TagDiagnosis of MS

#MSCOVID19: get vaccinated

Barts-MS rose-tinted-odometer: ★ (Blue Thursday #000080) Where are all the new MS patients gone? We have national data showing that there has been a 30% fall in the number of new patients with MS starting on disease-modifying therapies (DMTs) during the COVID-19 pandemic. Where are these patients? I suspect due to the reconfiguration of the NHS because of COVID-19 many of these patients have yet...

On being EBV-negative and having MS

Barts-MS rose-tinted-odometer: ★★★★★ I have been diagnosed with MS and I am Epstein Barr Virus (EBV) negative. Therefore, EBV is not the cause of MS. Correct? I wish it was that simple.  Firstly, no laboratory test is 100% sensitive and specific. In other words, some people who have negative standard EBV serology may still have the virus, i.e. a false negative result, and some people who have a...

PTSD

Barts-MS rose-tinted-odometer: zero ★s I look after a patient with MS who is now in her late 60’s. She was diagnosed with MS almost 30 years ago in the early ’90s. She has done very well and has by definition benign MS. Apart from mild unsteadiness of gait, a weak right leg that causes a mild limp when she is tired and back pain, she is fully functional. She was treated with interferon-beta for...

Parallel Universes

I attended an online meeting yesterday and gave my usual talk on why the MS community needs to change its worldview from MS being a “clinico-radiological” entity to being a “biological disease”. There are many reasons for doing this but an alternative MS worldview will allow us to (1) diagnose MS earlier, (2) start treatment earlier, (3) define prevention strategies targeting very early MS or the...

The central vein sign in MS

Multiple Sclerosis (From Reich et al NEJM 2018) Last week, I blogged on smoldering lesions visualized on MRI as a marker of progressive MS. Today, I will discuss the central vein sign. This publication in JAMA by the MAGNIMS group (a group of MRI bods from the world over) is therefore, timely. If you haven’t heard of the central vein sign, it is the presence of a vein within an MS lesion...

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