Brainstem Involvement and advanced MS

  I posed the following question earlier, but it somehow got lost in the shuffle and was never answered. I understand, of course, how difficult it must be for you to keep track of all these questions without inadvertently missing one or two. My question was as follows:

  Hello. I am 41 and was diagnosed with MS when 19. It has been of the RR variety.
  Following minor surgery with general anesthesia a month ago, I immediately
  experienced a severe exacerbation leaving me almost unable to walk. I was
  given 5 days of IV Solumedrol followed by a month of tapering Prednisone, but
  there has been no improvement in my symptoms; a few, in fact, have worsened.
  Yesterday I was read a copy of my neuro's report to my PCP, and now I am
  terribly frightened.
  The report says that I suffer from spastic paraparesis, right-sided central
  facial paralysis, pseudo-bulbar speech and nystagmus as a result of brainstem
  involvement. I also have some trouble with swallowing and frequent hiccoughs,
  for some strange reason. Prior to this exacerbation, I've never had brainstem
  involvement before, but I've heard and read that brainstem involvement
  constitutes advanced MS, that it doesn't respond well to treatment, and that
  it tends to indicate that the individual has entered into a progressive form
  of MS that isn't likely to reverse itself. Is this true in your opinion? Is
  it possible that this may all clear up and I'll go back to where I was? Is
  it also true that my breathing may be affected and that I may require a
  respirator?
  Please don't tell me that I need to see my neuro and ask him these questions,
  for he has a tendency to hide things from me, and I need to know the answers
  to these questions for my own peace of mind. Thank you for listening.
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Thanks for the question. As you know MS is an unpredictable disease. Patients can present with demyelinating lesions in an part of the nervous system. The brainstem contains may areas important in boby function and control that abnormalities in this area can produce very serious neuologic problems. I do not think that having a lesion in this area defines a change in the status of your MS  to a more progressive form. Patients with brainstem problems can and often do have recovery just like any other lesion. Abnormalities in this area can affect your breathing. It is important to treat this condition as you would any exacerbation and hope for the best. Good luck
This information is provided for general medical eduaction purposes. Please consult your doctor regarding diagnostic and treatment options.

[jonilyn]

A related discussion, Can M.S. cause restrictive pulmonary disease? was started.