What is the treatment for acute MS exacerbations?

• A. Antibiotics
• B. Antidepressants
• C. Plasma exchange
• D. High-dose intravenous steroids

Answer: (D)

Acute MS exacerbations are flare-ups of new or worsened neurologic deficits due to active inflammation. The main goal in this moment is to speed recovery of function, not to alter the long-term course of the disease. High-dose intravenous corticosteroids provide rapid anti-inflammatory effects that reduce edema around demyelinating lesions and accelerate regain of neurologic function. A typical approach is methylprednisolone given intravenously at about 1 gram daily for 3 to 5 days, sometimes followed by a taper with oral steroids.

Plasma exchange is reserved for severe relapses that do not respond to steroids or when steroids are unsuitable. Antibiotics and antidepressants don’t address the inflammatory relapse itself.