Feb 24 2012
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 ...
Jan 19 2012
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...
Jan 16 2012
Transverse Myelitis, Part 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 ...
Jan 12 2012
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...
Jan 02 2012
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...
Dec 15 2011
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. ...
Dec 05 2011
Optic Neuritis: Treatment and 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...
Nov 17 2011
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...
Nov 14 2011
Fatigue and MS: Part 4
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...
Nov 10 2011
Fatigue and MS: Part 3
Despite making lifestyle changes, many patients with MS will nonetheless need a medication to promote wakefulness. The three most commonly-used medications are amantadine (Symmetrel®), modafinil (Provigil®), and stimulants such as Ritalin or Ad...