ABSTRACT
Patients with multiple sclerosis (MS) characteristically experience periodic attacks and remissions, at least in the early years of the disease. Most often, attacks are mild and spontaneous recovery is the rule. Steroids shorten the duration of the attacks but are not proven to influence the ultimate outcome.1,2 However, occasionally attacks of MS may be devastating and patients may not recover from them. Furthermore, other related idiopathic inflammatory demyelinating diseases (IIDDs), such as acute transverse myelitis, acute disseminated encephalomyelitis and neuromyelitis optica,3 often cause severe neurological disability, and the outcome is often poor. Marburg’s variant of MS4 is widely believed to be a fatal disorder (based on small case series). In situations where patients experience severe, perhaps life-threatening disability, no treatments have been proven to rescue patients from disability when steroids are ineffective.
