Multiple sclerosis oral therapy

Martinez-Cacenes EM (1998) Amelioration of flu-like symptoms at the onset of interferon beta-lb therapy in multiple sclerosis by low dose oral steroids is related to a decrease in interleukin-6 mduc-tion. Arm Neurol 44(4) 682-685. 

Gran, B. N. Tabibzadeh A. Martin E.S. Ventura J.H. Ware G.-X. Zhang J.L. Parr A.R. Kennedy A. M. Rostami. The protease inhibitor, Bowman-Birk Inhibitor, suppresses experimental autoimmune encephalomyelitis a potential oral therapy for multiple sclerosis. Mult. Scler. 2006, 12, 688. 

Baclofen is approved for the treatment of reversible spasticity and its associated pain in a variety of nemo-logical conditions of both spinal cord and cerebral origin, such as multiple sclerosis, amyotrophic lateral sclerosis, and spinal cord injmies. It can be administered orally or intrathecally. Intrathecal baclofen is used to manage chronic intractable spasticity in patients who are unresponsive, or who have intolerable side effects, to a minimum 6 week course of oral therapy. There must be a positive response to a test dose of intrathecal baclofen prior to implantation of a continuous infusion pump. The safety and efficacy of baclofen have not been established in the pediatric population. 

An individual case of a 45-year-old female with multiple sclerosis who presented to the emergency department with symptomatic sinus bradycardia after the completion of a high-dose oral prednisone therapy for multiple sclerosis-related optic neuritis has been reported [6 ]. She received l,250mg of oral prednisone per day for 5days in total and finished her course 3 days before her emergency department presentation. The patient s pulse rate and symptoms resolved on their own a week after the completion of the high-dose prednisone. There are very few adult cases that report this side effect and all of them have been with intravenous methylprednisolone. This is the first case report of a patient with symptomatic bradycardia from an oral CS regimen. 

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