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Neurology (Expert Forum)
MS treatment
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MS treatment
by metabolicwreck, Feb 25, 2006 12:00AM
I was recently diagnosed with MS, based on diagnostic tests, not clinical symptoms. Positive MRI of cervical spine, positive MRI of brain, elevated ANA titers, CSF with oligoclonal bands and IgG.
I suspect that I have primary progressive MS, based on my age (51) and the fact that I have had no known exacerbations. I do have some symptoms that can be attributed to MS, now that I am aware of it.
From my reading, it appears that there is no prophylactic treatment for PPMS, is that correct? I am supposed to meet with my neurologist to discuss treatment options, but I'm not sure there are any.
Also, is MS genetically linked? Should my adult daughter watch for symptioms?
Thank you for any information you can provide.
I suspect that I have primary progressive MS, based on my age (51) and the fact that I have had no known exacerbations. I do have some symptoms that can be attributed to MS, now that I am aware of it.
From my reading, it appears that there is no prophylactic treatment for PPMS, is that correct? I am supposed to meet with my neurologist to discuss treatment options, but I'm not sure there are any.
Also, is MS genetically linked? Should my adult daughter watch for symptioms?
Thank you for any information you can provide.
Doctor's Answer
by CCF-Neuro-M.D.-PW, Mar 02, 2006 12:00AM
If you had no clinical symptoms, its unclear as to why those tests were ordered?
Relapsing MS and progressive MS can be differentiated by the clinical history - I cannot tell which one you might have, without knowing what your symptoms are and their pattern over time - a neurologist specializing in MS would be the best person to tell you this as the treatments do differ. Some doctors actually beleive that they are two seperate diseases (ie with different causes and mechanisms) but this is controversial.
Beta interferons and glatiramer acetate have been found to reduce clinical attacks and MRI progression in relapsing MS but not in progressive MS. There are some treamtents to slow the disease process in progressive MS such as pulse steroids. The treatment is best planned by a specialist in MS. As you can see, the correct diagnosis is critical as the drugs are expensive and have side effects. Progressive MS tends to have a relative paucity of MRI changes compared to relapsing MS, so the MRI can also give clues to the diagnosis. Attacks in relapsing MS do not have to be clinical - even when asymptomatic, new MRI lesions can come and go.
We do not know the cause for MS. It is slightly more common in twin studies, so is though to have somewhat of a genetic predisposition, but probably many different genes are inloved in this (as opposed to one gene such as in diseases like muscular dystrophy). Therefore there is usually no cause for concern in family members especially if only one family member is affected.
Good luck
Relapsing MS and progressive MS can be differentiated by the clinical history - I cannot tell which one you might have, without knowing what your symptoms are and their pattern over time - a neurologist specializing in MS would be the best person to tell you this as the treatments do differ. Some doctors actually beleive that they are two seperate diseases (ie with different causes and mechanisms) but this is controversial.
Beta interferons and glatiramer acetate have been found to reduce clinical attacks and MRI progression in relapsing MS but not in progressive MS. There are some treamtents to slow the disease process in progressive MS such as pulse steroids. The treatment is best planned by a specialist in MS. As you can see, the correct diagnosis is critical as the drugs are expensive and have side effects. Progressive MS tends to have a relative paucity of MRI changes compared to relapsing MS, so the MRI can also give clues to the diagnosis. Attacks in relapsing MS do not have to be clinical - even when asymptomatic, new MRI lesions can come and go.
We do not know the cause for MS. It is slightly more common in twin studies, so is though to have somewhat of a genetic predisposition, but probably many different genes are inloved in this (as opposed to one gene such as in diseases like muscular dystrophy). Therefore there is usually no cause for concern in family members especially if only one family member is affected.
Good luck
Pika.
Vega: I think you missed part of this. The neck pain quite possibly has nothing to do with MS. The MRI finding was confirmed with a lumbar puncture. And, I do have other symptoms, annoying enough that I had mentioned them to my GYN and my neurologist, but until now they weren't put together. So, I feel fairly confident of the diagnosis. And, my neurologist is conferring with an MS specialist.
Email me privately and we can continue the discussion.
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