What is the first-line treatment for an acute MS exacerbation?

What is the first-line treatment for an acute MS exacerbation?

• A. IV high-dose corticosteroids
• B. Oral prednisone only
• C. Plasmapheresis
• D. Interferon therapy

Answer: (A)

Acute MS relapses are driven by active CNS inflammation, so the goal is to rapidly dampen that inflammatory process to speed recovery. The most effective way to do this is high-dose intravenous corticosteroids. A typical regimen is intravenous methylprednisolone at 1 gram daily for about 3 to 5 days. This approach provides a strong and fast anti-inflammatory effect within the CNS, which often leads to quicker improvement of neurologic symptoms during the flare. Oral prednisone can be used if IV therapy isn’t available, but the intravenous route is preferred because it tends to produce a faster and more reliable response. If symptoms fail to improve with steroids, plasmapheresis is considered for refractory relapses, especially severe cases. Interferon and other disease-modifying therapies are aimed at reducing the frequency and severity of future attacks rather than treating the current acute relapse.

Acute MS relapses are driven by active CNS inflammation, so the goal is to rapidly dampen that inflammatory process to speed recovery. The most effective way to do this is high-dose intravenous corticosteroids. A typical regimen is intravenous methylprednisolone at 1 gram daily for about 3 to 5 days. This approach provides a strong and fast anti-inflammatory effect within the CNS, which often leads to quicker improvement of neurologic symptoms during the flare.

Oral prednisone can be used if IV therapy isn’t available, but the intravenous route is preferred because it tends to produce a faster and more reliable response. If symptoms fail to improve with steroids, plasmapheresis is considered for refractory relapses, especially severe cases. Interferon and other disease-modifying therapies are aimed at reducing the frequency and severity of future attacks rather than treating the current acute relapse.