| | No infection × new neuro deficit >24h → Methylprednisolone 1g IV x 3-5d | |--------------|-------------------------------------------------------------| | JCV+ on Natalizumab | Switch to Ocrelizumab or Ofatumumab if index >1.5 | | First sign of cognitive change | Refer for neuropsych eval, consider switching to high-efficacy DMT | | Fatigue refractory to modafinil | Check B12, Vit D, TSH, Hb. Consider occupational therapy. | | PML suspect | New focal deficit + Natalizumab + JC+ → STAT MRI brain with contrast |
This guide is intended for looking to specialize in multiple sclerosis care or understand the role. ms praxis