Questions and Answers

Neurologique has a second life ... in Second Life (SL).

After Neurologique Engineer attended the most recent support group, I faced many email questions; and with the permission of those who made these queries, and as a service to you, they follow below:

Question:

I have just had a relapse and would like to know what is the direct correlation between brain lesions showing on and MRI and the relapse symptoms of vision loss, pupil malfunction and new pain symptoms. This is my first relapse I was diagnosed 1 year ago and showed no new lesions on the MRI taken during the relapse.

What drugs are available to help with memory function and concentration. Most of my lesions are on my frontal lobe and are affecting my cognitive function.

Answer:

While there are many more MS lesions on MRI than relapses, the lesion causing a specific relapse is not always seen. This may have to do with imaging technique and timing, but may also have to do with where in the central nervous system (CNS) the symptoms are coming from and how large the lesion is.

This is why sound neurological history and examination is more valuable than tests, like MRIs.

Memory function is an important part of our everyday lives and has a large impact on quality of life. Many neurologists use the anti-dementia medications (this does NOT mean you have Alzheimer's disease). We also use an anti-diabetes medication in an off-label fashion to help with concentration and attention.

It is important to determine the reason for the memory problems -- is it a pure memory problem, depression, agitation, lack of concentration/attention, fatigue or inappropriate functioning (such as may be seen with frontal lesions).

For more on the cognitive issues, see my blog at:

http://www.healthcentral.com/multiple-sclerosis/c/428/57171/cognitive

Question:

My 15 yr old was diagnosed in Jan of this yr with MS after an attack which left her with slurred speech and her gait was off until May. She has now returned to school, still taking her meds including, avonex, fish oil vitamins, darvocett, and provigil. She is no longer taking P.T.

When she was about 6 yr old, she had an episode which was diagnosed as bells palsy, lasted only for about 6 wks. Her right side of face was drawn and that was all.

My question is: If the dr. who diagnosed it as bells palsy had taken an MRI, would he have found the MS then or by any other means at that time, and put her on the meds then, could she possibly have not had the attack in Jan of this yr?

Answer:

While I completely understand you asking "what if ...," this is not beneficial to you or your daughter.

You did all you could as a loving mother and MS is fairly rare in 6 year-olds, so your daughter's doctor would probably not have considered it (and would not be expected to).

Another issue is that 6 year-olds are not usually good at staying still for MRIs and there is risk involved in sedating a young child; these risks may have been determined to be too great.

The question I have is whether this was truly Bell's palsy (whole side of face droopy) or whether it was just lower facial droop. Most often Bell's palsy occurs after or during a viral infection.

Question:

I was diagnosed at 36 years old and was immediately put on beta-seron. what I got from this was a seizure disorder and anxiety, which ruined my quality of life.. I stopped the interferon after 5 or 6 years, but still have the seizure disorder.. what I want to know is is there hope for a better quality of life in the future? I am no longer on any meds for the MS, however, I take trileptal and several other meds, due to the symtoms of the MS.. I am now 55 years old.

Answer:

MS does place you at a greater risk for seizures -- see:

http://www.msfocusforum.com/forums/showthread.php?p=99889

But, new-onset seizures do argue that there may have been a new MS plaque despite the Betaseron.

Quality of life is impacted by the beneficial effects of the medications on the one hand, and the potential side effects on the other hand.

I strongly believe that MS patients should be on a disease modifying agent for their MS (under the supervision of their neurologist) and there are multiple other medictions besides Betaseron, as well as clinical trials of newer medications.

In reference to the video blogging, text blogging and tweeting I will be broadcasting from ECTRIMS (European Committee for Treatment and Research in MS) this week (September 9 - 12), I received the following question:

Question:

i don't expect my question to be answered, but i had to send it.
i am a person who has been living with RRMS for 10+ years.

my questions for you or whoever wants to answer is this:
why don't we get reports from REAL patients about the goings on at conferences like these? why is it only from a medical p.o.v?

Answer:

Patients are more than welcome to come to these meetings; infrequently I have seen some there. The problem is the cost of the meeting, time missed from work, travel etc.

- Dr. Daniel Kantor, MD BSE
Medical Director
Neurologique

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