Multiple Sclerosis

Alternative and complementary therapies in multiple sclerosis.

Most MS patients use unconventional therapies, usually as complementary measures in addition to the conventional treatment. Only a few adequate clinical trials exist in this field. By definition, the efficacy of these therapies is unproven. Moreover, the possible risks are also largely unknown. Some therapies rely on rational pathophysiological considerations, other must be regarded as potentially harmful. The influence of diet on MS is unproven. Possibly, unsaturated fatty acids are beneficial. However, a few randomized trials yielded inconclusive results. Long-term supplementation of Vitamin D is associated with a decreased MS incidence. There is, however, insufficient evidence for an influence of Vitamin D on the course of the disease. Because of the high prevalence of osteoporosis in MS patients, prophylaxis with Vitamin D and Calcium is widely accepted. The effects of various minerals, selenium, antioxidant compounds, fish oil or vitamins remain speculative.

Hyperbaric oxygen therapy for multiple sclerosis.

Abstract: Multiple Sclerosis (MS) is a chronic, recurrent and progressive illness with no cure. On the basis of speculative pathophysiology, it has been suggested that Hyperbaric Oxygen Therapy (HBOT) may slow or reverse the progress of the disease. The object of this...

Mini-forum on multiple sclerosis (MS) and hyperbaric oxygen therapy.

MS is a disease in which manifestations wax and wane, and which is not immediately fatal (and sometimes not at all), and proving or disproving the therapeutic worth of an intervention can be frustratingly difficult. The response of multiple sclerosis (MS) to hyperbaric oxygen (HBO2) therapy falls into this category. The letter of James and Perrins [see page 236] takes the pro- HBO2 point of view in direct opposition to a recent editorial by Dr. Jacoby in the Journal (1). The dispute has unaccountably become both polarized and emotional, reminiscent of other medical debates, which were finally resolved by carefully designed outcome studies. If, on the basis of current evidence, HBO2 therapy for MS can be neither accepted nor dismissed out of hand, there are two time-tested ways of approaching the truth. One is to perform comprehensive reviews of all available data, which has been done by Bennett and Heard (2). Although the authors failed to find an effect of HBO2, they left open the possibility that HBO2 might be effective for some subsets of patients, perhaps using prolonged treatment.

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