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I’m on treatment, why am I getting worse

Today someone asked “Selma Blair today tweeted she is getting sicker with her MS. Given her personal wealth and access to the best treatments. And we now have treatments that effectively shutdown ms in rrms. Also given she has had plasma exchange. My question is why is she getting sicker? “ The simple answer is I don’t know because I am not familiar with her particular case...

Sugar crash

My recent blog post on food coma (14-Jan-2019) not only uncovered another hidden symptom in MSers but has led us to start exploring this phenomenon in our patients and, hopefully, to some evidence-based advice on how to manage the problem.  In our short web survey on food coma, I was surprised to find that 86% of MSers report this phenomenon with 28 of the 81 respondents (35%) reporting their...

Nodding off when reading mouse EAE papers? Is it because they are full of mushroom food? Wishful thinking or simply terrible data analysis?

Autoimmune encephalomyelitis in NOD mice is not initially a progressive multiple sclerosis model. Baker D, Nutma E, O’Shea, Cooke A, Orian JM, Amor S, Baker D .Ann Clin Trans Neurol 2019 Objective Despite progress in treating relapsing multiple sclerosis (MS), effective inhibition of nonrelapsing progressive MS is an urgent, unmet, clinical need. Animal models of MS, such as experimental...

PML carryover onto ocrelizumab

I have just received the following information from Roche, which is reassuring in that As of July 3rd 2019, the Roche can confirm there have been no new carry-over cases of PML in MS patients treated with ocrelizumab since their last update in April 2019. The seventh case was reported in March 2019.As of April 2019, over 100,000 people have been treated with ocrelizumab globally, within a...

HSCT, is it remission, or is it a cure for MS?

Most of you who read the blog know that I’m highly cynical when it comes to the word ‘CURE’ in the same sentence as a brain disorder or autoimmunity. In fact, it’s very similar to hearing the word VEGAN in the same sentence as pizza or donuts (apologies to any vegans who are currently sitting across from one of these right now; there’s always tomorrow). Why? Where do...

Identity

MS and identity. We know what MS does to us physically – but what about to our self? Receiving a diagnosis of multiple sclerosis is devastating. Full stop. The disease course is varied and unpredictable – and we humans we don’t like uncertainty. There is no cure; medical treatment is limited and the symptoms are wide and diverse. In addition, the onset of MS often occurs in young...

#ThinkSocial

At our second MS Services Variance meeting, ‘Raising the Bar’, in Birmingham last week my colleague Helen Ford and I co-chaired the workstream on the social determinants of health (SDoH).  What are the SDoH? The SDoH are life-enhancing resources, such as food supply, housing, economic and social relationships, transportation, education and health care, whose distribution across populations...

fifty shades of microglia

Fifty Shades of Microglia.Brioschi S, Peng V, Colonna M. Trends Neurosci. 2019 Apr 17. pii: S0166-2236(19)30044-X. In a recent study, Masuda and colleagues (Nature 2019;566:388-392) used single-cell RNA-sequencing (scRNA-seq) to profile microglia across different anatomical compartments, developmental stages, and types of brain pathology in mice. Moreover, the authors performed a novel...

Zombie

Are you an anticholinergic zombie?  A few months ago a 63-year-old MSer was admitted to hospital because of faecal impaction and overflow diarrhoea. She had had worsening constipation for years and was having intermittent diarrhoea due to liquification of stool from an overgrowth of bacteria in her colon, above a massive faecolith (a faecal rock). Her neurologist had her on a long-acting...

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