The Progressive MS Clinic at Ohio State will identify and treat your progressive MS early and restore your function to help avoid progression.

Progressive multiple sclerosis (MS) is a complex and unpredictable condition, requiring the attention of many specialists. At the Ohio State Progressive MS Clinic, a variety of strategies are available to alleviate many symptoms, improve function and compensate for disabilities.

As a patient, you will receive a multidisciplinary care plan designed to address your physical and emotional needs. Your care plan may include neurologists, physical therapists, occupational therapists, speech-language pathologists, neurovestibular specialists, neuropsychologists, urologists, pharmacists, nurses, counselors and social workers. Our MS neurological rehabilitation team offers individualized rehabilitation plans to help each patient reach their maximum functional ability.

The Progressive MS Clinic at Ohio State will identify and treat your progressive MS early and promptly, while restoring your function in innovative new ways to help avoid progression.

Symptoms of multiple sclerosis

Multiple sclerosis is a nervous system disease that affects your brain and spinal cord. It damages the myelin sheath, the material that surrounds and protects your nerve cells. This damage slows down or blocks messages between your brain and your body, leading to the symptoms of MS. They can include:

  • Visual problems
  • Spasticity (painful and disabling stiffness)
  • Muscle weakness
  • Trouble with coordination and balance
  • Sensations such as numbness, prickling or "pins and needles"
  • Thinking and memory problems
  • Fatigue

No one knows what causes MS. It may be an autoimmune disease, which happens when your immune system attacks healthy cells in your body by mistake. Multiple sclerosis affects women more than men. It often begins between the ages of 20 and 40. Usually, the disease is mild, but some people lose the ability to write, speak or walk.

Source: NIH: National Institute of Neurological Disorders and Stroke

There are four main types of multiple sclerosis:

There are four main types of multiple sclerosis:

Relapsing-remitting MS

Relapsing-remitting MS affects about 85 percent of people with MS. One or more symptoms described above flare up (this is the relapse) and then improve somewhat or completely (remit). During a relapse, new symptoms appear or old symptoms worsen. During remissions, the disease does not seem to progress. The duration of relapses and remissions varies from person to person.

Secondary-progressive MS

Secondary-progressive MS is a second stage of MS that follows at some point for most people with relapsing-remitting MS. In this phase, MS symptoms progress more steadily (not necessarily more quickly). Along with steady decline, it is possible to experience acute relapses with new or worsening symptoms.

Primary-progressive MS

Primary-progressive MS affects about 10 percent of people with MS and produces symptoms that worsen progressively over time. There are no noticeable relapses or remissions; however, the rate of declining function varies and may even hold steady at times.

Progressive-relapsing MS

Progressive-relapsing MS also worsens progressively but causes sudden worsening of symptoms in addition to the steady progression of symptoms. A person with this type of MS may or may not have some recovery from an attack. There is no remission.

Diagnosing multiple sclerosis

Because a number of conditions have symptoms similar to MS, an accurate diagnosis is critical in creating an effective care plan. Ohio State’s MS physicians spend a lot of time examining you and talking with you about your symptoms. They take you through a walking test and a hand coordination test to assess function in your limbs.

In addition, our neurologists offer you diagnostic tests, all available within our Multiple Sclerosis Center:

  • Lab tests, such as blood and urine tests, to check for vitamin deficiencies, infections and autoimmune markers
  • Magnetic resonance imaging (MRI) to detect lesions on the spinal cord or in brain tissue. Ohio State houses one of only a few 3 Tesla MRI scanners in the state. This high-powered machine produces clearer, more precise images to aid in accurate diagnosis
  • Lumbar puncture (spinal tap) to check spinal fluid for further evidence of MS
  • Evoked potential test to measure the speed at which the brain tracks electrical signals in response to various stimuli to legs and arms
  • Optical coherence tomography to monitor progression of MS through the eye. Ohio State recently acquired this new imaging tool that allows physicians to look for thinning of the retina (the lining at the back of the eye), which has been associated with progressing MS

Managing multiple sclerosis

Although there is no cure for MS, Ohio State’s Multiple Sclerosis Center is making groundbreaking changes to improve the lives of people who have MS. We provide education and information about treatment options to help you and your family make informed decisions about your care.

Our physicians design a treatment plan with you to help you achieve your goal.

Therapies and treatments include:

Disease-modifying therapies

Disease-modifying therapies to stop or slow the progression of the disease. Our MS specialists prescribe oral, injectable and intravenous medications.

Infusion treatments to relieve acute symptoms

Infusion treatments to relieve acute symptoms such as fatigue, balance problems or bladder problems during an MS relapse or flare up. Some therapies administered in our Infusion Center are:

  • Intravenous immunoglobulin therapy (IVIG), made from donated blood products, to boost the immune system, improve function and possibly delay onset of another flare-up of symptoms
  • Intravenous steroids to treat inflammation
  • Plasmapheresis (plasma exchange) in which blood is removed from your body, and blood cells and plasma are separated. Your blood cells are then mixed with a new solution and returned to your body. This option is used for sudden, severe MS relapses that don’t respond to steroids

Supplemental and alternative therapies

Supplemental and alternative therapies to help with strength, balance, communication and quality of life. Services include occupational therapy, physical therapy, speech therapy, relaxation techniques, massage, cognitive therapy and counseling.

Medications for managing symptoms of MS

Medications for managing symptoms of MS, including spasticity (severe and often painful muscle stiffness), urinary tract issues, fatigue and balance problems. Anti-spasticity medications include baclofen, which can be taken orally or delivered to your spinal cord through a pump implanted under the skin of the abdomen. Botox® injections also can relieve spasticity.

Progressive MS

It is widely recognized that the best approach to stop progression in MS is to identify people at risk of having progression early. People are more at-risk for progressive MS if:

  • They have an increased number of lesions
  • They have spinal cord damage by lesions
  • They are at a young age at diagnosis
  • They have a lack of response to traditional MS medications
  • MS medications fail to respond
  • They have a lack or delay to access to care and treatment
  • They are a smoker
People experience the symptoms of MS differently. However, secondary-progressive and primary-progressive MS produce symptoms that gradually worsen over time. Therefore the goal is to identify patients with progression of disability and avoid the onset of irreversible damage in at-risk individuals.

Our multidisciplinary approach for multiple sclerosis

Our Multiple Sclerosis Center serves our Neurological Institute, which brings together physicians, scientists, nurses and therapists to develop new technologies and better treatments for people with complex neurological conditions

Ohio State has an entire team of professionals dedicated to diagnosing and managing MS, all within our Multiple Sclerosis Center:

  • Five neurologists with fellowship training in MS
  • Nurse practitioner
  • Infusion (IV) nurses
  • Social worker
  • Urologist
  • Psychologist
  • Psychiatrist
  • Neuropsychologist
  • Physical therapists

Disease-modifying therapies

Disease-modifying therapies, which slow down the disease. Ohio State investigators are devoting significant energy to finding better, newer or better-tolerated medications to halt or significantly slow the progression of the disease and its symptoms.

Performing stem cell transplants in people with rapidly progressing MS is one example of halting the disease. A small sample of patients at Ohio State who have undertaken this rigorous treatment have gone from being wheelchair-bound to walking unassisted during a three-year treatment plan.

Relapse management

Relapse management, which seeks to hasten recovery from acute MS episodes or minimize side effects of medications given during relapse. The previous decade saw major advances in this arena, with direct contributions from Ohio State research.

Improving diagnosis

Improving diagnosis of the disease and assessment of how well people are responding to treatment.

Symptomatic therapy

Symptomatic therapy to help people with MS improve the quality of their lives right now with new medications, new combinations of medications or new applications.

As a participant in the National Institutes of Health’s (NIH) NeuroNEXT: Network for Excellence in Neuroscience Clinical Trials, Ohio State’s research team collaborates with an elite group of medical centers nationwide on the rapid development and implementation of protocols in neurological disorders.

Patients who receive care at Ohio State’s Multiple Sclerosis Center can enroll in dozens of clinical trials, including:

  • Industry-sponsored trials, some for which Ohio State is a national leader in enrollment
  • Government-sponsored trials, including important NIH and National Multiple Sclerosis Society trials of new medications or medication combinations
  • Ohio State-initiated, -designed and -funded trials in areas where Ohio State investigators have specialized interest, such as spasticity (severe stiffening of the muscles)

Ohio State played a significant role in developing a baclofen therapy (anti-spasticity medication) pump implanted in the abdomen of a person with MS to deliver baclofen through a catheter to the spinal cord to relieve pain and relax the legs and arms. This therapy is among the most effective approaches available to treat spasticity.

Our Multiple Sclerosis Providers