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Monday, August 15, 2016

5 Things a Neurologist Wants You to Know About Multiple Sclerosis


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Whether you’re newly diagnosed with multiple sclerosis (MS) or have had it for decades, you probably have some questions about the disease, how it might affect you in the future, and how to stay as healthy as possible for as long as possible.
Robert Fox, MD, a neurologist at the Mellen Center for Multiple Sclerosis at the Cleveland Clinic in Ohio, shares what he tells his patients with MS about what doctors know — and don’t know — about MS, and what doctors and patients can do to treat symptoms and prevent disability.

1. This Is a “Good” Time to Be Diagnosed With Multiple Sclerosis

Being diagnosed with MS is never a good thing, but, Dr. Fox says, “We’re at a point in MS where once we find the right treatment, in the majority of cases, we can get the disease completely managed so that patients can continue doing all the things they want to do in life, whatever that is.”
“We don’t always do it with the first treatment,” he cautions. “Sometimes, it takes the second or the third, but usually — at least in the early stages of MS — we can get the disease fully managed and fully controlled.”

2. Multiple Sclerosis Has Two Components: Inflammation and Neurodegeneration

Scientists are beginning to think differently about the different types, or stages, of MS.
“We used to think of MS as two separate stages or two different types — either relapsing-remitting MS, or secondary-progressive MS — and primary-progressive MS is sort of lumped in with the secondary-progressive MS,” Fox says.
“What we’ve come to realize,” he says, “is that it’s probably not two separate, distinct forms or stages of MS, but rather two different components that overlap one another.”
One of those components is the active inflammation, which causes injury to the brain and spinal cord. “And the other is what I call the degeneration of progressive MS,” says Fox, in which old injuries gradually get worse.
This explains why a person’s symptoms may get worse even when an MRI shows no new lesions.
“Patients will have predominance of one aspect of the disease at one point, and then predominance of another aspect at another point.”
While the inflammation associated with MS can often be controlled, so far, doctors’ ability to change the course of degeneration in MS is limited.

3. Doctors Take a Three-Pronged Approach to Treating MS

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