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Tripping over the red tape: Purple crocodiles in your pool? 

One of the often unadressed consequences of an MS diagnosis is that you need to gain a new and unwanted expertise: you need to debug the services of your health care provider. Irrespective of whether you suffer from MS-related fatigue, walking difficulties or reduced vision, you will need referrals for rehabilitation services such as occupational, physical or vocational therapy or for adjusting...

Memory B cells are very diverse

This paper is hard core science and too methodological for you to bother reading but, I report it to show how complex the B cells are. We usually define B memory cells by a marker called CD27. If B cells express CD20+/CD19+ and CD27. They are called memory B cells. In this paper they look at the expression of a number of markers and they see a lot of diversity. They define classical memory B...

Sepsis in MS patients and Intensive care admissions

Sepsis (or blood infection) is a dangerous thing. I remember first realising this as a Junior doctor in respiratory medicine, when an audit of pneumonia admissions revealed a mortality of 60%. Sadly, this has not improved by much even with the latest antibiotics. As I rotated through, transplant medicine, haem-oncology, and finally into ICU, I found myself forever pre-occupied with watching the...

Association of British Neurologists goes Harrogate

If you’re a pwMS in the UK, make sure you have all questions to your neurologist answered by Tuesday since chances are, they will spend Wednesday – Friday in Harrogate meeting colleagues and friends at the annual meeting of the “ABN“. And given, you know, this is another one of those “first” F2F meetings since COVID-19 has – at least for now –...

Multiple Sclerosis and Migraine

By Dr Saloua Mrabet, Tunis, currently Fellow with BartsMS “Doctor!! Am I having a relapse? Do I need a new MRI? Do I need steroids?” These are some basic questions when your patient with Multiple Sclerosis (PwMS) calls you very anxious after a typical migraine attack. And even more perplexed when you answer “No!! it’s not a relapse”. She adds “But Doctor!! I am really struggling, I’m unable...

Don’t drink and drive or is that don’t drink and DMF

The lastest offering from our furry friends is about ethanol and the breakdown of dimethyl fumarate to its active ingredient monomethyl fumarate. In this study they report that giving ethanol to mice slows the breakdown of the drug so a DMF chaser may not be the way to take DMF. So remember not to get hammered before your twice daily pill. As it may inhibit the levels reaching the brain Ethanol...

Guest Post. Imaging Multiple Sclerosis

Dr Jasmin Patel It is sometimes difficult to distinguish multiple sclerosis (MS) from other related neuroinflammatory diseases such as neuromyelitis optica spectrum disorder (NMOSD) and MOG-antibody associated disease (MOGAD) based on brain MRI. This is particularly an issue in clinical practice when there are multiple brain lesions present. Although MS lesions tend to occur in characteristic...

EBV and MS

Bar-Or A, Banwell B, Berger JR, Lieberman PM. Guilty by association: Epstein-Barr virus in multiple sclerosis. Nat Med. 2022 . doi: 10.1038/s41591-022-01823-1. ProfG has been banging on about EBV and MS as long as I have known him, but when two papers come together (one showing that you get infected before you get MS and the other one suggesting a mechanism of how T cells are activated in (i)...

COVID MS and second and third vaccines

The Italian Researchers have done some of the largest studies on COVID19. We have seen that anti-CD20 antibodies and fingolimod inhibit antibody production and fingolimod inhibit T cell responses and you therefore would expect that break through infections in these groups would be a problem. When looking at delta infections there was a small increased risk but there were very few such...

How to recover from an MS relapse

A relapse is one scary experience. The tendency of traditional medicine in the past was to advocate bed rest and the patient to adopt a ‘sick role’. The lack of research in this area meant that doctors were left to adopt beliefs that were outdated by modern standards; they truly believed that bed rest during an MS relapse helped with the recovery process. This would make sense if in...

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