The long-term management of MS is directed at slowing the progression of the disease and providing symptomatic relief during exacerbations. In order to modify the disease and its exacerbations, immunomodulation with adrenocorticotropic hormone (ACTH), corticosteroids, interferon, and other immunosuppressive drugs has been studied. High-dose methylprednisolone therapy may shorten the duration of exacerbations, especially early in the disease course. Several weeks of oral prednisone therapy can be added to the initial IV steroid therapy, but the effect on the disease is unclear. Alternatively, ACTH can be given. Diets high in fruits, vegetables, and grains may protect against the development of MS symptoms.13 Intravenous immunoglobulins are probably not effective in the treatment of MS.14
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