Multiple Sclerosis: Its Etiology, Pathogenesis, and Therapeutics With Emphasis on the Controversial Use of HBO

Gottlieb SF, Neubauer RA. Multiple sclerosis: its etiology, pathogenesis, and therapeutics with emphasis on the controversial use of HBO. J Hyper Med 1988; 3(3):143-164-A review of the current hypotheses in the etiology and pathogenesis of multiple sclerosis (MS) is presented together with the implications for therapy. A new hypothesis as to etiology is presented. Special emphasis is placed on the controversy surrounding the use of hyperbaric oxygen in a critical analysis of the published double-blind studies and related discussions. Emphasis placed on the predominant infective and autoimmune hypotheses cannot be supported, either from the pathology of the disease or by the response to treatment. It is concluded that the evidence of beneficial effects of hyperbaric oxygen therapy, despite the use of patients with advanced disease in trials, is very impressive, especially in chronic progressive disease. It is also concluded that there is need for further research and that such studies should examine the effects of hyperbaric oxygenation alone, and in combination with other therapeutic agents, in individual patients with the methods of real-time investigation now available. Meanwhile, based on comparative efficacy and safety, hyperbaric oxygenation is recommended for treating early stages of MS, especially for treating cerebellar and bowel-bladder disorders.