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Doctors' Answers to "Frequently Asked Questions" - Multiple Sclerosis
Multiple Sclerosis Diagnosis [posted 11/10/98]
Answer: MS is a funny disease in that the symptoms and lesions can come and go. There are some tests of spinal fluid etc which point to a diagnosis;but, MS is a diagnosis of exclusion. That is, there is no one test that will diagnose the problem. Usually, it is preferable to have the waxing and waning type if that is truly your diagnosis. But, each of us has several patients who have been in this bind and it is frustrating.
Multiple Sclerosis Inheritance [posted 8/7/98]
Answer: We don't think MS is hereditary, however, we don't know the cause and some think it may be infectious. In general, there is minimal to no risk for the children of MS patients to develop the disease. This view might change as we understood the cause of the disease.
Multiple Sclerosis and Roxanol [posted 8/6/98]
Answer: You are only hypothyroid if you are not receiving sufficient levo-thyroxine replacement. I doubt that this would be the case, subsequently, there is no special precaution in taking any morphine based product concerning thyroid status. There would be caution in giving Roxanol or any morphine based drug if the patient was hypothyroid due to metabolic differences. Secondly, Prolixin is a completely different class of drug. Side effects and metabolism are completely different. While you should use caution and start at low doses, there should be no comparison between Prolixin and Roxanol.
Answer: MS is a funny disease. Some patients have a "flare" and no subsequent disease for many years, others develop rapid progressive disease unresponsive to any therapy. There is an MS Association, and I would contact them. There are also new treatments also released, which will probably change MS outlook quite a bit.
Answer: It is not currently clear. Common sense says that aborting an attack will preserve neurologic function, and this is the bias of medical treatment. However, there are no controlled studies and probably never will be.
Cerebral Palsy and Multiple Sclerosis Speech Disorder
Answer: ACTH is commonly used in flares of MS, usually with some success. There is a whole new type of drug ready to be released in MS which has the potential to completely change out treatment of MS-- these drugs should be released in 4-6 months.
Answer: MS is a condition where the body "turns on itself" meaning that it directs the inflmmatory response against the coveing of nerves rather than the usual targets such as bacteria and viruses. There are new therapies for MS and if your brother should turn out to have MS he should get under the care of a neurologist(if he's not already seeing one), as MS is a neurological disorder. MS is unpredicatable and therefore, it is very w difficult for anyone to say exactly what the future will hold.
Answer:Steroids have mixed blessings. While they decrease inflammation and immune response they also accelerate most of the aging processes of the body. One of these is osteoporosis.
Osteoporosis is commom as one ages and occurs more rapidly if there is no sexual hormones(like estrogen, progesterone and testosterone)available. There have been numerous studies documenting the bone loss inherent in use of steroids. In general, it is related to dose and duration-higher doses for longer periods are more of a problem. Most physicians who use steroids for any long duration recommend use of vitamin D and calcium supplements during steroids and bone density measurements. The evidence that this helps is sketchy;but, leans towards improvement with this treatment. Studies are in progress concerning use of calcitonin and alendronate sodium during steroid treatment.