Tremor

Betablockers, primidone and in severe cases thalamic ablation or stimulation. ACUTE RELAPSE

Methylprednisolone 1 gram/day i.v. for 3 days followed by a reducing dose of oral prednisolone will speed recovery.

If used in an initial attack of optic neuritis it will reduce the number of relapses within the next 2 years.

MODIFY NATURAL HISTORY

No benefit from long-term steroids. Cyclophosphamide, azathioprine, total lymphoid irradiation and plasma exchange - anecdotal evidence of benefit in aggressive illness. Low dose methotrexate of marginal value in primary and secondary progressive disease. Interferons (Beta IB and 1A)

Possibly by down-regulation of antigen recognition will in the short-term reduce relapse rates but have no or little effect on disability.

Similar results have been obtained from Copolymer I (a synthetic polypeptide). The interferons and copolymer I show a reduction in the rate of MRI change.

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