I was diagnosed in 2013 with optic neuritis and RRMS a after a 3 +yr search. During the past 17 months I have had 2-3 additional relapses with additional issues: bilateral pulmonary embolisms, stomach cellulitis, sepsis, and MRSA that have all contributed to a steady progression of disability in walking and hands/arms. If my MRIs are showing only a slight progression, but my disability is greatly increased, is it indicating that I am moving into the next stage from RRMS? I have been on Aubagio for 15 months.
MS patients are very sensitive to worsening of baseline function due to systemic problems. It is very likely that due to the unfortunate development of other problems (bilateral pulmonary embolism, sepsis, etc) your overall performance and neurological function appears to be deteriorating. Most of the time, there is a dissociation between the way you feel and perform and the way the MRI looks, particularly when the underlying problem is due to reconditioning. I recommend you try to engage in physical therapy as soon as your doctor allows you, and close follow up with your neurologist with frequent MRIs (every 6 to 12 months) to identify progression earlier. It is also a good time to discuss with your doctor if Aubagio is the best therapy for you at this point.
-Augusto Miravalle, MD
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