AuthorNeuro Doc Gnanapavan

Walk beside me…just be my friend

“Don’t walk in front of me… I may not followDon’t walk behind me… I may not leadWalk beside me… just be my friend”― Albert Camus Since lock-down or ‘knock-down’ as I like to call it, I’ve succumbed to the reading club. I have just completed the reading of ‘Motion of the body through space’ by Lionel Shriver, which in my haloed opinion is the most depressive book that...

Neurofilament and vitamin D supplementation

In a moderately sized study from Finland, investigators wanted to know whether the addition of vitamin D to interferon-beta-1b (a first line disease modifying treatment) had a favourable outcome on disease activity. In order to assess this they measured serum (blood) neurofilament levels a protein found in neurones as a marker of MS disease activity. What they found was that the addition of...

Swallowing difficulties in MS

Swallowing difficulty or dysphagia occurs in a third of MS cases. Aside from the discomfort, it is dangerous for small bits of food to go down the wrong way into the lungs rather than in to the gullet. The latter can lead to chest infections (termed aspiration pneumonia), and is the leading cause of death in neurodegenerative conditions including MS. Early review of swallowing by Speech and...

CNS lymphoma in autoimmunity

Non-Hodgkin’s Lymphoma (a cancer involving predominantly of B cells) involving the brain, also known as primary CNS lymphoma (PCNSL) is something I see every year like clock work for the haem-oncology service at St Bartholomew’s Hospital, London. And despite the regularity of my visits, there is something extraordinary about the whole experience. You start to either vegetate or have...

Blood flow restricted exercise anyone?

I’m not what you’d call an exercise buff. Running in particular, was relegated to the back of the closet in my late 20s, primarily to save my joints from being sawed to pieces like a bookshelf in my 60s. And whilst, endurance training in the form of cycling and triathlons is the penultimate in fitness these days, I’ve preferred to watch from the side lines at a distance...

COVID-19 vaccine and ocrelizumab

The proof of the pudding is in the eating of it, not in the pudding or its concealed ingredients. Don’t take my word for it. From New York come two cases that were SARS-CoV-2 (COVID-19) antibody negative after developing COVID-19 while on ocrelizumab. Both cases were aged 39 and 42, within an age range that would be considered immune competent and therefore fully capable of forming an...

Do you smoke cannabis?

The findings from this study may interest some of our readers. Cannabis use in MS is licensed for spasticity management and to a lesser extent proven to be helpful with refractory neuropathic pain. Some also use cannabis to manage the psychological downsides of MS. Given it’s increasingly popularity since legalisation, the authors set out to determine whether discontinuing cannabis worsened...

COVID-19 has changed neurology

I generally don’t like to rock the boat on anything, this applies to what I wear, eat, the people I co-locate with and work. It should therefore come as no surprise that my response to our changing practice if anything luke warm. I understand fully (more so than you may credit) the impact that COVID-19 has had on hospitals, and continues to do so. But, in my opinion this should be temporary...

Do you use supplements?

Your body is a temple; or we’d like to think so, but even the most educated of us are susceptible to adding floors and basements to our temple with various additives and dietary quirks. Logic tells us that beyond fatty acids and vitamin D the rest is just fru fru, kitsch to our Id. It is not uncommon for me to get through an MS clinic without someone inquiring about diet or vitamins. So I...

Interferon-beta anyone?

Am I wasting everyone’s time and online space writing about interferon-beta? The fact of life is that some of you still use it. In some parts of the world it may be the only disease-modifying therapy that is readily available. However, having said this, there needs to be a method to the madness of picking first line treatments for MS, and this at least for the interferon’s is...

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