Multiple Sclerosis (MS)

cmsc logoPatients concerned with a diagnosis of MS often experience a number of emotions. In addition to feeling anxious and sometimes confused, people often wonder how a diagnosis of MS will affect their relationships, work, and everyday life.  With many decisions to make, including which treatment course is best for you, it is important to build a comfortable working relationship with your clinical team.

At Integrated Neurology Services, PLLC,  we follow the standards of NEDA, or No Evidence of Disease Activity. What this means is we define success of a therapy as the absence of new or enlarging lesions on MRI in addition to the absence of worsening disability as defined by the EDSS (Expanded Disability Status Scale). This approach leads to the possibility of earlier detection as well as a more accurate prognosis and is now viewed as the benchmark by which all Disease Modifying Therapy (DMT) is measured .

Why should you choose Integrated Neurology Services as your MS specialists?

  • We view MS as a controllable disease.
  • Academic level care in service. Dr. Fishman, a board certified Neurologist,  is well known for his skill, experience, and success in treating MS.  He has been at the forefront of MS treatment since 2005. The Infusion suites at Integrated Neurology Services were the first establishment to infuse Tysabri in the Metro D.C. area outside of a clinical trial.
  • Clinicians from Georgetown University Medical Center, Johns Hopkins Hospital, and the University of Virginia Health System frequently refer patients to Dr. Fishman for his expertise.
  • Our MS Center is a certified chapter of the Consortium of Multiple Sclerosis Centers
  • We have three convenient locations in the Metro DC area: Alexandria, Falls Church, and Lorton, Virginia.
  • Short wait times for new patient appointments. At Integrated Neurology Services, we aim to get you an appointment with one of our highly qualified clinicians in as short a time as possible.

What is Multiple Sclerosis (MS)?

MS is a disease of the central nervous system made up of the brain, spinal cord and optic nerves. Typically, the nerve pathways of the central nervous system are protected by a covering called the myelin sheath. This sheath acts as an insulator for the nerves and helps to increase the rate of conduction. In patients with MS, the myelin sheath is attacked by their own immune system. This leaves the nerves exposed and prone to further damage resulting in a disruption of flow of information traveling from the brain to the rest of the body.

Depending on the extent of the damage, symptoms of MS can include any combination of the following:

  • Numbness
  • Tingling
  • Muscle stiffness
  • Weakness
  • Balance issues
  • Vision issues
  • Fatigue
  • Bowel and/or bladder incontinence
  • Sexual difficulties

Origins of MS Treatment

Many doctors think of MS as a progressive disease with no effective treatment. It wasn’t until the advent of MRI’s 1980s that let us see the brain closely enough to develop effective therapies. Researchers tested different treatment regimens on patients with little success until the 1990s.

In 1993, the first treatment, Betaseron®, became available. Until 2007, it remained the only treatment option. Since that time, however, other treatments have been developed with additional promising drugs are on the horizon. Since that time we now have at our disposal:

3 oral medications:

2 infusible medications:

And 5 injectable medications:

At Integrated Neurology Services, we offer all treatment options in an attempt to manage most, if not all, of your overall symptoms. Our goal when developing a treatment strategy for our patients with MS is to manage patients’ symptoms while also attempting to stop any worsening progression of MS. We will tailor your treatment options to best suit your needs. While it is important to initiate treatments targeted towards the Multiple Sclerosis, it is also crucial to treat the patient as a whole.

Current MS Treatment Options

Disease Modifying Treatment (DMT)

For patients with relapsing-remitting MS, disease modifying treatment (DMT) can decrease the frequency and severity of relapses. DMT serves as the cornerstone for the management of MS. Currently, ten drugs have been approved for this purpose:


Medication Type Examples Method of Administration
Injectables Betaseron®
Patients administer injectable medications themselves in the form of a shot under the skin or in a muscle. Depending on the medication type, doses may be given daily or weekly.
Intravenous Infusion Novantrone®
These drugs are given at the clinic, often monthly or quarterly. (Learn more about our infusion suite.)
Oral Medications Gilenya®
These medications are pills taken by mouth once or twice a day.


Recommended Websites:

Virtual MS Center

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