fingolimod (Gilenya®)
  • Interferon beta-1a weekly (Avonex®)
  • Interferon beta-1b every other day (Betaseron®/ or Extavia*)
  • Interferon beta-1a three days a week (Rebif®)
  • Mitoxantrone (Novantrone®)
  • Natalizumab (Tysabri®)
  • Terifluonomide (Aubagio*)

Infusion therapy
Medication delivered intravenously that can include steroid injections, IVIG treatments, Natalizumab treatments, and various chemotherapy treatments.

Botulinum toxin 
A muscle-relaxing medication given by injection to decrease spasticity related to multiple sclerosis (MS) and other neurological conditions.

Physical therapy
Customized exercise programs that can help fight fatigue and improve mobility are designed for patients to implement at home. Our physical therapists also teach safe walking techniques to reduce falls and train patients in the use of devices aimed at improving gait pattern. 

Baclofen pump
A medication delivery system using a pump and catheter that are surgically implanted under the skin of the abdomen near the waistline. The pump delivers baclofen through the catheter directly into the spinal fluid to help relax muscles and decrease spasticity. 

There are several online resources available to obtain additional information on multiple sclerosis.  Below is a list of websites that provide information on treatment, diagnosis, medications, support groups and other issues related to MS: