Thursday, July 28, 2016

Can a Brain Tumor Be Confused With MS?

Diagnosing multiple sclerosis is not as easy as undergoing an MRI scan and having a neurologist watch you walk; instead, it is a challenging process, and neurologists want to get it right. One thing that was considered even before I underwent MRI scans in 2000 for optic neuritis was the possibility of a brain tumor. It turned out not to be a tumor, but I wasn’t diagnosed with MS at the time, either. Over the years, several patients have reported similar “not a brain tumor” diagnoses when telling their MS stories.

Can a brain tumor be confused with MS?

An extremely rare form of multiple sclerosis, called tumefactive MS, involves brain lesions that look like tumors. These lesions are usually larger and more aggressive than normal MS lesions. Treatment usually begins with high-dose intravenous corticosteroids (e.g., Solumedrol) followed by disease-modifying therapies for MS and symptomatic treatments.

In a recent study, researchers investigated the unusual concurrence of MS and brain tumors. They point out, however, that it is difficult to determine whether brain tumors in MS are more common than in the general population. People with MS undergo more MRI scans than healthy individuals, thus the diagnosis of brain tumors in MS patients may appear to be more frequent (Platone et al. 2015). But not all cancer-related brain tumors appear large; they can also look like multi-focal enhancing white matter lesions which are the hallmark of MS.

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Lymphoma May Be Confused For Multiple Sclerosis

Friday, July 22, 2016

When Is It Time For Nursing Care?

People living with more advanced MS develop special needs.

Family and friends often provide care and become a major source of assistance for people with MS as their disease advances and disability progresses. In addition to emotional support, caregivers may begin to informally provide long-term care services at home. When needs become too great at home, families begin to consider long-term care in a nursing home.

What is long-term care?

Long-term care covers a range of services and supports that help to meet personal care needs.

Most long-term care is not medical care, but rather help with the basic personal activities of daily living (ADL), such as bathing, dressing, eating, or using the toilet. Family members may also help with instrumental ADLs such as transportation, shopping, meal preparation, housework, managing money, taking medication, or responding to emergency alerts such as fire alarms.

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When Should You Consider Nursing Home Care?

Wednesday, July 13, 2016

Managing MS During and After Pregnancy

Disease activity during pregnancy

For some women with MS, pregnancy brings about fewer MS symptoms. This may be due to the body’s immune system being more tolerant of the growing human being inside. Clinical and MRI disease activity related to MS are suppressed, particularly during the third trimester. This connection has led to research using hormones such as estriol to treat MS. So far the studies have been small, showing modest benefit.

Disease-modifying therapy during pregnancy

Women with MS are encouraged to stop disease-modifying therapy (DMT) once they become pregnant, if they had not already stopped DMT use when trying to get pregnant. Women with MS who become pregnant while on a DMT should consider participating in a formal pregnancy registry such as the one sponsored by or those hosted by pharmaceutical companies. Several small studies have reported outcomes related to the use of DMTs during pregnancy, particularly during the first trimester, but information is still limited. Data suggest that glatiramer acetate or interferon beta are safe to use. However, each person with MS needs to make personal decisions regarding DMT use and pregnancy in collaboration with her doctor.

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Modern MS Management During and After Pregnancy

Thursday, July 7, 2016

Benefits of Pilates on Quality of Life with MS

Symptoms of MS can include fatigue, weakness, impaired posture, and difficulties with movement and cognition. Symptomatic treatment of MS often combines medication, rehabilitation, exercise, nutrition, or mind-body techniques and complementary medicine.

Exercise is a frequently used treatment that has demonstrated significant improvements in muscle strength, exercise tolerance, and mobility in studies of people with MS. But the majority of these studies have focused on strengthening and aerobic exercises, not on exercises that improve core stability. Yoga and clinical Pilates are two mind-body techniques that do focus on core stability.

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Clinical Pilates Improves Cognitive Function and Quality of Life in People with MS

Tuesday, July 5, 2016

Misdiagnosis and Multiple Sclerosis

Diagnosing multiple sclerosis is not a simple process, and even experienced doctors make mistakes. Even with improved testing tools and more detailed diagnostic criteria, MS misdiagnosis remains an important problem in neurology, with significant consequences.

Misdiagnosis is too common in MS

Rates of MS misdiagnosis range from 6 percent to 35 percent, based on a number of studies published between 1985 and 2005. There are several possible diseases that a person misdiagnosed with MS might have instead. Two of the most common missed diagnoses in these studies were psychiatric disease (23-27 percent) and migraine (9-10 percent).

In a more recent study (Solomon 2012), 95.1 percent of neurologists surveyed (n=122) had evaluated a patient, previously diagnosed with MS by another provider, who they “strongly felt did NOT in fact have MS.” Within the preceding year 39.7 percent of respondents estimated that they had seen three to five such patients. More than one-third (34.4 percent) reported seeing six or more misdiagnosed patients in the last year, including 20 (17.2 percent) respondents who had seen 10 or more such patients.

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Problems with Misdiagnosis of MS: But I Have ALL the Symptoms of MS!!