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Question:
My daughter is a twin – age 12. They are fraternal. Only one has MS (diagnosed at age 11). What's the chance that the other twin will get MS? The neurologist did find it interesting that one month before the double vision started (for the twin with MS) and eventually the MS diagnosis – her period started for the first time; but for the other twin (that doesn't have MS) - her period started a year later. Answer: The risk to fraternal twins of MS patients is higher than the general population, but still rather low (5-15% range depending on the study that is read). It is not clear why some people get MS and not others, but we do have data to suggest that it takes a variety of events happening at the right time. It takes a genetic risk, but then the person has to be exposed to the right trigger. Maintaining adequate vitamin D3 levels have been shown to reduce the risk of MS and would be something all families should consider when one child gets diagnosed with MS. Benjamin M. Greenberg, MD, MHS Director, Transverse Myelitis and Neuromyelitis Optica Program Director, Pediatric Demyelinating Disease Program Department of Neurology and Neurotherapeutics Department of Pediatrics Cain-Denius Scholar of Mobility Disorders University of Texas Southwestern Medical Center Here is my question:
I know I read somewhere that the steroids for MS relapses are not the same type of steroids associated with the ones athletes take (that illegal kind) - is that correct? What is the difference between the two types of steroids? Answer: The term steroid simply refers to chemical molecules that share a common chemical ring stricture. There are many steroids that are important in biology. The steroids used in MS are corticosteroids and reduce inflammation. The steroids used by athletes are anabolic steroids and are similar to the hormone testosterone (leading to increased muscle mass). While they are both steroids, they have nothing to do with each other based on biologic activity. Benjamin M. Greenberg, MD, MHS Director, Transverse Myelitis and Neuromyelitis Optica Program Director, Pediatric Demyelinating Disease Program Department of Neurology and Neurotherapeutics Department of Pediatrics Cain-Denius Scholar of Mobility Disorders University of Texas Southwestern Medical Center Question:
If the Epstein-Barr virus is thought to be connected to MS, is it possible that I got that virus from a woman I worked with for four years, which then led to my MS? My co-worker was diagnosed with PPMS during our first year of working together, and her husband's first wife was diagnosed with MS several years before that. This seems like too much of a coincidence. Thanks. Answer: The association between viral infections and MS have been studied for decades. Most of the studies have failed to reveal a direct cause and effect relationship. The best data suggests that if the “right” person gets exposed to Epstein-Barr virus at specific times in their life, then their risk of MS goes up significantly. So, it is not as simple as a coworker passing along a virus. The Epstein Barr virus is ubiquitous – it could come from anyone and usually someone with close contact to a person, not a casual co-worker. Beyond this, it is worth noting that MS is actually a common disease. With a prevalence of 1 in 900, it is rare for a person in the US NOT to have contact with people with MS. Thus, while there definitely could be a link to meeting people with MS, the disease was probably triggered years before that meeting occurred. Benjamin M. Greenberg, MD, MHS Director, Transverse Myelitis, Neuromyelitis Optica and Pediatric Demyelinating Disease Programs Director, Neurosciences Clinical Research Center UT Southwestern Medical Center Childrens Medical Center Dallas, Texas |
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