http://www.healthline.com/health-blogs/feeds/perspectives-in-ms?key=perspectives-in-ms Healthline Health Blogger Jonathan Howard - Perspectives in MS en-us Copyright (c) 2013 Healthline, All rights reserved. en-us Copyright (c) 2013 Healthline, All rights reserved. http://www.healthline.com/health-blogs/perspectives-in-ms/goodbye Goodbye!!! Unfortunately, this is going to be my last column for now. Let me take this chance to thank the folks at Healthline for giving me the opportunity to write as much as I did. The one requirement I made when I started writing is that n... Tue, 28 Feb 2012 08:00:00 GMT http://www.healthline.com/health-blogs/perspectives-in-ms/goodbye Jonathan Howard, MD 2012-02-28T08:00:00Z http://www.healthline.com/health-blogs/perspectives-in-ms/combination-therapy One of the interesting questions to emerge in MS therapies in the next few years will be the possibility of using combination therapy to slow down disease progression. This means the use of more than one medication with different mechanisms of ... Fri, 24 Feb 2012 08:00:00 GMT http://www.healthline.com/health-blogs/perspectives-in-ms/combination-therapy Jonathan Howard, MD 2012-02-24T08:00:00Z http://www.healthline.com/health-blogs/perspectives-in-ms/bg-12-part-2 In my first post on BG-12, I introduced the two major studies supporting its efficacy. No discussion of medication is complete without acknowledging the downsides, however. The most common side effects of BG-12 were flushing, headache, gastroi... Tue, 21 Feb 2012 08:00:00 GMT http://www.healthline.com/health-blogs/perspectives-in-ms/bg-12-part-2 Jonathan Howard, MD 2012-02-21T08:00:00Z http://www.healthline.com/health-blogs/perspectives-in-ms/bg-12-part-1 One of the most exciting disease modifying medications on the horizon in the treatment of MS is currently known as BG-12. It is made by Biogen, the same company that makes Avonex and Tysabri. This is the first oral medication from this company ... Thu, 16 Feb 2012 08:00:00 GMT http://www.healthline.com/health-blogs/perspectives-in-ms/bg-12-part-1 Jonathan Howard, MD 2012-02-16T08:00:00Z http://www.healthline.com/health-blogs/perspectives-in-ms/tincture-of-time One of the most frequent e-mail questions I have received is from someone describing their symptoms and wondering whether or not these symptoms could be due to MS. This, of course, is a common reason for patients to visit an MS Center as well. ... Tue, 14 Feb 2012 08:00:00 GMT http://www.healthline.com/health-blogs/perspectives-in-ms/tincture-of-time Jonathan Howard, MD 2012-02-14T08:00:00Z http://www.healthline.com/health-blogs/perspectives-in-ms/relying-tests-diagnose-ms-part-2 In my previous post, I reviewed the diagnostic criteria for MS and some of the reasons a diagnosis is often not as straightforward any anyone would like. I also explained why doctors put great stock in the MRI and the lumbar puncture results in... Mon, 06 Feb 2012 08:00:00 GMT http://www.healthline.com/health-blogs/perspectives-in-ms/relying-tests-diagnose-ms-part-2 Jonathan Howard, MD 2012-02-06T08:00:00Z http://www.healthline.com/health-blogs/perspectives-in-ms/relying-tests-diagnose-ms Why are doctors so heavily reliant on MRI and lab tests to diagnosis MS? During a recent online chat about MS, one person asked the question: “why are doctors so heavily reliant on MRI and lab tests to diagnosis MS?” This is a good question.... Thu, 02 Feb 2012 08:00:00 GMT http://www.healthline.com/health-blogs/perspectives-in-ms/relying-tests-diagnose-ms Jonathan Howard, MD 2012-02-02T08:00:00Z http://www.healthline.com/health-blogs/perspectives-in-ms/vitamin-d-part-2 While the role of a low vitamin D level is a becoming an established risk factor for MS, it is not universally accepted as such. Even less clear is the role for vitamin D supplementation once the diagnosis of MS has been made is less clear. A s... Tue, 31 Jan 2012 08:00:00 GMT http://www.healthline.com/health-blogs/perspectives-in-ms/vitamin-d-part-2 Jonathan Howard, MD 2012-01-31T08:00:00Z http://www.healthline.com/health-blogs/perspectives-in-ms/vitamin-d-part-1 Perhaps the biggest mystery in the entire field of MS is why do some people get the disease and others do not? Genetics play a role in who gets the illness, though the role is rather small. In identical twins who share the exact same DNA, if on... Thu, 26 Jan 2012 08:00:00 GMT http://www.healthline.com/health-blogs/perspectives-in-ms/vitamin-d-part-1 Jonathan Howard, MD 2012-01-26T08:00:00Z http://www.healthline.com/health-blogs/perspectives-in-ms/gilyena-safety-update As soon as I submited my posting entitled "Safety Update," new information broke regarding the safety of the medication Gilyena (from the business section concerned about stock prices!). At this point, all I know can be found in this article he... Mon, 23 Jan 2012 08:00:00 GMT http://www.healthline.com/health-blogs/perspectives-in-ms/gilyena-safety-update Jonathan Howard, MD 2012-01-23T08:00:00Z http://www.healthline.com/health-blogs/perspectives-in-ms/trigeminal-neuralgia Of all of the symptoms of MS, few make patients as miserable as a syndrome known as trigeminal neuralgia (TN). The trigeminal nerve is the nerve that carries sensation from the face to the brain, and also carries motor fibers for the muscles u... Thu, 19 Jan 2012 08:00:00 GMT http://www.healthline.com/health-blogs/perspectives-in-ms/trigeminal-neuralgia Jonathan Howard, MD 2012-01-19T08:00:00Z http://www.healthline.com/health-blogs/perspectives-in-ms/transverse-myelitis-2 In my previous post I reviewed the basic anatomy of the spinal cord, one of the main site of damage in MS. As with lesions in the brain, lesions in MS tend to affect the white matter and involvement of the gray matter suggests an illness other ... Mon, 16 Jan 2012 08:00:00 GMT http://www.healthline.com/health-blogs/perspectives-in-ms/transverse-myelitis-2 Jonathan Howard, MD 2012-01-16T08:00:00Z http://www.healthline.com/health-blogs/perspectives-in-ms/transverse-myelitis-1 One of the most common sources of symptoms in patients with MS is from lesions in the spinal cord. The spinal cord is a relatively thin band of nervous tissue that contains the pathways that allow us to feel, move, and use the bathroom. The sp... Thu, 12 Jan 2012 08:00:00 GMT http://www.healthline.com/health-blogs/perspectives-in-ms/transverse-myelitis-1 Jonathan Howard, MD 2012-01-12T08:00:00Z http://www.healthline.com/health-blogs/perspectives-in-ms/setting-the-agenda Under ideal circumstances, I always take 5 minutes before I meet with a patient to review their chart and recent lab results. This is not only to refresh my memory about patients I may not have seen for many months, but also to see if I need to ... Mon, 09 Jan 2012 08:00:00 GMT http://www.healthline.com/health-blogs/perspectives-in-ms/setting-the-agenda Jonathan Howard, MD 2012-01-09T08:00:00Z http://www.healthline.com/health-blogs/perspectives-in-ms/secondary-progressive-vs-relapsing-remitting One of the most common questions I am asked by patients is whether they are in the relapsing-remitting phase of MS or in the progressive phase of the illness. Lets again review what these terms mean. About 85% of patients start the illness wit... Thu, 05 Jan 2012 08:00:00 GMT http://www.healthline.com/health-blogs/perspectives-in-ms/secondary-progressive-vs-relapsing-remitting Jonathan Howard, MD 2012-01-05T08:00:00Z http://www.healthline.com/health-blogs/perspectives-in-ms/relapse-treatment-part-2 In my previous post, I discussed the treatment of relapses, primarily through the use of intravenous (IV) steroids. In certain patients, however, IV steroids are not an option. Either they have poor intravenous access or they simply cannot tole... Mon, 02 Jan 2012 08:00:00 GMT http://www.healthline.com/health-blogs/perspectives-in-ms/relapse-treatment-part-2 Jonathan Howard, MD 2012-01-02T08:00:00Z http://www.healthline.com/health-blogs/perspectives-in-ms/relapse-treatment-part-1 In a previous post, I defined an attack. In this post, I would like to talk about how neurologists treat attacks. Treating a RelapseIn almost all cases, neurologists will use high doses of intravenous corticosteroids to treat a relapse. This... Thu, 29 Dec 2011 08:00:00 GMT http://www.healthline.com/health-blogs/perspectives-in-ms/relapse-treatment-part-1 Jonathan Howard, MD 2011-12-29T08:00:00Z http://www.healthline.com/health-blogs/perspectives-in-ms/relapses-disability-part-2 In my last post I briefly summarized two papers that showed that relapses in MS were only very rarely sources of permanent disability. But does this mean that relapses don’t matter? Does this mean that by using medications to prevent relapses ... Tue, 27 Dec 2011 08:00:00 GMT http://www.healthline.com/health-blogs/perspectives-in-ms/relapses-disability-part-2 Jonathan Howard, MD 2011-12-27T08:00:00Z http://www.healthline.com/health-blogs/perspectives-in-ms/relapses-disability As I have discussed in previous posts, the characteristic feature of MS, at least is its early stages, is relapses- also known as attacks, exacerbations, or flares. Prevention of relapses is also the main criteria by which treatments for MS ar... Thu, 22 Dec 2011 08:00:00 GMT http://www.healthline.com/health-blogs/perspectives-in-ms/relapses-disability Jonathan Howard, MD 2011-12-22T08:00:00Z http://www.healthline.com/health-blogs/perspectives-in-ms/safety-update As I promised in an earlier posting, I would periodically update the safety information on Tysabri and other medications in MS. Every month, the company that makes Tysabri, Biogen, publishes updated information on the number of PML cases.Accordi... Mon, 19 Dec 2011 08:00:00 GMT http://www.healthline.com/health-blogs/perspectives-in-ms/safety-update Jonathan Howard, MD 2011-12-19T08:00:00Z http://www.healthline.com/health-blogs/perspectives-in-ms/polypharmacy In a previous post, I wrote that when patients start taking a new medication they should not assume that any new discomforts are side effects of the medication. Otherwise, they may end up discarding a potentially very useful medication. ... Thu, 15 Dec 2011 08:00:00 GMT http://www.healthline.com/health-blogs/perspectives-in-ms/polypharmacy Jonathan Howard, MD 2011-12-15T08:00:00Z http://www.healthline.com/health-blogs/perspectives-in-ms/not-all-symptoms-due-ms A patient with MS recently came to my office complaining of a pain and tingling in her hand and wrist. It had been going on for several months and at times was a minor nuisance, but it became especially severe at night when it woke her from sl... Mon, 12 Dec 2011 08:00:00 GMT http://www.healthline.com/health-blogs/perspectives-in-ms/not-all-symptoms-due-ms Jonathan Howard, MD 2011-12-12T08:00:00Z http://www.healthline.com/health-blogs/perspectives-in-ms/genes-ms In August 2011, the MS society announced the publication of the results of a global collaboration to investigate the genetic underpinnings of MS. This was a major scientific undertaking that yielded impressive results. Almost 10,000 patients w... Thu, 08 Dec 2011 08:00:00 GMT http://www.healthline.com/health-blogs/perspectives-in-ms/genes-ms Jonathan Howard, MD 2011-12-08T08:00:00Z http://www.healthline.com/health-blogs/perspectives-in-ms/optic-neuritis-follow-up The most important study of patients with optic neuritis is termed the Optic Neuritis Treatment Trial. This was a large trial carried out between 1988 and 1991 of 454 patients with acute optic neuritis. This study made important contributions... Mon, 05 Dec 2011 08:00:00 GMT http://www.healthline.com/health-blogs/perspectives-in-ms/optic-neuritis-follow-up Jonathan Howard, MD 2011-12-05T08:00:00Z http://www.healthline.com/health-blogs/perspectives-in-ms/optic-neuritis One of the most distinctive initial presentations of MS is an entity called optic neuritis. As the name implies, optic neuritis is an inflammatory disorder of the optic nerve. The optic nerve carries visual information from the eye to the brai... Thu, 01 Dec 2011 08:00:00 GMT http://www.healthline.com/health-blogs/perspectives-in-ms/optic-neuritis Jonathan Howard, MD 2011-12-01T08:00:00Z http://www.healthline.com/health-blogs/perspectives-in-ms/neuromyelitis-optica-part-2 In my previous post, I introduced the diagnostic criteria for NMO. There are many similarities between MS and NMO, but there are many important differences. Like MS, patients with NMO suffer from relapses, though the relapses are generally rest... Mon, 28 Nov 2011 08:00:00 GMT http://www.healthline.com/health-blogs/perspectives-in-ms/neuromyelitis-optica-part-2 Jonathan Howard, MD 2011-11-28T08:00:00Z http://www.healthline.com/health-blogs/perspectives-in-ms/neuromyelitis-optica Multiple sclerosis is by far the most common demyelinating disease of the central nervous system, but certainly not the only or even the most severe such illness. In this post, I would like to discuss a much rarer illness known as either neurom... Thu, 24 Nov 2011 08:00:00 GMT http://www.healthline.com/health-blogs/perspectives-in-ms/neuromyelitis-optica Jonathan Howard, MD 2011-11-24T08:00:00Z http://www.healthline.com/health-blogs/perspectives-in-ms/unidentified-bright-objects A recent article in the New York Times discussing the use of MRIs in orthopedics caught my attention. The article mentions a study where 31 healthy baseball pitchers received MRIs of their shoulders. According to the study, “The pitchers were... Tue, 22 Nov 2011 08:00:00 GMT http://www.healthline.com/health-blogs/perspectives-in-ms/unidentified-bright-objects Jonathan Howard, MD 2011-11-22T08:00:00Z http://www.healthline.com/health-blogs/perspectives-in-ms/medication-compliance Recently, an article published in the May 2011 edition of The Canadian Journal of Neurological Sciences caught my eye. The article,“Adherence to Multiple Sclerosis Disease-Modifying Therapies in Ontario is Low,” examined the pattern of use of t... Thu, 17 Nov 2011 08:00:00 GMT http://www.healthline.com/health-blogs/perspectives-in-ms/medication-compliance Jonathan Howard, MD 2011-11-17T08:00:00Z http://www.healthline.com/health-blogs/perspectives-in-ms/fatigue-part-four The final step I take when patients complain of fatigue is to do a thorough review of their medications. On the list of potential side effects of many medications, sedation is a near universal presence. First of all, the interferon medicat... Mon, 14 Nov 2011 08:00:00 GMT http://www.healthline.com/health-blogs/perspectives-in-ms/fatigue-part-four Jonathan Howard, MD 2011-11-14T08:00:00Z