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Saturday, December 16, 2017

See how your Amazon Purchases benefit what we do to provide information, resources and services to the MS Community

Wrap-up your holiday shopping at and Amazon donates to MS Views And News. This holiday, give the gifts that give back.

Here’s how you can help: go to (
Log in with your same Amazon account info, and then, please select MS Views and News. That's it.

Amazon will donate .5 percent of your purchase to MS Views and News. Believe me when I tell you that every dollar helps.

Thus far in 2017 we raised money through Amazon that allowed us to provide a new educational program to patients and caregivers and so we are hoping to be able to raise more dollars this holiday season that will allow us to provide this kind of educational event to an area of need in 2018, as well. Help support what we do to educate MS Patients and Caregivers with needed information and resources

By using Amazon Smile, there is no additional cost to you. Something cool that I just learned is that if you’re ever on the site and forget to use Amazon Smile, just delete the “www” on your address bar and type “smile” in its place. It works the same way.

MS Views and News as well as all whom we educate, do very much thank you for using our link.

Happy Holidays!

Best Wishes,

Stuart Schlossman and the MS Views and News team


Symptom Management and Lifestyle Modifications in Multiple Sclerosis

This article was selected as a need to know for those affetced by MS

by Lori Mayer, DNP, MSN, RN, MSCN

Why is this important to me?
MS is a chronic disease that is typically diagnosed in early adulthood and lasts for decades. Symptoms are different in each person and change over time. Symptom management and lifestyle modification can improve symptoms and lead to a healthier and longer life.

Who will benefit from reading this study/article?
This article addresses a variety of symptoms, and thus, all people with MS will benefit from reading this article.

What is the objective of this study?
Symptoms of MS may produce a variety of levels of discomfort, pain, and disability and may decrease quality of life and interfere with activities of daily living. Managing your symptoms will improve your overall health and well-being. Managing your symptoms accompanies the use of disease-modifying therapies and is just as important. Because you may experience more than one symptom and because symptoms change over time, you should periodically review your symptoms with your healthcare provider to determine which symptoms concern you most. It is also important to be aware that certain symptoms may simultaneously present, and therefore become more intensified. For example, pain, spasticity, and gait problems may occur together. The following symptoms are common in MS and can be effectively managed:

Fatigue: Fatigue can affect employment, quality of life, and cognitive abilities. By addressing those things that tend to cause fatigue, a healthcare provider can often assist at reducing fatigue levels. Fatigue may also be reduced with exercise, strategies to conserve energy, and behavioral and drug therapy.

Sensory problems: These include numbness and pain. Pain, which may cluster with cognitive problems, can be neuropathic (caused by damage to the nervous system), inflammatory, secondary to other MS problems, or unrelated to MS. Treatment is guided by the cause of pain.
Cognitive problems: These problems typically occur later in MS and include difficulties with information-processing speed, memory, and executive function (planning, attention, managing multiple tasks, etc.). Cognitive problems can affect employment, activities of daily living, and adherence to prescribed medications and rehabilitation activities. Treatment involves ruling out other factors that affect cognition and then creating a coping plan that may involve behavioral therapy, physical and mental exercise, and drug therapy.

Mood disorders: Major depressive disorder and anxiety are common and occur early in the disease course. Therapy may include drug treatment, psychotherapy, and exercise.
Bladder problems: These are common in later stages of MS and can lead to social isolation. Treatments include proper hydration, antibiotics, bladder training, medication, nerve stimulation, and sometimes catheterization, which are all aimed at achieving continence, improving quality of life, preventing infection, and protecting the kidneys.

Spasticity: Spasticity can cause pain, posture problems, limited mobility, and other problems. Management of spasticity includes physical therapy and certain medications.

Modifying your lifestyle choices to achieve wellness and reduce vascular risk factors is important for everyone, especially those with a neurological disease such as MS, because such modifications can improve brain health. Brain weight and volume change over time in everyone, however, the loss of brain volume occurs faster in people with MS. Proper diet, exercise, and avoiding smoking contribute to better brain health and are particularly important if you have MS. The following lifestyle considerations are important:

  • Weight: Obesity creates chronic, low-grade inflammation and can cause some degree of damage to the brain. Thus, maintaining optimal body weight if you have MS is important.
  • Smoking and alcohol use: Tobacco use can decrease the effectiveness of some MS drugs. More studies are needed to understand the interaction between alcohol use and MS, but if you have MS, you are urged to not smoke or consume excessive amounts of alcohol.
  • Vitamin D: Low vitamin D is a risk factor for developing MS. Vitamin D supplements can be useful.
    • Diet: The digestive system contains many types of helpful bacteria. The bacterial make-up of your digestive system is influenced by what you eat, vitamin D, smoking, and alcohol consumption. A healthy diet that includes vegetables, fish, vitamins A and D, and certain elements is anti-inflammatory and leads to the presence of healthy bacteria in your digestive system. In contrast, unhealthy fats, red meat, high salt, and high sugar can increase inflammation and have a harmful effect on gut bacteria. Thus, consuming a healthy diet creates a state of healthy bacteria and low inflammation that will benefit brain health. A healthy diet is especially important if you have MS.
    • Exercise: Exercise improves many MS symptoms, and people with MS should exercise a few times a week if possible.
    • Sleep: Sleep disorders are common in MS and can cause fatigue. Good quality sleep is important for brain health, especially if you have MS.
    • Temperature control: MS symptoms can worsen in hot or humid weather, and thus, temperature control can improve MS symptoms.
    • Stress: People with MS appear to respond abnormally to stress. Although stress cannot be completely eliminated, steps to reduce stress will benefit you if you have MS.
    • Medical marijuana: Medical marijuana may improve some MS symptoms. This topic is controversial, and more studies are needed to assess the risks and benefits.
    • Mental and social engagement: If you have MS, you should try to be mentally and socially active, which may improve brain health.
    • Vascular risk factors: Heart disease, high blood pressure, high cholesterol, and diabetes negatively impact brain health and should be identified and treated if you have MS.

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    Monday, December 11, 2017

    Diagnosing and Understanding MS

    Your doctor will need to perform a neurological exam, a clinical history, and a series of other tests to determine if you have MS.
    Diagnostic testing may include the following:
    • MRI is the best imaging test for MS. Using a contrast dye allows the MRI to detect active and inactive lesions throughout the brain and spinal cord.
    • Evoked potentials require stimulation of nerve pathways to analyze electrical activity in the brain. The three types of evoked potentials doctors use to help diagnose MS are visual, brainstem, and sensory.
    • A spinal tap, or lumbar puncture, can help your doctor find abnormalities in your spinal fluid. It can help rule out infectious diseases.
    • Doctors use blood tests to eliminate other conditions with similar symptoms.
    The diagnosis of MS requires evidence of demyelination in more than one area of the brain, spinal cord, or optic nerves. That damage must have occurred at different times.
    It also requires ruling out other conditions that have similar symptoms. This includes Lyme disease, lupus, and Sjogren's syndrome.
    If you have MS, the myelin in your body becomes damaged. Myelin is the protective layer that covers nerve fibers throughout the central nervous system.
    It’s thought that the damage is the result of an attack by the immune system. As your immune system attacks myelin, it causes inflammation. This leads to scar tissue, or lesions. All of that inflammation and scar tissue disrupts signals between the brain and other parts of your body.
    It isn’t clear what may cause the immune system to attack.

    Is MS hereditary?

    MS isn’t hereditary, but having a parent or sibling with MS raises your risk slightly. Genetics may play a role. Scientists have identified some genes that seem to increase susceptibility to developing MS.
    Researchers think there could be an environmental trigger such as a virus or toxin that sets off the immune system attack.
    Article Source

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    A new T2 lesion in a patient with the clinically isolated syndrome does not necessarily imply a conversion to multiple sclerosis.

    Capone F, et al. Clin Neurol Neurosurg. 2017.


    In the follow-up of patients with the clinically isolated syndrome, both clinical and MRI findings should be carefully evaluated by clinicians to avoid misinterpretation and inappropriate diagnosis of multiple sclerosis. We describe a case of a patient with a previous diagnosis of clinically isolated syndrome who developed a new asymptomatic brain lesion at the MRI follow-up. The careful evaluation of clinical history and radiological findings allowed the correct diagnosis of cocaine-associated ischemic stroke. Our case highlights that, in patients with the clinically isolated syndrome, the appearance of a new lesion on MRI does not necessarily imply a conversion to multiple sclerosis. Among "better explanations", ischemic lesions are of relevance and, in patients without typical risk factors for stroke, rarer causes such as cocaine assumption should be considered.

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    Systematic assessment and characterization of chronic pain in multiple sclerosis patients

    Ferraro D, et al. Neurol Sci. 2017.


    Pain is one of the most disabling clinical symptoms in patients with multiple sclerosis (MS). Several studies have already assessed the prevalence of pain in MS patients, reporting variable results, probably due to methodological differences. The aim of this single-centre cross-sectional study was to define the prevalence and characteristics of chronic pain in a population of MS patients using validated tools, and to analyse these data in relation to demographic and clinical features, including disease duration and disability (EDSS and its single functional system scores). Of 397 enrolled patients, 23 were excluded due to a Beck's Depression Inventory Score > 19. In the remaining 374 patients, the overall prevalence of chronic pain was 52.1%, most frequently affecting the lower limbs (36.9%). Neuropathic pain was the most frequent type of chronic pain (89 patients, overall prevalence of 23.7%) and was associated with a sensory functional system involvement. Pain intensity was significantly higher in patients with neuropathic pain as opposed to patients with non-neuropathic pain. Patients with chronic pain and, in particular, patients with neuropathic pain had significantly higher EDSS scores than those without pain. Only 24% of patients with chronic pain and 33% of patients with neuropathic pain were on a specific long-lasting treatment for pain. The present study supports the routine assessment of neuropathic pain in MS patients, especially in those with a sensory functional system involvement, in order to avoid underdiagnosing and undertreating a potentially disabling condition.


     29224058 [PubMed - as supplied by publisher]

    Full text

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    Diet Rich in Fruits, Veggies and Whole Grains May Slow MS Progression, Study Shows


    A diet rich in vegetables, fruits and whole grains may decrease symptoms and lessen disease progression in patients with multiple sclerosis (MS), a study suggests.

    Diet Rich in Fruits, Veggies and Whole Grains May Slow MS Progression, Study Shows  “People with MS often ask if there is anything they can do to delay or avoid disability, and many people want to know if their diet can play a role, but there have been few studies investigating this,” Kathryn C. Fitzgerald, the study’s lead author and a researcher at Baltimore’s Johns Hopkins School of Medicine, said in a press release.
    “While this study does not determine whether a healthy lifestyle reduces MS symptoms or whether having severe symptoms makes it harder for people to engage in a healthy lifestyle, it provides evidence for the link between the two,” added Fitzgerald, who belongs to the American Academy of Neurology.
    Researchers enrolled 6,989 patients with all types of MS — recruited from the North American Research Committee registry — and analyzed their responses to a questionnaire on diet habits.
    The team, using Patient-Determined Disease Steps, assessed how diet and other lifestyle habits, such as routine physical activity and avoidance of smoking, were linked to disease severity. Patients disclosed their disease history in the previous six months.

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    Analysis Suggests Oral Steroids Better Than Intravenous Ones for Treating Relapsing MS

    DECEMBER 4, 2017    Ashraf Malhas, PhD

    Oral steroids may be cheaper, more convenient and less invasive alternatives than intravenous steroids in treating relapses in multiple sclerosis (MS) patients, suggests an analysis of five randomized trials.
    Glucocorticoids are recommended as the first line of treatment for MS relapses. Yet recent studies have shown no significant difference between oral methylprednisolone (a steroid) and intravenous methylprednisolone in terms of efficacy and safety.

    In the study, “Oral versus intravenous methylprednisolone for the treatment of multiple sclerosis relapses: A meta-analysis of randomized controlled trials,” which appeared in the journal Plos One, Chinese researchers aimed to assess the clinical efficacy, safety and tolerability of oral versus intravenous methylprednisolone to treat MS relapses.
    The team used searches to identify studies and trials that involved methylprednisolone treatment for MS. After extensive filtering of the literature, it narrowed the search down to five randomized, controlled trials. Within these trials, 198 patients had received oral methylprednisolone, while 200 patients had received intravenous methylprednisolone. Patients in these studies had similar mean ages and the duration of follow-up was between four and 24 weeks.
    None of the studies reported significant differences between the oral and intravenous groups in terms of improvement of clinical outcomes at 28 days after relapse.
    Furthermore, no significant differences were observed between the two groups with respect to adverse effects including rash, anxiety, dysgeusia (distortion of the sense of taste), stomach pain, headache, nausea, diarrhea and palpitations.
    However, patients in the oral group were more prone to insomnia than those in the intravenous group, which is why the team recommends taking oral methylprednisolone in the morning.

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