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afya
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> 85% are relapsing remitting of which 15% are mild so called benign and 2/3 eventually become secondary progressive 15% are primary progressive Mx aims to reduce frequency and severity of relapses (so only works with relapsing remitting and needs early Rx) - complex 2nday care to limit disability and relieve Sx Symptom relief - Spasticity - baclofen and gabapentin - either/or/both, dantrolene or tizanidine 2nd line and benzodiazepines 3rd line - esp good for night time spasms altered sensation/seizures - anticonvulsants cerebellar tremor - clonazepam or isoniazid with pyridoxine fatigue - amantadine - helps 40% pts depression - amitryptiline Urinary frequency/incontinence, bowels and impotence - usual remedies
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