Management of Multiple Sclerosis Flares

Diagnostic Imaging

• MRI follow-up should be conducted within 3-12 months depending on the patient's disease characteristics and treatment, including T2-weighted and FLAIR sequences to detect new or enlarging lesions, and T1-weighted sequences with gadolinium enhancement to detect active inflammation 1

Treatment Considerations for Special Populations

• For patients with severe, life-threatening presentations, more frequent monitoring may be required 1
• For patients with incomplete recovery after initial corticosteroid treatment, evaluate for disease-modifying therapy adjustment if on treatment 2

Long-term Management Following Flare

• Assess need for initiation or modification of disease-modifying therapy (DMT) 2
• For patients with highly active disease despite DMT, consider escalation to high-efficacy DMT 2
• In cases of treatment-refractory disease with frequent relapses, autologous hematopoietic stem cell transplantation (AHSCT) may be considered in appropriate candidates 2, 3

Rehabilitation During Recovery

• Implement rehabilitation strategies as soon as possible after the acute phase of treatment, focusing on optimizing physical, social, and emotional functioning during recovery 4