Welcome to the Virtual MS Center!
Ask any question you want about Multiple Sclerosis and one of our experts will answer it as soon as possible.
Here is My Question:
I have always suffered from shin splints - sometimes just from walking quickly, but definitely when running, so I just don't run for exercise. These splints make it difficult to lift the fronts of my feet until the pain passes. I have also often got cramps in my feet if I am in a certain position and they come on FAST. I was recently diagnosed with benign MS after suffering temporary (months long) blindness in half of my field of vision (both eyes) that began 18 months ago. MRI's at the beginning of this detected two optic lesions, no spinal lesions. A few months ago, I had another MRI and two new lesions in different spots, had appeared. Is it possible that the shin splints and foot cramps were an early symptom of MS? I find it hard to believe that I ( a 57 year old woman) have had MS and didn't know it - especially given that MS symptoms usually start well before middle age. Perhaps these were early symptoms that I never investigated? Thank you. Answer: Chronic neuroinflammatory and degenerative conditions generally emerge over 3 phases:
Revere P (Rip) Kinkel, MDProfessor of Neurosciences Director of the Multiple Sclerosis Program University of California San Diego #multiplesclerosis #MS #shinsplints
0 Comments
Here is My Question:
I have female patient who has had MS complete paralysis for over 10 years now, is age 50 and is not sick nor has any chronic illnesses. Mentally stable, can move her head and shoulders, slightly able to move her chest forward, Just want to ask if is there anything that could help her move her arms and legs again, She’s bedridden and utilizing a wheelchair when going out of the house. Answer: To my knowledge, your patient would not be a candidate for any current research studies to restore function to paralyzed limbs. Mind controlled interfaces bypassing areas of injury in the spinal cord (so called digital bridges) to volitionally activate gait programs in the lower spinal cord are now possible following spinal cord injury. Other approaches including cybernetic frames to assist residual movement or mind-controlled robotic limbs are also possible. The main problem with MS is the diffuse injury and damage to the nervous system; there is not a single injury at a spinal cord level in most cases of MS. This diffuse injury makes it difficult, though not impossible, to apply these techniques. In particular assisted activation of movement using attached frames is an area of research using MS patients. If you find any research group interested in using MS patients for these applications, please let us know so we can post the information for our readers. Revere P (Rip) Kinkel, MDProfessor of Neurosciences Director of the Multiple Sclerosis Program University of California San Diego #restorefunction #spinalcord #MS #multiplesclerosis Question:
Thank you for generously sharing so much information and knowledge on your website.
Answer: Regarding telemedicine consultations, these are typically available at most tertiary care centers that have an MS specialist. However, the physician needs to have a medical license in the state in which the patient resides. And of course, the physician will need to have access to the MRI images to review them. Otherwise, the patient will need to travel with the imaging studies to the state where the MS center is located. 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:
Whenever it’s either hot outside, inside or heat from the shower or baths and I stand up my vision goes fuzzy and everything goes black and I can’t see or feel my body and I’ll fall and sometimes I’ll just pass out. Answer: Blurry vision induced by heat or high temperatures is a well described phenomenon in patients with MS who have had optic neuritis. This is called Uhtoff phenomenon, named after the ophthalmologist who first described this. It is not damaging your optic nerve fortunately but if you can cool your body down or avoid high temperatures you should be able to avoid these episodes from happening in the future. 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 #multiplesclerosis #Uhtoff #MS #blurryvision Here is My Question:
Is there information on the long-term impact of B cell depletion therapies (whether treating MS or otherwise)? Specifically when the B cells are left to repopulate, do they become more inflammatory than before? What would be the rationale for these therapies if your disease could potentially be worse than before? Answer: This is an excellent question. First, we do not know of any rebound in disease activity as B cells repopulate. This suggests it is highly unlikely that the B cells that return are in some way more aggressive or harmful to you. In fact, there is no clear temporal relationship between the return of total B cells (so-called CD19 + cells) and the return of disease activity. People can go for long intervals after repletion of B cells without any return of disease activity. We can only say that a return of disease activity is more likely the longer the duration between infusions. There is evidence in other inflammatory conditions treated with anti-CD20 therapies (Ocrevus, Rituximab, Kesimpta and Briumvi are all anti-CD20 agents) that a return of disease activity is more likely once central memory B cells return. Whether this applies to Multiple Sclerosis is unclear at this time. Central memory B cells are a subset of total B cells that take longer to return than naive CD19+ B cells. We also know that immunosuppression and secondary hypogammaglobulinemia are more likely with cumulative high doses of intravenous anti-CD20 therapies (particularly rituximab and Ocrevus; Briumvi is rather new with no experience to guide us at present). So far it appears that secondary hypogammaglobulinemia (one cause of immunosuppression and infections) is less common with low dose subcutaneous treatment using Kesimpta. Answering your question directly requires us to gain a better understanding of the mechanism(s) of short and long-term benefit with anti-CD20 therapies. For instance, once we deplete your B cell population with these therapies, are the cells which return during the bone marrow repletion process less autoreactive and/or better regulated? If this were the case and we found a biomarker reflecting this improved regulation, we could personalize your treatment and avoid unnecessary prolonged B cell depletion and potential immunosuppression. Other individuals may require higher or more frequent doses for a desired benefit. Hope this helps. Revere P (Rip) Kinkel, MDProfessor of Neurosciences Director of the Multiple Sclerosis Program University of California San Diego #multiplesclerosis #Bcells #Bcelldepletion Here is My Question:
Can you please explain what symptoms might be associated with a T9 spinal lesion? I currently have reduced sensation/numbness on one side (R) of my lower back, wrapping around my lower abdomen and down the front of my R leg. Some back and hip pain on R side as well. Thank you. Answer: You've done a great job describing the symptoms associated with a partial right sided demyelinating lesion at the T9 level. Sensory nerves carrying pain sensitive axons from the T9-T12 or even the L1 right sided dermatomes (depending on the length of the lesion in the cord) enter the spinal cord in this area and cross over to the opposite side of the spinal cord about 2 levels above their entry zone. These dermatomes (T9-L1) correspond to the region of numbness you describe on the right side of your trunk and the front of your right leg. From here they travel up the left side of the spinal cord in the spinothalamic tract. Common symptoms include a tight squeezing sensation around the trunk, sensitivity to light touch or pressure and a burning or tingling sensation. Other possible symptoms really depend on the location of the region of demyelination and could include weakness in one leg, tingling in one or both feet, urinary urgency or retention, constipation, lack of sensation in your private parts or decreased balance. Revere P (Rip) Kinkel, MDProfessor of Neurosciences Director of the Multiple Sclerosis Program University of California San Diego #multiplesclerosis #MS #partialrightsidedemyelinatinglesion Here is My Question:
Can I get a permanent disability right after my diagnostic from SSI? Answer: SSI is based on age/disability and low income, whereas SSDI is based on disability and work history/credits. I suspect based on your question that you are looking for SSDI based on your disability level. This can be hard to qualify for shortly after a diagnosis of MS, since most individuals with MS do not have significant disability this early in the disease. Exceptions include people with primary progressive MS or very aggressive forms of MS. Even people with obvious disability are often rejected the first time they apply. It is often necessary to hire a lawyer to take your case before an administrative law judge in this circumstance to obtain SSDI. Talk to your neurologist or contact the national multiple sclerosis society for more information on applying for either SSI or SSDI. Revere P (Rip) Kinkel, MDProfessor of Neurosciences Director of the Multiple Sclerosis Program University of California San Diego #disability #multiplesclerosis #MS #SSI Here is My Question:
If I had a scan 6 months ago do I need another scan? Answer: There are many reasons for a repeat MRI scans 6 months after the last scan. I cannot comment further without knowing your case better. I would first suggest that you discuss this with the ordering provider, hopefully the doctor managing your MS. Revere P (Rip) Kinkel, MDProfessor of Neurosciences Director of the Multiple Sclerosis Program University of California San Diego #MRI #multiplesclerosis #MS Here is My Question:
Does MS cause tingling and burning sensations in different parts of the body? Answer: MS can cause various abnormal sensations, including tingling and burning, in any part of the body. Deciding whether an odd sensation is related to MS depends on a number of factors that a neurologist or MS specialist will elicit during their taking of your history and examination. These factors include the temporal onset and duration (episodic vs always present) of the symptom, location, precipitants, associated symptoms and findings, and the potential role of medication or other medical conditions. Revere P (Rip) Kinkel, MDProfessor of Neurosciences Director of the Multiple Sclerosis Program University of California San Diego #MS #multiplesclerosis #tingling #burning Here is My Question:
Hello, I was wondering why my neurologist only ordered a MRI of my brain and brain stem to establish new baseline post rituximab infusion? When I was first diagnosed I had lesions on both brain and spine. Just trying to get clarification. Thank you. Answer: There are several potential reasons that a neurologist would only order an MRI of the brain. These include but are not limited to the following:
Revere P (Rip) Kinkel, MDProfessor of Neurosciences Director of the Multiple Sclerosis Program #multiplesclerosis #MS #rituxumab Here is My Question:
My fingertips and feet are numb and if I eat anything cold my mouth feels like it’s burning. Is this MS? Answer: Very odd pattern of sensations for MS. You will need to be evaluated by a neurologist to figure out the cause of these symptoms. Revere P (Rip) Kinkel, MDProfessor of Neurosciences Director of the Multiple Sclerosis Program University of California San Diego #multiplesclerosis #MS #numbness Here is My Question:
Can you wear a fabric face mask in hospitals? Answer: Hospitals differ in their mask policies based on state, region and warning level. Some will ask you to put on the masks they provide at the door while others will allow you to wear your own cloth mask. Revere P (Rip) Kinkel, MDProfessor of Neurosciences Director of the Multiple Sclerosis Program University of California San Diego #mask #covid #multiplesclerosis #MS Here is My Question:
Can you get laser hair removal on your face if I have MS? This question has been asked/answered before. If you type in LASER in the search box in the upper right side of this page you will see the answer. Thank you! This question has been asked/answered before. If you go to the search box on upper right part of this page and type in PLASMA, you will see the answer. Thank you!
Here is My Question:
Which HRT is best for a person with MS? Thank you. Answer: This question has been previously asked/answered. Here is the LINK Here is My Question:
I am taking Finasteride for prostate treatment. I have noticed significant muscle weakness since starting this medication only 6days ago! Is this unusual? Answer: There are rare reports of myopathy (muscle disease causing weakness) or other muscle problems (weakness and spasms) in patients on finasteride. I would advise talking to your doctor about this problem. Revere P (Rip) Kinkel, MDProfessor of Neurosciences Director of the Multiple Sclerosis Program University of California San Diego #finasteride #multiplesclerosis #MS Here is My Question:
Can I take phentermine, a weight lost supplement, after being administered with an Ocrevus infusion? Answer: Phentermine is a stimulant (activates sympathetic nervous system) and may have unacceptable interactive affects with other medications administered during Ocrevus infusions. For this reason, I would encourage you to discuss these possible interactions with your doctor. He or she may advise you not to take the phentermine around your infusions. Revere P (Rip) Kinkel, MDProfessor of Neurosciences Director of the Multiple Sclerosis Program University of California San Diego Here is My Question:
Diagnosed with Meralgia Paresthetica. Surgery to release bundled nerve was unsuccessful. Discomfort persists. Do I have MS? Question: Meralgia Paresthetica is caused by damage to the lateral femoral cutaneous nerve of the thigh. This nerve supplies sensation to the lateral upper thigh down to just above the knee. This type of neuropathic pain (burning/sensitive to even light touch) is not caused by a central nervous system problem and is therefore not associated with MS. Meralgia paresthetica is common in people overweight, people with diabetes and after total hip replacement surgery using an anterior approach. There are many other causes but these are probably the top 3 currently. Revere P (Rip) Kinkel, MDProfessor of Neurosciences Director of the Multiple Sclerosis Program University of California San Diego #multiplesclerosis #MS #meralgiaparesthetica |
PLEASE NOTE: This information/opinions on this site should be used as an information source only. This information does not create any patient-HCP relationship, and should not be used as a substitute for professional diagnosis and treatment. Please consult your health care provider before making any healthcare decisions or for guidance about a specific medical condition.
Archives
March 2024
Categories
All
|