CIS

[Emykins]

In February my 24 year old girlfriend was hospitalized for optic neuritis while on vacation out of our state. Other than some bladder problems she blamed on heredity (and could still be hereditary?), this was the first symptom she's had. They treated with IV steroids and did the diagnostics for MS. Her vision came back completely by the 6th day and she came back home. The follow up appointment she had with an MS clinic (2 hours away) was in May, so she transferred her appointment to a local neurologist who saw her two weeks ago. He diagnosed her with CIS, which in his own words is essentially pre-MS. I know from reading the results the hospital faxed her that she did have brain lesions (and a declining lymphocyte count for each day in the hospital, and a low IgA level). With all the reading I've done, it seems like she should have been put on medicine to stave off another attack. Unfortunately the reading I've done seems to have been all technical, so I wanted to ask people who have the experience of the disease, not med school. Is it normal to have been diagnosed with CIS but not be given a treatment plan? She does go back for some more of the same tests in his office in a week or so though, so I'm hoping for a real result then (maybe just territorial over testing?).
Also, one of my professors told me that cold weather brings on flare ups. Is this true? Does anybody's work-related stress aggravate symptoms?
Thanks,
Emy

[sllowe]

It would be good to have this info for the Drs .

Also want add on a bit, that all the CRAB meds are available to treat CIS.  It's just not all Drs take this approach.

As soon as I get a chance, I'll pop in some links to the specif info....

[Lulu54]

I just bumped the post I did last week on Copaxone and the approval for its use in CIS - you may want to follow the link and print this for the doctor.

My best,
Lulu

[PastorDan]

Welcome to our neighborhood, Emykins.

I'm undiagnosed myself, and my medical knowledge is largely all by osmosis, but here's what I've learned.  CIS could indeed be thought of as pre-MS.  In order to call it "MS, you have to have multiple symptoms (for instance, ON or some bladder issues) and you have to have multiple occurrences (such as in February and later this year, or at some time in the past if it can be documented that there was a previous occurrence of MS-like symptoms).  See the Health Page on the McDonald Criteria (Health Pages are accessed through the link to the upper right of this page).

(Quix, did I get that part right?)

From my limited viewpoint, I'd say only recently has it been "officially" pronounced that disease-modifying drugs (we call them DMDs around here) should be started as soon as possible in cases of CIS, where MS sounds very likely but has yet to be confirmed.  Perhaps the local neurologist isn't aware of this, and perhaps he has some other reason for not starting such treatment in your girlfriend's case.

As for cold weather bringing on flare ups, I understand that it can, but that hot weather is more likely to cause problems than cold.  Somewhere else in those health pages, it probably talks about heat sensitivity issues.

Still remembering that I am undiagnosed, all I can say is that my work-related stress aggravates all sorts of things, but I've not noticed an absolute one-to-one type connection between work stress (I have multiple jobs, wearing multiple "hats"), and any particular symptom(s).

I hope and pray that your girlfriend suffers no more symptoms, but if so, you can be sure that this forum is a haven of caring, supportive, and usually informed people, who are happy to help however we're able.

[sllowe]

Welcome Emykins,

I'm so glad you found us here and that you are doing some research for your girlfriend.  

You have learned so very much alreay it seems.  Yes, the studies do show that treating CIS reduces the risk of definite MS.  Here is a link for you where we discussed the most recent study relating to ON and MS.  I think you will find this very informative.

http://www.medhelp.org/posts/Multiple-Sclerosis/MULTIPLE-SCLEROSIS-RISK-AFTER-OPTIC-NEURITIS/show/664930

Also, some Drs take a "wait and see" approach.  So, no it's not uncommon, but the data does not support this approach. Sounds to me that the Dr. knew what he or she was looking at - but just needs a nudge to prescribe treatment with a DMD.  At 24 - she's young, and may not ever have another attack or progression - you just never know.

How is she feeling now? She symptomatic? Did they treat her with steroids at any point?  Oh, and a big YES to stress and aggrevation and symptoms.  My 1st attack was during a high stress, busy time.  Though it was my typical means of operating and I've always loved to work this way - the attack stopped me dead in my tracks.

HOpe to see you around - I think you will like it here.
Thanks for joining us!