The goals of treatment for Schilder’s disease are to relieve symptoms and maintain function as long as possible. Physiotherapy, occupational therapy and nutritional support in the later stages are commonly employed. Corticosteroids have been shown to be effective in some patients. Additional treatment could include IVIG, rituximab and/or immunosuppressive drugs.
Prognosis of Schilder’s disease is variable. The clinical course is usually progressive, but significant improvement and remissions have also been described. Survival has been reported to be less than ten years after the onset. Patients with a good response to corticosteroids and those with smaller lesions may have a better prognosis. If the course is progressive, larger and larger patches of demyelination occur, interfering with motor movement, speech, personality, hearing and vision. Ultimately, the vital functions of respiration, heart rate and blood pressure are affected, leading to the individual’s death.
Reviewed by Elias Sotirchos, MD November 2019