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Ask any question you want about Multiple Sclerosis and one of our experts will answer it as soon as possible.
Here is My Question:
Thank you for the opportunity; I do not currently have a primary care physician. At a very young age (3-4 I believe) I contracted a very serious case of meningitis. I know that I was close to death and had to be taken from Nor Cal to Anaheim. Without a background in medicine Google is a troubling source for self diagnosis. I do have a BA in Journalism and am at least able to filter BS. In short, my symptoms of left hemisphere weakening, numbness, spasticity, gait, etc sure sound like MS is slowly setting in over the past 8 years or so. I know my fever was extremely high when I was young. In short, am I likely correct (I know you can’t do much more than say ‘see a damn doctor already man!’ that the damage to demyelination from my 30 year old illness is a contributing factor to this motor control deterioration? I’ve tried yoga, Thai chi, etc abs still jog daily....Yet engaging/firing the correct muscles to support athletic and daily movement has become near impossible. It was therapeutic just to share that; so thanks. I have no health insurance and I hear constantly about early diagnosis abs therapy. I don’t want charity and I understand the pharmaceutical world more than most. Is there anything I can do (nutrition, supplements, style of exercise) to help slow my symptoms (assuming it is MS). Thank you! Ryan in Portland Answer: You’re right, Dr. Google isn’t an adequate substitute for the actual specialist. The assumption of MS is a big one and I remain unconvinced based on symptoms with a history of meningitis presented. However, I’ll play ball and simply say that in the case of confirmed MS—and in addition to a disease modifying therapy, a healthy/well-balanced diet, exercise, and potentially supplementing with vitamin D3 5,000 IU daily, may be helpful. Patients with MS are not exempt from other health issues that come with age. High blood pressure, diabetes, cholesterol problems, etc can also injure the nervous system and increase the rate of disability. Ultimately, however, a proper evaluation with an MS specialist is in order. Please be kind in response to this post. My knowledge and command of the English language is likely not up to par with a journalist. A. Scott Nielsen MD MMSc Neurologist and MS Specialist at Kaiser Permanente
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Here is My Question:
What diet will help those with MS who are unable to take the medication? Answer: There have been many proposed MS diets over the years and many claim anecdotal evidence as proof of efficacy. The fact is that there is no high level scientific evidence for these diets. Many have been packaged as “anti-inflammatory” diets which is a testable hypothesis for a well designed clinical trial. It remains a challenge to carry out such a study because people, by nature, cheat on their diets (which make it difficult to confirm actual benefit). You can certainly trial a diet yourself and gauge your response. Of course, it would be best to review the selected diet with your PCP to ensure no contraindications to the diet based on your other health factors. It remains advisable to follow recommendations for a general well-balanced diet. Food choice affects other areas of health that MS patients are not excluded from. For instance, high salt, carbohydrate, fatty, etc diets can accelerate cardiovascular disease that can also injure the nervous system. As far as the inability to take an MS therapy, I have to question that statement. There are so many available (and different) MS therapies that it would be hard to believe that ALL are contraindicated in one person. Even if there was a religious or other exception of conscious to a specific type of therapy, there remains a variety of medication class/type/mechanism to find a suitable therapy for everyone who would otherwise qualify for a disease modifying therapy. Use of one of these therapies is better than nothing for MS patients who remain in the inflammatory phase of their MS. A. Scott Nielsen MD MMSc Neurologist and MS Specialist at Kaiser Permanente Here is My Question:
In your opinion-is it safe to take the Pfizer covid vaccine if I've had transverse myelitis? Answer: This is a great question. Having a history of transverse myelitis is not a contraindication for getting the vaccine. You should discuss this with your neurologist first as there may be factors in your medical history that may affect this decision. But in general, I would say that most neurologists recommend patients who have had transverse myelitis get the vaccine. Benjamin Osborne, MD Director, Neuromyelitis Optica (NMO), Neuro-Ophthalmology Clinics and MS/Neuro-immunology Fellowship Director Associate Director of the NIH/Georgetown Neurology Residency Program Medstar Georgetown University Hospital Here is My Question:
Which part of the spine should be considered to check for lesion in MS? Is the C and D spine enough or should we consider the L spine as well? Answer: Your physician should know the appropriate nervous system regions to evaluate you for MS using MR imaging. Remember, MS only affects the optic nerves (which is part of the central nervous system), brain and spinal cord. The spinal cord ends at the L2 vertebral body level, so imaging of the cervical and thoracic spinal cord usually covers the entire spinal cord region. Revere P (Rip) Kinkel, MDProfessor of Clinical Neurosciences Director of the Multiple Sclerosis Program Clinical Neurosciences Director University of California San Diego Here is My Question:
A quick preface, for several years I have had sarcoidosis that has almost exclusively manifested in my eyes, the only exception being some minor skin issues at the beginning. Recently one of my eyes started drooping and my regular appointment with my neurologist led to him ordering a series of tests. The brain MRI showed several lesions (15+), spinal MRIs were "normal" (no lesions), and lumbar puncture showed a few bands. I had a series of blood tests too. When I had the most recent appointment with my neurologist for results and a hopeful diagnosis, he said he couldn't give one because I am not having many overt, typical MS symptoms as he would expect and because the sarcoid could now be neurological. He referred me to another MS specialist which may take a while to get in to see, so my question is - what further tests can be done to help distinguish the two and determine what's going on? I feel like I have gone through a thorough workup and while I fully appreciate using caution to make the proper diagnosis, I am unclear on what other diagnostic tools will help. My other question, if I may, is with my recent brain MRI showing so many lesions, is it expected to have a subsequent MRI now or a year down the road? When I asked my neurologist (who specializes in MS), he said I would not have others, which surprised me. Thank you for your time and knowledge. Answer: This is tough question to answer without being able to review the MRI scan images. I always recommend that the original diagnosis of sarcoid be verified (was there a biopsy that proved it to be sarcoid?) or was the diagnosis made based on a chest x ray and high serum ACE blood test result? If the sarcoid diagnosis is certain and there is clear evidence of it based on a prior biopsy, I would tend to favor the current diagnosis being neurosarcoidosis but that is very hard to make without reviewing the images. Sometimes you can look at the spinal fluid CD4/CD8 ratio. Regardless of the diagnostic uncertainty I think it would be prudent to obtain a repeat MRI brain with contrast at some point in the future, especially if the diagnosis is not certain. It may never be possible to definitely clarify the diagnosis of what is causing the lesions on the brain MRI as there is no simple blood test for MS or other diagnostic test to confirm MS. You can see oligoclonal bands in the spinal fluid in both diseases (neurosarcoid and MS) so that does not help differentiate them. Benjamin Osborne, MD Director, Neuromyelitis Optica (NMO), Neuro-Ophthalmology Clinics and MS/Neuro-immunology Fellowship Director Associate Director of the NIH/Georgetown Neurology Residency Program Medstar Georgetown University Hospital |
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