How to manage Multiple Sclerosis (MS) symptoms prior to Magnetic Resonance Imaging (MRI)?

From the Guidelines

To treat MS symptoms prior to an MRI, focus on managing specific symptoms with appropriate medications, as these will not affect MRI results and can provide relief while awaiting diagnosis. For fatigue, consider amantadine (100 mg once or twice daily) or modafinil (200 mg daily) 1. For pain and spasticity, baclofen (5-25 mg three times daily) or tizanidine (2-4 mg as needed) may help. Gabapentin (300-1200 mg three times daily) can address neuropathic pain. For bladder issues, oxybutynin (5 mg twice daily) might be beneficial. Over-the-counter anti-inflammatories like ibuprofen (400-800 mg every 6-8 hours) can help with pain and inflammation. Some key points to consider when treating MS symptoms prior to an MRI include:

• Staying well-hydrated and getting adequate rest before the MRI
• Consulting with a healthcare provider before starting any medication, as they can tailor recommendations to specific symptoms and medical history
• Understanding that definitive MS treatment typically begins after diagnosis confirmation through MRI and other tests 1. It's essential to prioritize managing symptoms to improve quality of life while awaiting diagnosis, and these symptomatic treatments can provide relief without affecting MRI results.

From the Research

Treatment of MS Symptoms Prior to MRI

To manage MS symptoms before an MRI, various treatment options are available, including:

• Pharmacological approaches:
  • Anticonvulsants such as carbamazepine, gabapentin, and lamotrigine for painful paroxysmal symptoms and chronic pain syndromes 2, 3, 4
  • Antispastic agents like baclofen or tizanidine for spasticity-related pain 2, 5, 6
  • Tricyclic antidepressants for chronic pain syndromes 2
  • Cannabinoids, whose role in pain treatment is still being determined 2, 3
• Non-pharmacological approaches:
  • Physiotherapy and physical therapy to improve mobility and reduce spasticity-related pain 2, 5, 6
  • Neurosurgical methods for trigeminal neuralgia 3
  • Cognitive behavioral therapy, acceptance and commitment therapy, and mindfulness-based stress reduction for neuropathic pain management 3

Management of Specific MS Symptoms

For specific symptoms, the following treatments can be considered:

• Painful paroxysmal symptoms: carbamazepine, lamotrigine, gabapentin, or oxcarbazepine 2
• Chronic pain syndromes: tricyclic antidepressants, gabapentin, or lamotrigine 2
• Spasticity: baclofen, tizanidine, or gabapentin 2, 5, 6
• Neuropathic pain: cannabinoids, muscle relaxants, anticonvulsants, antidepressants, or opioids 3