Here is My Question:
Hello, I just turned sixty and have had MS for 35 years or so took Avenox and stopped it for extreme flu like symptoms, then took Tecfidera for 8 months or so then stopped it for fear of PML. Just had an MRI that showed little activity (inflamation) is what one neurologist calls it. He wants to repeat MRI in 6 months and perhaps treat then if needed while another neurologist. I see occasionally says I should treat! My question is : How should one make a decision on either or? Thank you in advance for any input you may have have on this subject .
Your decision hinges on what is being referred to as, "a little activity", on your MRI and over what time interval this "activity" occurred. MRI activity decreases with each decade, particularly in those with stable MS without progressive disease by the age of 60.
You need to have an expert independently review your MRI scans to determine if there is really any ongoing MS activity. If there is doubt, then staying off treatment and repeating your MRI in 6 months is reasonable, particularly at the age of 60.
You also need to have a full discussion of your concerns with your neurologist since they are the only ones capable of providing a fully informed opinion based on your history and examination. For instance, we have no information about your disease course, level of disability, risk factors for disease progression or other medical conditions. All these factors are important to treatment decisions.
Revere P (Rip) Kinkel, MDProfessor of Clinical Neurosciences
Director of the Multiple Sclerosis Program
Clinical Neurosciences Director
University of California San Diego
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