Plasma exchange is a procedure in which the blood of a patient is removed from his/her body by a negative pressure, plasma from this blood (Plasma is the clear solution in the blood which contains the auto antibodies which might be the cause of multiple sclerosis) is removed, and fresh plasma is mixed with the red blood cell of the patient and this is re-infused into the body of the patient again. In patient with severe multiple sclerosis repeated plasma exchanges have been associated with a significant clinical improvement. Dr Sumit Singh has innovated the plasma exchange protocols in India for patients with multiple sclerosis. The results of plasma exchange do not come in a single day. In single admission plasma exchange is performed every alternate day on the patient for five cycles. At least four or five such five day cycles are done in the patients over a period of two years. As there is no treatment available at present for patients with PPMS or SPMS, Plasma exchange is a viable treatment option.

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2) Baclofen pump

Patients with severe multiple sclerosis sometimes have exceptionally severe spasticity which is unresponsive to routine medical treatments. These patients sometimes might benefit from a baclofen pump insertion. Baclofen pump is an automatic device which pumps a metered quantity of baclofen (an antispasticity drug) into the spinal canal – directly around the spinal cord. The benefit of this pump is that it delivers very low quantity of the drug to the body with a higher impact on the patients spasticity than the oral drug, and is totally devoid of the side effects of oral medication. Once in position the pump safely works for about five to six years. The amount of drug delivered by the pump can be monitored by a radiofrequency programmer from outside the body. The pumps require a refill every three to four months.