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Here is My Question:
I've been on Copaxone for 1 year recently diagnosis with MS. I had an MRI and found 2 more lesions with no symptoms...how bad is finding 2 more within a year? I have changed my meds to Tecfidera. Answer: This is a hard question to answer as care definitely has to be individualized, but one key is to ensure that the MRI data is correctly interpreted relative to starting the copaxone. For, example, copaxone takes 4-6 months to “kick in” so, if a MRI was done before copaxone, then the medication was started and then one year later a new MRI was obtained that showed new INACTIVE lesions, there would be know way to know if the lesions formed before or after copaxone had ‘kicked in’. Thus, it might not represent copaxone failure. If, however, MRIs were obtained after starting copaxone and then again a year later and despite the copaxone there were new lesions, it would suggest that someone was a suboptimal responder to copaxone and changing medication would make sense. Benjamin M. Greenberg, MD, MHS Vice Chair of Translational Research and Ambulatory Care Department of Neurology and Neurotherapeutics Director, Transverse Myelitis, Neuromyelitis Optica Programs Co-Director, Pediatric CONQUER Program UT Southwestern Medical Center Childrens Health Dallas, Texas Here is My Question:
Does Lemtrada work on spinal lesions as well as it does brain lesions? Thank you. Answer: Lemtrada, similar to the other DMTs, target the immune system at different points to reduce the likelihood of new lesions or inflammatory events throughout the nervous system (including the spinal cord). Lemtrada (and the other DMTs) have never demonstrated the ability to repair old lesions (which the nervous system does in a limited way). A. Scott Nielsen MD MMSc Neurologist and MS Specialist at Kaiser Permanente Here is My Question:
Can you have MS and not have lesions in your brain? I was diagnosed 16 years ago after years of being called "suspect MS". I had oligoclonal bands present in my CSF, documented by an Opthalmologist - Optic Neuritis, numerous symptoms and was diagnosed as having RRMS. After a number of IV steroid 'pulse therapy' sessions I was started on DMT's in 2001. I have had 3 major relapses since and a number of smaller ones. My neurologist died and I inherited a new one who says I can't have MS if I don't have lesions in my brain. I am very confused and scared. Answer: While it is certainly rare to see individuals with MS who have normal MRI scans of the brain, especially after many years, it still occurs. Whether or not your MS is at all similar to typical cases of MS is another question altogether. One condition that should always be excluded is neuromyelitis optics, also called Devic’s disease. This condition used to be considered a subtype of MS but is now considered an entirely different disease. Devic’s disease often involves only the spinal cord and optic nerves, and may worsen if you are treated with an interferon. There are other possibilities as well and you should work with your neurologist to sort out these diagnostic issues. If required, you may need to travel to an academic MS center for another opinion. Revere (Rip) Kinkel MD Director of the Multiple Sclerosis Program Professor of Clinical Neurosciences University of California San Diego |
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.
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