🩺 General MedicineNeurologyStudentInternResident

Multiple Sclerosis

Also known as: MS · demyelinating disease

A chronic immune-mediated demyelinating disease of the central nervous system — neurological episodes 'disseminated in time and space' (optic neuritis, sensory/motor/cerebellar/brainstem symptoms). Most begin as relapsing-remitting.

Source · Reviewed 2026-08-15 · v1.0— AI-assisted draft — verify against the cited guideline before clinical use.

⚕️ Education only — not medical advice. Verify against the latest official guideline and your local protocol; confirm every drug dose against the cited source before clinical use.

Who gets it

Young adults, more often women; commoner further from the equator; genetic plus environmental factors (low vitamin D, EBV, smoking).

Red flags — escalate / refer

An acute severe relapse (disabling weakness, brainstem or cord signs) or a first demyelinating event → neurology; distinguish a true relapse from an infection/heat-related pseudo-relapse.

Work-up / diagnosis

1A clinical diagnosis supported by the McDonald criteria — MRI (lesions disseminated in space and time), sometimes CSF oligoclonal bands, and exclusion of mimics.
2Characterise the pattern (relapsing vs progressive).

Management — overview

Specialist-led; acute relapses → a short course of high-dose corticosteroids (speed recovery, don't change the long-term course).
Disease-modifying therapies reduce relapses/progression in relapsing MS.
Symptomatic management (spasticity, bladder, fatigue, pain, mood), rehabilitation, vitamin D, smoking cessation and MDT support.

In-depthFull dosing & advanced protocol

Drug dosing

High-dose corticosteroid (acute relapse)

Shorten relapse recovery

Adult dose: Short course per protocol
Route: IV / oral

ICMRStandard Treatment Workflows (STWs), India — Dept. of Health Research & ICMR (2022+) ↗

Disease-modifying therapy (specialist)

Reduce relapses/progression in relapsing MS

Adult dose: Per protocol
Route: Various

WHOWHO Model List of Essential Medicines (electronic EML) (2025 (24th)) ↗

Disseminated in time and space

The McDonald criteria formalise 'lesions separated in time and space'.
Steroids speed relapse recovery but do not alter the disease course; DMTs reduce relapses.
Distinguish a true relapse from a pseudo-relapse (infection/heat — Uhthoff's phenomenon).

ICMRStandard Treatment Workflows (STWs), India — Dept. of Health Research & ICMR (2022+) ↗

References

Guidelines change. If something here is out of date, tell us — we keep these current.

🚩 Report outdated / suggest update

More protocols

HypertensionPersistently raised arterial pressure (≥140/90 mmHg) — a leading, modifiable cause of stroke, heart attack, heart failure and kidney disease.DengueAn Aedes-borne viral febrile illness. Most cases self-limit, but plasma leakage can cause severe dengue — early recognition of warning signs and careful fluid therapy save lives.MalariaA mosquito-borne protozoal (Plasmodium) febrile illness. In India P. vivax and P. falciparum predominate; prompt diagnosis and species-specific treatment prevent severe disease.

Loading…

👤 Who gets it

🚩 Red flags — escalate / refer

🔎 Work-up / diagnosis

🧭 Management — overview

💊 Drug dosing

High-dose corticosteroid (acute relapse)

Disease-modifying therapy (specialist)

📈 Disseminated in time and space

📚 References

More protocols

👤 Who gets it

🚩 Red flags — escalate / refer

🔎 Work-up / diagnosis

🧭 Management — overview

💊 Drug dosing

High-dose corticosteroid (acute relapse)

Disease-modifying therapy (specialist)

📈 Disseminated in time and space

📚 References

More protocols

Who gets it

Red flags — escalate / refer

Work-up / diagnosis

Management — overview

Drug dosing

Disseminated in time and space

References

Who gets it

Red flags — escalate / refer

Work-up / diagnosis

Management — overview

Drug dosing

Disseminated in time and space

References