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ms or not

10 days ago my 28 years old brother got left side parathesia in his face and tongue..mri revealed single lesion in left brachial pontis it's 1 cm...and this attack is his first ..some doctor suggested ms and recommend avonix once a week for one year others say that they cant be certain about this..i'm confused shall i give him avonix and expose him to risk of side effects without even being sure of diagnosis?how can i get a certain diagnosis? how long an ordinary ms attack last?
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429700 tn?1308007823
Nevine, welcome to the MS forum.  Wow, you live in Egypt--a place that I would love to one day visit!  

MS is very unpredictable, so it's hard to say how long an attack will last.  First attacks will sometimes be very hard and last for several weeks or even months, but this is so variable.   Also, attack times will even vary in the person themselves.  My last attack only lasted a couple of days.  However, I've had attacks that have lasted several months.  

I wonder if some of our doctors saw evidence of other attacks to make the diagnosis of MS.  Depends on what the doctor sees upon examination and taking the patient's history.  Usually, evidence of more than one attack is needed to make the diagnosis (hence the word "multiple" in multiple sclerosis).  Evidence of only one attack is called CIS or clinically isolated syndrome.  However, many doctors will go ahead and treat CIS with DMDs to delay the next attack.  People with demyelinating lesions on the MRI, will have a 60% chance of developing MS later on.  Early treatment is often how doctors will treat CIS.

See these websites:


When it comes to side effects of the DMDs, I asked this same question to my neuro before my diagnosis.  I made the statement something to the effect of that he had to be careful with my diagnosis because you don't want to put me on medicines because of the side effects . . . and he cut me off and said that if I did have MS, that any side effect that came from the DMD would be tiny in comparison to what the disease could do.  

For the most part, monitoring with the use of blood tests, will help prevent any long-lasting problems caused by DMDs.  Most people do not experience any long-lasting side effects from the medicine.  Some people on Avonex will experience flu-like side effects which can be pre-treated with Ibuprofen.  There's several people on this forum that have taken this drug, and can give some tips for your brother to help.  

Sending you warm hugs from Texas to Egypt!
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147426 tn?1317265632
Hi, and welcome to the forum.   Your brother has a good sister to be caring about him and asking these questions.

I am surprised that your brother has received a diagnosis in such a short time and with only one small symptom and only one lesion.  Also, it seems too soon to have received the results of all the tests that are done to rule out other diseases which look like MS.

To diagnose MS one must see two or more attacks and have two or more places in the nervous system that have been damaged.  Also, the doctor MUST rule out "all more reasonable explanations for the person's symptoms."  This testing usually takes more than 2 weeks.

The most your brother could have been diagnosed with is called a CIS or Clinically Isolated Syndrome.  This means there has been only one attack.  The other diseases still MUST be ruled out.

MS must be very rare in Egypt.  This is another reason why there must be extra care to be fairly sure that what your brother has is MS and not something else.

I would get the opinion of other neurologists before starting Avonex.  Once you begin a medication like Avonex, it is taken for life, not just for a year.  I'm sure you are confused, but it has only been 10 days.  You can ask if they have "ruled out" (excluded) all of the other diseases that mimic MS.

Quix, MD
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