Multiple Sclerosis: Signs, Symptoms and Treatments

Multiple Sclerosis: Signs, Symptoms and Treatments


If everybody’s ready I’m gonna go ahead and
get started I don’t know if everybody’s here yet but I’m it is a little after 6 so I guess we
should get moving so I want to thank everybody for
coming to the talk Um, I am Christina Johnston I’m a neurologist that work that works at
Lakeshore Health Partners on I’ve been the in town practicing for the
past year so I’ve sort of met quite a few patients with MS in my first year of
practice and I was asked to do a talk to the
community about a common problem that I’ve seen so far and MS was like the
first thing that popped into my head I thought um, there would probably be some
questions and things that um, there’s been some new medications
that have come out over the past few years so I thought it would be a reasonable thing to review just kind of do
an overview of what is MS uh what are the symptoms of MS, how
do we diagnose MS and then some of the newer therapies
that have come out over the past few years I wanted to kind of touch base on those and then will be
plenty of time for questions at the and I didn’t get really really specific about
a lot of things cause I knew there was going to be probably a lot a questions so um but we’ll have plenty of time for
that at the end okay also I wanna apologize ahead of time I
have a cough drop in my mouth cause I’m getting over bronchitis so I apologize in advance um okay so I have nothing to disclose I’m independently employed I don’t work for
anybody else except for LHP so just want to get that out of the way ahead of time so what is MS what happens with MS? Um MS is a chronic disease in the that affects the
central nervous system that means that the brain the spinal
cord and also the optic nerves which are the nerves that project to the eye and allow us to see can be involved in this
process Um, everyone has an immune system that
normally fights of diseases such as bacteria and viruses any sort of infection and we think that the reason MS occurs is because
there’s a sort of case of mistaken identity that the immune system mistakes the central nervous system as a foreign object or foreign being and it
unfortunately attacks it and creates a problem so statistically
speaking everybody likes to talk about statistics a little bit to get a general
idea of how big of a problem this the
is in terms of our country um it affects approximately
the statistics vary a little bit but around 350 to 500 thousand so um people in just the United
States alone worldwide there’s over two and a half million individuals and the estimate that in in the United
States alone approximately 200 people per week are diagnosed with this disease
so it is rather common um more so than a lot of
neurologic diseases and its probably affected a lot of I means I’m sure a lot of people up here
in this room are affected but even in the general community most of us
can say that we know someone or or know of someone that has or um a family member who is affected by MS
or a friend or something it’s very very commonly seen. Um, it typically
affects males less than females I we don’t really know
understand why that is but the ratio is about two to three females to one male um but that’s kinda what we
see typically caucasians are affected more
predominantly um than African-Americans although
caucasians african-americans and Hispanics are the most commonly affected we don’t
always see it as much in asians although it can occur and there’s a few other ethnicities this
is not as common um children can be affected by this
disease although it’s very rare in my training I did see I a few
children that were affected but mostly it occurs in our younger years it kind of the the saying
is that it affects a person when they’re in the prime of their life their
twenties or thirties or forties or fifties when they’re really you know doing great
they’re living their life they’re having children they’re getting married and this happened so it tends to occur kind of in the northern
areas of the world the United States predominately in
the United States it’s even more in the upper portions of the
country as you get more South it doesn’t seem to be as prevalent and
that’s the case across the world so europe Japan some of those areas are more
often effected northern European countries
specifically tend to have a higher predominance of
MS as well we’re not really sure what that is there
some theories about that vitamin D or sunlight exposure
could be playing a role in why that occurs more commonly than nearer to the
equator because it’s very infrequently seen in the
countries that are closer to the equator The life span a person with MS is generally about on the average only a
few years shorter than the normal life span of a
typical American so you know people who are diagnosed with
MS still live a full life only they have to sort of um deal with the
symptoms and the chronicity of this disease so we still haven’t identified exactly
what the cause of the disease is but there’s a lotta research so I just put this slide in because this
is I found this on-line and it’s a picture above many famous faces who have been affected by MS I think that’s Teri Garr Annette Funicello who just passed
away she was seventy years old so she lived a long time with MS Richard
Pryor Ann Romney was in the news with the last
election kinda brought a lot of attention toward MS and raised a lot of questions about it
Meredith Vieira’s husband I think Richard Cohen is his name he’s
um a famous individual who’s been in the
news a lot about you know what attention toward MS and Jack
Osbourne was diagnosed a few years ago so he’s been in a few newspapers and magazines over the
past year so that i’ve seen so but it is it does affect anybody so so getting into a little bit more
detail about specifically what is it so everyone’s brain and spinal cord
are you know consist of nerves and the
nerves are lined by a protective barrier called the myelin
sheath so the analogy that we use is that it’s like an electrical cord with a protective you know insulation around the cord and that’s the case with
the nerve so what happens is that the normal
nervous system connects the brain to the spinal cord to
the nerves in the extremities which connects with the muscle and
allows us to do things like move walk feel a sensation uh, visualize the
world so when the immune system attacks
the the myelin or the covering up the nerve
it creates a disruption in the signal transmission and so the signals can’t get from the brain
to the leg or to whatever is affected and it creates a problem so it usually happens when inflamation occurs after the attck of the immune system on the myelin so what happens with that is an attack a
clinical attack a relapse a flare whatever term you choose to use our or your
neurologist uses to use but that’s what it is so it’s a sudden
onset of neurologic sometimes meaning weakness numbness
anything like that that comes on and doesn’t go away for at
least 24 hours for some people it lasts for you know 3-4 days
for some people it lasts several weeks and some people never I mean it can
persist longer so typically though that’s not the case
typically it’s a short term a few days a few weeks and then it
gradually starts to improve which is why I sort of people can have
symptoms and then they get better and they ignore it and they don’t even know
that they have symptoms of MS. Oftentimes it
happens to a 24-year-old 25-year-old you know a young person they get better and they don’t think
anything of it until something happens later so that’s the classic pattern that we here of
relapsing remitting so a relapse followed by a remission
meaning healing and going on with normal
activity so the symptoms can come on later in
life usually in this in the setting up
infection if we’re stressed out if we’re tired and it’s the result of the sclerosis left on the brain or the sclerosis just means a scar so
after the brain is attacked or there’s a damage to
the nerve there’s a scar that forms as it heals
but that scar doesn’t have the same capacity that it
had prior to its damage so it can leave residual
symptoms going forward. Over the course of one’s
lifetime you can see a decline in physical activity you can see a decline
in cognitive ability so there are some chronic components to
this disease which is what leads to the disability component you know and and managing these
chronic symptoms is you know that’s my job that’s what the
neurologist sort of managers and and deals with
on a routine basis so I put an illustration in here and actually
tried to put into my slide but it didn’t work so
I’m gonna actually just go to the YouTube website it’s not my video but I found it online
and I thought it was a fantastic illustration of the pathology that just
tried to explain Multiple Sclerosis, MS is a disease that
affects the central nervous system the CNS which consists of the brain
spinal cord and optic nerves everything we do whether it’s taking a step, solving a
problem or simply breathing relies on the proper functioning of the
CNS to understand how MS may impact
the CNS we must explore the disease at the
cellular level in the brain millions of nerve cells
called neurons continually send and receive signals each signal is a minute but necessary
part of intricate CNS orchestrations that
culminate in the actions sensations thoughts and
emotions the comprise the human experience normally the path over which a nerve
signal travels is protected by a type of insulation called
myelin sheath this insulation is essential for nerve
signals to reach their target in MS the myelin sheath is eroded and the underlying wire like nerve fiber
is also damaged. This leads to a breakdown in
the ability of the nerve cells to transmit signals it is believed that the loss of myelin
is the result of mistake in attacks by immune cells immune cells protect the body against
foreign substances such as bacteria and viruses but in MS something goes awry immune cells
infiltrate the brain and spinal cord seek out the myelin and attack as ongoing inflammation and
tissue damage occurs nerve signals are disrupted this causes
unpredictable symptoms that can range from numbness or tingling to blindness and
paralysis these losses may be temporary or
permanent that was a really nice illustration of
what I tried to explain but obviously I can’t do the video as nicely that explained it
but I thought that was a good explanation sort of of what the
physiology of MS is just so that you can all understand if you weren’t aware already so again why does it happen we don’t really
know there’s a lot of theories out there there’s been a lot of
investigations about what specifically causes it because for for like I said it affects us at a
younger age so there’s a theory that it’s gotta be viral I mean we’re all exposed to varying
viruses throughout our lifetime the one that’s most commonly thrown
out there is the Epstein Bar virus which many of us were exposed to
in childhood some of us were affected and got mono from it some of us had
no symptoms of it and they think it could be
contributing or have some some role in making the immune
system go awry and creates this this disorder as I stated earlier vitamin D has
recently become a sort of big focus of MS and especially in preventing
relapses because we we think that low vitamin D levels
low sunlight exposure kinda that northern latitude thing that I talked about before
that that has some implication in in the relapse in and the and the incidence of worsening disease so there’s a lot of
research going on in that and a lot of physicians now are starting to monitor
vitamin D levels and if they’re low which most people in
Michigan have a low vitamin D level we’re starting to replace it and kind of
get those level up a little bit into a more therapeutic
range because we think it’ll help genetics is also something that
they’re looking into it can run in families there’s definitely a large number of you know families that do have MS
that runs in the family but they haven’t identified a specific genetic linkage I mean I have a number of patients in my
practice in my training I saw a lot of people that you know their parent was diagnosed
or they had a sibling who had been diagnosed with MS so it it seems like it has some sort of
genetic linkage but we just haven’t really identified it yet so MS is a broad diagnosis there are four types
of MS. the most common and the most
significantly more common is the relapsing-remitting multiple sclerosis that affects about eighty-five percent
of people who are affected by MS it’s clearly the most common a much much less common is a primary
progressive multiple sclerosis I’m not going to spend a lot of time on
that one or any of the others because it just it’s not as commonly seen but
primary progressive multiple sclerosis you don’t really see the relapses
the patients who are affected by that they they get a symptom and they don’t
recover from it so there continue anytime that they have
a new attack on their system they just continually decline but they don’t have
like an outward attack and then recovery so it’s a little bit different
and we think it might be a little bit the
the physiology of it is obviously a little different we haven’t clearly
identified that either there are not as many there
really aren’t any therapies for that type of MS either and relapsing
remitting Multiple Sclerosis does have a number of therapies so I wanted to really focus on that type for this talk secondary progressive multiple
sclerosis is kinda something that you see later in life in the disease process
after you know you’ve had it for a number
years you start to sort of not have as many relapses or not as often and and things just start to quiet
down or they seem like they quiet down but what we know about that is that in
that stage the relapses become less prominent but the disability part seems to become more evident so the
scarring on the brain that occurred earlier in life now starts to affect us more seriously and then progressive relapsing
multiple sclerosis is very for a rare but it is a is a condition
where there’s a progressive component
that can have relapses but that you know you you have a relapse but you don’t
completely recover and it’s more profound than in relapsing-remitting so it’s a little
tricky to diagnose you don’t see that one as often either this is sort of a illustration of the the type that I just described this one
at the very top here is called benign multiple sclerosis
that you know it it we don’t see that
one a whole whole lot there’s a very few people that have multiple sclerosis but they the completely return back to
normal and they just don’t really develop disability over their lifetime it definitely occurs it’s just not as
common and we don’t we don’t tend to focus
on that one as much either those people are usually kinda grouped
in with the relapsing-remitting because it is so soimilar there’s relapses the disability just doesn’t seem to be
as profound but you can see with this illustration
was trying to say is that with with each relapse there’s a sort of a
peak in disability the the y-axis here’s the disability
factor this is time so as our lifetime goes on there’s a a
relapse and we get better but if you notice you
don’t completely return to baseline you may have a teensy bit of a
residual weakness or whatever your disability is and then a few years go by and then you
have another relapse and maybe you still don’t return exactly to that baseline at
you are at and as it goes on it’s just a little bit
gradual progression of the disability component with primary progressive as I said there’s
just really no relapses there’s just a continual steady increase in the
amount of disability over time but you just don’t see
those peaks in sudden onset of symptoms the secondary progressive form here is
very similar but as I said there’s just a much more you know a much less recovery to to the baseline there and it just as you
get later in life to even the relapses become less prominent
so and then this is the progressive
relapsing so symptoms I mean everybody wants know
what are the symptoms I think so many people in my office who come and say I think I have MS I’ve been reading
on the internet I think I have MS please tell me I don’t have MS. I can’t tell you how many times I see
that and then there are the people that come in they possibly do have MS so how how do we how does the
neurologist know well I mean obviously this is a great
illustration because it shows that it affects every part of the body essentially oftentimes initial symptoms can
consist of loss of vision in one eye or optic neuritis sudden wake up one
morning can’t see out of an eye pain painful vision gradually progresses
over a few days and then after a few weeks starts to
return that’s very commonly seen as one of the initial symptoms of MS it can vary though I mean some people
can have episodes of double vision or sudden imbalance but as I said earlier in the
talk but symptoms have to be sorta consistent and last for more than 24
hours so when people come to me and say I woke up this morning my leg is numb
and later in the afternoon it back to normal that’s not MS okay certainly sensation can be affected numbness paresthesias meaning tingling burning
that type of thing that can that can definitely be MS
but it’s not something that you know we wake up with in the morning and it’s
better by afternoon that’s different weakness oftentimes the initial symptoms or
later symptoms of a relapse or weakness that affects a limb you know my arm is all the sudden clumsier or
heavier than it used to be and it’s just not getting better and I think something’s wrong its it’s a
profound neurologic symptom that doesn’t get better or doesn’t get better
right away okay with the spinal cord involvement you can see things like
bowel and bladder dysfunction urinary incontinence urinary urgency having to go all the time difficulty
emptying things of that nature. it can affect
our swallowing it can affect our speech it can affect our cognition are
focus our mood are energy level I mean everyone who has
MS the most common complaint is fatigue. I’m
tired I have no energy I have to take a nap every day because
it’s just it wipes you out so these are the symptoms but it’s the
way the symptoms present and the duration and and that that really helps the
neurologist to to hone in on this could possibly be an MS symptom. so as I said when someone comes to me
and they want to know how do I know if I have MS a neurologist is gonna really you know tease
through the details of the history the history to a
neurologist is the most important thing because I wanna know what is happening right now
but I also want to know what has happened before I mean what in your earlier you know
years have you presented with or have you had and your
ignored it because it got better you didn’t think anything of it um the timing of it as I said how long
does it last how when did it go away. has it ever come
back um that’s really really critical to
making a diagnosis the neurologic exam is obviously very
important um and can only you know a neurologist
is probably the only one who can do it very well um it’s a challenging thing to do um
the imaging of the brain and spinal cord is very important before we had MRI MS was much more
difficult to diagnose because we didn’t have specific pictures where
we could see the lesion or the inflamation or the attack um sometimes now less commonly we we still do a spinal tap to make an
analysis of the spinal fluid and see that there’s evidence and inflamation but thirty years ago anyone who possibly
had MS got a spinal tap nowadays that’s not
necessarily the case MRI has significantly brought us much
more advanced and we don’t always have to do
that now evoked potentials which are the visual um the visual testing to see if
anyone’s had optic neuritis I mean we used to have to do those
things to really solidify a diagnosis and sometimes we didn’t know sometimes
we had to wait now we sometimes may have to wait a
little bit to see if there is another relapse or see if there are new symptoms
that develop but most of the time or very very often we can figure it out rather quickly
because I technology has advanced so much but again I do see people sometimes where I say this is a clinically isolated syndrome you have a high likelihood of developing
MS based on your symptoms based on your imaging but it’s not a
MS yet because they’re very strict criteria that a neurologist uses and I’m not going to get into all that cause it’s really boring
and so this is a typical MRI of a
patient who’s been affected by MS. so I have two views here um this is a
sagittal image and this is an axial image of a typical MRI so what we’re seeing here is these areas here here here here sort of along the middle of the
brain this is the these are the eyes here this is the back of the head the spinal cord starting to develop down
here so we’re as a neurologist, we look kinda along
the center of the brain where MS likes to hang out it tends to affect the portions near to
the ventricle which is this portion here and these are the ventricles here and
here as well and in both images you see these areas of inflamation these bright spots on the brain and they
really like to hang out near the ventricles we don’t know why but um that’s the sort of classic picture of what an MS brain looks like
these areas where the inflammation is located is probably when a
relapse occurred so we like to monitor MRI’s going down
the road after a diagnosis is made to monitor the progression of the
disease to monitor if the the medication that you’re on is
working it really provides a lot of information this is a picture of a spinal cord that has um a lesion on it so kinda just a
general illustration of what we’re looking for
when a neurologist orders an MRI that’s why we want to get so what do we do for treatment um
there’s no cure but we have significantly advanced in
therapies over the last twenty years um there’s at this time still enormous
amount of research in MS, um, they as I said in the last three years there’s
been three new therapies that have come out which I’ll talk about in a few minutes um there’s a lot of drug trials going
on right now there’s clinical trials there’s you know in the lab trials going on and
we’re moving very much toward toward um you know better therapies and therapies that are
working much much um stronger at reducing relapses and
minimizing disability which is really important so obviously though it’s still a
balancing act because we have to maintain our immune system and find a
therapy that allows our immune system to be suppressed enough so that it’s not
going to continue to attack itself so it is rather challenging and that’s
why it’s taken so long to get to where we are now we
have therapies available that work with minimal side effects and um you know that you can be on for a long a
long period of time so the treatments that we do have
available obviously the acute relapse is when something happens most the the the
mainstay is steroids it still is it was fifty years ago um when you have
an acute relapse if anyone has ever um had a relapse
steroids are kinda the mainstay it ek expedites the healing process it doesn’t
cure anything but we want to get you back to your baseline as soon as quickly as possible and get you back
on back on your feet. Um, the disease
modifying therapies are the ones that I’m gonna spend most my time talking
about and the symptomatic therapies um I’ll touch on a little bit but that’s
really individual so you know based on what your symptoms are
there’s there’s multiple treatment options but it’s sort a very
individualized so in 1993 was the first um disease modifying therapy that came
out it was Betaseron it was an enormous breakthrough for MS
patients because all the sudden there was something to put to be on to reduce the relapse rate and
to reduce the potential of of progressing with
disability um since since that time so in 20 years we’ve come up with 8 FDA-approved
disease-modifying therapies actually I think there’s actually 9 but
one of them I didn’t include because I don’t see people using it much anymore
because it has a lot of bad side effects so kinda moving away from that one since
we’ve gotten some newer ones um ah all of the disease modifying therapies
that are on the market um have been shown to reduce relapses
most of them have been shown to at least reduce the progression of disability
and many of them have have also been shown to reduce the the
new lesions seen on the MRIs that we that we periodically check so most of the actually all the therapies are generally safe and well tolerated when I say generally there are a few um significant complications with
several of the therapies that we very closely monitor and we look out for and and we’re very on top of those ah potential risks so we’ll talk about that um on avaerage the injectable disease modifying therapies have been shown to reduce
relapes by 30 percent the injectable um have been around the longest um only in the last three years are there
pills available now so most people who have had MS this long have been on injectable
therapies of some kind um all have an anti-inflammatory
effect on the immune system so reducing inflammation bringing the
immune system down to a more manageable level and reducing the relapses um most of the
therapies require some kind of blood monitoring there are a few that don’t require as much but
there are you know a maintenance test that oftentimes have to be done to ensure
that it is it safe to continue beyond so the first category is that I’m gonna
talk about are the interferons interferons are normally present in our immune system and betaseron is the first one that
came out it’s also called extavia it’s believed to suppress the movement of T cells which are a typeof immune
cell across the blood-brain barrier so
there’s a there’s a wall between like the the blood flow and the brains cells
themselves and so the immune cells have to sort of transpose across that and invade the
brain to cause the attack so this medication
was aimed at reducing that transposition of
the T cells across the barrier the barrier into the brain this is an
injectable medication every other day it’s been around the longest there’s
been a lot of people who are on it at first and then since that came out there’s a
few others that have come out as well in the same category it’s approved for relapsing-remitting
multiple sclerosis it as I said reduces relapse and by
about thirty percent so it’s a pretty reasonable number
it does have the unfortunate side effect of them flu-like side effects with the injectables but um for its different for everybody and we
have you know wonderful nurses that we you know use to
train our patients to help sort of minimize those unfortunate side effects um interferon um beta-1a are the avonex and the rebif this is
the same medication but in a different form in a little bit different dose so avonex is a is a once-weekly
injection um it reduces relapses as I said by
about thirty percent as well all the interferons are about the same in
terms of numbers it’s been shown to slow disability
progression which betaseron did not and also reduce the MRI leasions that are seen mmm so avonex is once a week rebif is
three times per week under the skin both have flu-like side effects unfortunately but as I said for most people it’s
usually worse in the beginning when you’re starting the therapy as you sort of get established on the
therapy the flu-like side effects do tend to dissipate and you sort of learn how to how to manage
it you pick a day that sorta works for you that you’re able to be a little under the weather and still
kinda go on with your day to day functioning with both of these medications um blood
monitoring is required you have to monitor the lever we monitor the the the white count to make sure that
you still have a good immune system in that the platelets and other things haven’t
dropped so we do do periodic blood monitoring with the both of these
medications the other injectable medication is glatiramer acetate or Copaxone Copaxone is a different category of
medication that’s not an interferon its actually a combination of amino
acids that are believed to be found in the the
myelin or the on the a it resemble the mylan and it
supposed to suppress the T cells and reduce inflammation um it’s approved for relapsing-remitting
multiple sclerosis as well it does also have a 30 percent
reduction in relapse rate it has not been shown to decrease
disability um but it is widely prescribed it every
day under the skin it has very minimal
side effect it has no flu-like side effects it is tolerated by most people who do
the injections and its kind this is the one I kinda tell
people it’s like being a diabetic you sort of just do your shot every day and you just
go on with your your day so this is one that’s
been very widely prescribed for women who want to have children it’s
safe during pregnancy this is the only one that has been shown to be safe for pregnancy
for women that are in their childbearing years and
affected by MS this is one that is often used because you know you don’t
have to go off of it you don’t have to go back on it for some of these medications
it takes several months before they reach full effectiveness so that’s a nice
that’s a nice perk Tysabri is a once-a-month infusion Tysabri is a very wonderful drug when it
came on the market it was like the breakthrough it was I believe 2007 I
have to look that up specifically but it may have been 2007 when it came onto the market and it was pulled from the market a year
later because of an infection of the brain that was found
to occur called PML PML is a viral infection that is
irreversible and it can result in death it can
result in very significant disability and it is not taken lightly
by any neurologist it is a wonderful drug now in the sense
that it’s once a month you go for your fusion you
go home and that’s it for the month and you feel great and there’s no side
effect and its a fantastic option but it has very specific protocol that has to be very closely adhered to
only approved neurologists and approved centers can
administer this medication you have to have very strict criteria with every infusion you have to have
a patient who is incredibly willing to adhere to the rules and it it is very closely monitored but it has a reduction
relapses of by about 67 percent so far surpasses all the other ones it slows disability progression and
reduces the MRI lesion and it’s a great drug but I’ll tell you
have seen PML and it’s not great it’s horrible it
kills people its it is worse than MS so that’s why we don’t we don’t pick this
for every person with MS this is a medication that
is reserved for patients who have failed other therapies and are having
progression and we need to do something stronger but it’s a great drug Yes when it is used yes as is the case with some of
these other medications that we’ll talk about so these are the new oral therapies so any
other a 50 and tech for their of health which is awesome no injection
many more so don’t wanna make you mine in 2010 it’s a once-a-day tablet it has a
reduction in relapse is about fifty percent but unfortunately this one has um some
unfortunate cardiac side effect that we have to really closely monitored there have been some reports of sudden
cardiac death with this medication so we have to pick patient to have no history of cardiac problems are
very minimal risk risk of cardiac disease on it has it produces a disease progression
it reduces MRI region on it up believed to keep the lymphocytes inside the lymph nodes and
prevent them from I’m going to go to the brain so that’s
how we think it works I’m this one can also affect our vision
in ’cause a macular degeneration so that’s something that has to be screen
while on this medication on there’s a little bit of blood
monitoring of the screen for z/os oster or her on that shingles by rest but its job it’s a good medicine to it’s been out
for three almost three years now and there’s a number people on it and
they’re doing great sold that was the first one I last follow by your weather pro why we
always called theraflu my careful in mind is a agent that has been
I around for I’m not not here for the
night um left phone in my which is another
derivative I love up here for the night or similar has been around for much longer so we do
have some information about this on similar products and it was approved as a once-a-day tab what you is believed
to have hit a flamer three properties that reduce the lymphocytes and the in the central nervous system the
specific seven or a little little sticky to me I don’t completely
understand that exactly but its I’m it’s been around and it’s
starting to be prescribed more commonly on it has a specific similar with the
injectables about 30 percent I’m however the big the big fancy
statistic here is that eighty percent left new lesions on MRI which is you
know a really important I factor for for
patients this is %uh pregnancy category axo
anyone who’s in there childbearing age range is probably not
going to be a good candidate for this medication because it’s very risky I’m category act in the medical world
mean absolutely not cannot get pregnant on
this medication even males who on could potentially
impregnate their wives are supposed to be warned about that because that’s been
found from and also to be a problem so we have
to monitor blood pressure and we have to do a TV screen but this is a once-a-day
medication that is an option for people if you’re me on
your childbearing years and it’s okay to be on something like this than this is a great option I I mean I’m I’m really excited about the final South
I’m and tech for there is the most recent one that just came out a few
months ago it’s a twice-a-day medication it has a
little bit different I’m back in them mechanism of action a
predominately work from the anti-oxidant pathway from which is kinda a new thing I mean
we vote we always hear about anti-oxidant thing as both a drink all these and accident you know through
you said that thing for it that there there is a lot of ongoing
research in this area so there’s probably going to be more drugs in the
future coming out in the area this Heather a reduction relaxes by of
53 percent on disability is also decreased by 38
percent the side effect prior profile is pretty
good I mean it it does cost them flashing for people the face feel a little hot
for about an hour so after your does tends to get better after about an hour
from what I’m told and tends to minimize over the course of
the first few first few weeks by the end of the first
month and told that much better I’m it can cause an upset stomach some
gastrointestinal discomfort but its sounds like a great drug also
very little fight a fact starting to see i mean I have a couple
people are there now I haven’t heard a lot about feedback fell I’ve talked with some colleagues who
think it’s great I worked in a center that this was a medication on in the research trial I so great great day out on the fun this
medication was available in Europe for psoriasis so it’s been on
the market for a long long time and they have a lot of good data that
its safe and effective of L so this is a great option for people so with all these nomads how did the
neurologist user how does the patient on you know how do they know if their
candidate for these new medications well that’s complicated a little bit arm
you know for patients that have been stable on their injectable
medications it’s really hard to to take them off a
bit right away knowing that they’re doing so while for patients who have horrible side
effects they’ve been he never have an accident when he nearly there for
whatever the case maybe they had their compactness and the they just have had horrible
tolerability issue 3 years and now these pills are available I mean that’s a
reasonable option but it’s very individualized with each
case scenario its it differ on thought process into why would we
switch for some people they they do fine air
duct herbal medications but they’re just getting worse and they need something different and
these are available and they have a different mechanism action so it’s a different way of
fighting of immune system so that’s a reason to pick it for some people they have no symptoms
but there are my eyes are looking worth and something needs to be done so that
disease progression or disability doesn’t occur in 10 years so I mean there are a lot of thoughts
that go into a neurologist mind when we meet with you every visit to talk to
talk about your therapy I’m it’s not an easy choice on it’s it’s a it’s a big it’s a big
decision to switch therapies and there’s risk with which in therapy
and their side effects were searching therapy so is very individualized anyone know
them if they know all about the the risks of medication and it’s
it’s a case by case decision so what if I for one person the
necessary pie for the next person so what if you think you have an ass or
what if you know somebody who that you are concerned might have my math the to
see somebody about it they need to get evaluated by a neurologist somebody who
is familiar with a mass who can really look into it on because
what we know about a mass and what we’ve seen even before before I was even born and
31 years old well I mean this has been a long for
around for a long time and you know my trainers have been doing
this for a long time they saw people when there was nothing
to do and every year things got worse but now with
therapy things slow down and and people are
living longer with left disability with more functionality there no one not me it’s now they have amassed
because they can you know have less and less symptoms as they’re
like 10 cause on and if you don’t get treatment as soon as possible or as early as you can then the risk for
relapse is increase as and with that is disability so the
earlier you’re suspecting sometimes the girl you should see somebody Inc and
figure it out for people who have been diagnosed with
MS and have been living with us for years that the whole different you know
it’s a different ballgame arm the symptomatic therapies are as I
said earlier very individualized there’s plenty of medications out there to treat the fatigue to treat the
specificity to treat the depression to treat the bladder problems to you know I mean there’s there’s lots
of things that we have in its obviously with one thing is that work we try
something out then if you know something doesn’t work we stick with it but its its it depends on the same found
it depends on the person but I’m you know that’s a conversation
you have with your neurologist so when when a piece with a mask on
through my office and I see them and I say how
are you doing me not the time to say all my fighters
firing me or are not sleeping or how or and on the
top I mean because thats that the conversation that
you have with your neurologist is how are you doing mean when when I
walk in there are many say how are you know that’s what I’m I’m great but I’m the
Safari me I mean that’s what the neurologist new
snow that’s how we decide how to treat your symptoms and what to change in what to do
differently so physical therapy is a great option
occupational therapy for people who have you know you know different I mean it’s
different for everybody but those are great resource to the physical therapist in this town are
awesome their top-notch I’ve sold many great
responses from people that have gone physical therapy for you
know not just amassed we have a really great I’m community with wonderful resource s
so I find take advantage of that term in patients and I always make that an option on assistive devices
sometimes are very helpful for you know foot drop or whatever the case
may be on you know when upper extremities are
spastic and it’s hard to go grab things are open jars and its its there’s things available for
that so you have to talk to neurologist about it so that we can get get to the healthy
you need living environment something had to be
changed living in a house that doesn’t have a ton affairs you know bathroom accommodation things
like that so that we can minimize complications exercise is always you know I never tell
them not to exercise I mean there’s out there different degrees of exercisers
different things to do exercise is really important healthy
diet good sleep home you know stuff stress
management hard stress management is something that and
the doctor can preach to you and any person can preach to you but it you know I mean every person has
stress and everyone deals with it differently but it is important because when you’re
more stressed your symptoms are accentuated and it’s really important to
sort of keep that under control and if you’re struggling with that to
ask for help support refer great till I’m for pork
ribs are wonderful in the sense that they can give you someone from listen to your
struggle and also you know here what other people
have gone through it it’s wonderful in some cases they can make you a little
nervous that oh my gosh I am I gonna be in a wheelchair because that’s the most
common fear everybody and and I will tell you it’s
not it’s getting better I mean people are doing better for
longer with the advancement a medication so I think
the people that are weird wheelchairs thirty years ago if they were to have
been diagnosed now maybe wouldn’t be in a wheelchair as
feeling or maybe not ever its it’s two things have changed and
things have advance and we definitely are making a lot of strides so I put the fight in here actually we
have a handout over here with this information so these are just
some wonderful online resources that of anybody familiar with them but the
National MS Society is a fantastic resource for helping with you know disability
benefits for insurance for work for all sorts of questions that we face
in our day-to-day routine when you’re living with a math I’m
namath lifelines them a active sources those are both online
resources that can answer questions that can provide I’m you know there’s a mentor their I what I think both of them
actually I must leave by the time as active force have resources to talk with a mentor if
you need just somebody to talk to or someone who’s been there there there
those resources there on the ms. foundation & Spa shared
solutions is great because they help with you know in questions at work questions
about injectable therapies how to make things better if you’re struggling from they’re they’re wonderful owner
says that can provide way more our answers to questions that probably I
can hit and fell I use them a lot self and on your side and I went a little bit
over arm there’s about 10 minutes left I’ll have out safer any questions so I hope
that wasn’t too boring or 200 perfect I okay thank you I the the question why is on I had
mentioned some speech sometimes and the question was what would be some
speech something that frontal lobe lesions while I suppose that’s a complicated
answer as as is the case with most neurology
frontal lobe lesions if they involve them older pathway can affect you know the
mechanics above the mouth so can make you have a more def
arthritic or more about flirty your speech are making about the throat so could
have more modest phonic or some kind of like problem I know how to explain that very well but
it it can make your your speech down a little thicker because the
the vocal cords and the the the throat doesn’t move as nice and
easy as it use to sell I’m that would be the most obvious thing
I would think of so the question I was in the video
presentation there was a comment about how the the pathway or about the pathophysiology
of an ass is that detects the mylan but also that attacks the nerve fiber
itself meaning axe on and that is true what we learned about our math with MRI
is that when the mylan is damaged the accent
beneath it can start to wither away because it is
that we don’t know why that happens but probably because it isn’t protected
as well and so the signal isn’t being train ducted as well and the nerve
starts to die of a little bit and we know that because I’m MRI we see
these black holes is what they’re called but
their holes in the brain that occur almost on a bit
like a stroke but it’s not a stroke it’s completely different ideology but it’s a hole where the the nerve
itself has basically sort of deteriorated we didn’t really know that until MRI so
the theory has changed a little bit and that’s where we think the disease
disability long term comes from is when those black hole or the the axe
on itself has started to be this integrated or
affected is when the the secondary progressive disease come
then we’ve only learned that over the past twenty years but you it without contrast it’s actually I’m a
on the t1 sequences which I’m I have many sequences that we look
at and when we’re looking for active information we always look at the flare
fake ones are the key to flare sequence that those were the sequence as shown in
the images during this presentation but they’re also the sequence called t1
and that does demonstrate the black hole so we don’t see it an early amassed we
see then later on that cell but yes that’s a wonderful question
we didn’t know that for a long time I’m the question for
everybody is does the number I’ve lesions on MRI
correlate with the number relapses or the number are the severity of
disability I got answer is No I’m there are MRI’s they look horrible like the 1i showed
you I’ve no idea that Beijing was I I just picked that picture because I
thought it was a good illustration but MRI can be horribly deceiving and look where the like that and have
very few clinical symptoms okay the opposite case can occur when
the brain never really look that bad but the location of the lesion can be in
that specific precise location that it put leaves you with a lot a disability so patients who have
brain stem or spinal cord lesions and not a lot in
the outer portions of the brain can have a lot of disability in life
really bad and their brain doesn’t look that bad so it doesn’t always correlate but the reason we monitor MRI is because
we wanna see is there any new regions that have had some sort of
clinical correlation because there is a silent component and
math because every new lease and doesn’t always have a symptom so not in my training are not in my career time I’m I get a repeat didn’t
hear the question on can we use combination therapy to
improve the immune system fight against I math
I’m the reason the answers now we don’t do
that I’m and the reason is because for example in the i text every trial those patients that developed p.m. I’ll were also
another 30 some of them have been on avonex okay and some of them have been on other
chemotherapy drugs for other conditions and we think that that significantly
increases the risk of infection and so we’re incredibly leary I’ve
exposing people to too many infections because brain infections are very
serious so we don’t take that lightly and most of the studies are are compared
against placebo on there’s very few trial to compare
head to head against another product but they do not allow people to be in
studies with combination therapy for that reason because I’ve the risk of
infection so it ecological box and a lot of people
have discussed that but in my training in my career and even
I think in the twenty years that they’ve been
available people are just not doing that I mean I’ve I’ve not seen that anywhere cell and in fact sometimes when we take
people off medication and what’s worse is something different
we give them a little bit of a washout period meaning some time to get that drive out
other system so that that is not a risk exercise for that’s great it’s mentally therapeutic it obviously
very you feel better and we think that keeps you a mandatory
for longer felt thank you that that’s great can you still have a
mass if you don’t have lesions on your brain probably not okay that I am there is a condition called honor my
latest after car which is a very into a mass it’s not an ass but it is usually
consist of spinal cord lesions with no liens on the brain and optic
nerve so it’s nerves on the eyes and spinal cord and
nothing in the brain which it’s very similar amassed but if
you have a massive you have something on your bringing now in my opinion is in my opinion is a fun
better than vitamin D I’m I don’t know the answer to that I
think it I think it might be I mean look at the
people that live close to the equator they don’t have this problem see kinda wonder right but we don’t have
that ability we’ll we have you know how many month of cloudiness
and no sunlight and it makes us all depressed and cranky
but I mean it it does make you wonder bowl
that’s all we have as the vitamin d3 for or a supplement in
this area the country’s how often that’s a hard question how
often it is is it in the arms versus the legs or probably refers to
the life versus the arms or both I’m I don’t know that I’ve ever paid attention to that truthfully I
think we notice when it’s in the legs more of 10 because it affects
their walking effects are emulation but the arms are
not taken lightly either i mean writing we are driving everything we do I mean I
don’t I don’t really have an answer to that because I never really paid
attention to watch is more prominent for a lot of people in effect 15 the
body so if the arm and a leg on one side for of but is it just one arm or just
one lag I don’t know which one mark on for and
this is a complicated disease because everybody’s different not one single
person with MS looks like the next person it’s very variable cell it which is the
challenge so that I thought he wants to know
because the location of the lesion that MRI are so close to the ventricles in the
center of the brain does that mean that there’s something
having to do with what we ingest into our bodies and that it’s crossing
the blood-brain barrier somehow and affecting the brain in the centre portions from
something we ate I don’t know I i’m never heard back that
phiri inexpensive one for insurance is a lot of times are you
know people use their insurance if the pay
for those expensive thing so that’s why they hurts so much because insurance
companies molpe the big box and if you don’t have
insurance or free insurance won’t pay the static at the big bucks so I I truthfully I don’t have enough
lot of knowledge about where that cheapest devices are located I know
there’s just you know I i refer people to medical device
stores because every month options but I don’t know that that you’re right
they’re not they’re not cheap it’s such a in my practice I’m I don’t want anyone I don’t want anybody
not be on drug because they don’t have insurance there are so many resources most of
these drug companies will make sure you get the drug and and
most of them have assistance programs so that you can get it for free for a
year or two or you can pay you have attend our copay or they almost
all these drug companies bent over backwards to get you on their their therapies I meet my partner
trained in inner-city Chicago in you know he he saw people who had no
money no place to live and we’re getting drugs so these drug companies will make sure
that you can get therapy if you have a diagnosis so somebody who told me because they don’t
have insurance enactment take their medication I can I that’s not enough for me me hi I really do work very hard to get people
on therapy because I really strongly believe that you know I
don’t want to be disabled so I I want I want to make any
opportunity to keep you functional keep you living
as long as possible I think that’s changing a lot now I
think one other one other company they know for sure
absolutely will pay for your dog if you can afford it and in fact actually to %uh the company
then oh well yes people with the injectable the aft since the orals have come available I
mean I think I’ve only been here for a year okay so I’ve assumed a lot of people who
have been in this community and had a diagnosis and you know maybe they’re just looking
for a new neurologist so yeah people that I’ve had a long term
diagnosis and he did the injectables and couldn’t deal with it both people have been offered Drug I
tried to get them back on therapies I really have because I’m especially for
coming in there are already using a cane or there already have been you know something going on or or
they’re having relaxes and they’re still me the biggest thing is clinically how
are they doing it for not having relapses anymore and the baby there there stable or their may be progressing a little bit
you know that’s going to be a different situation
because these medications are pro for relapsing forms so on paper that is something we have to
be careful about because if you’re not having relapses anymore it may not be covered cell these these
therapies are only study in relapsing-remitting cases are not
studied in primary progressive they’re not studying and secondary progressive so that’s a little bit of an
individualized case as well but yeah if people have an offer the
injectable I am trying to get them back on your
therapy is thank you so much to everyone okay

100 Comments

  • AudreyTerp says:

    Why didn't you caption this video?! Terrible. Well I certainly won't be learning anything about MS from you.

  • Ron Excalibure says:

    Well, I'm 47, already have Epilepsy, and about 35% brain-damage from siezure-activity.  I have MS along-with Myotonic Muscular-Dystrophy.  Life is very difficult!

  • Andreas M says:

    very nice video!! I do have MS for 10 years! Thank you!

  • DukeOfChirk says:

    UK person with MS. The part of this clip from around 57 minutes gave me cold chills. Thank god for NHS.

  • David Ronson says:

    Terri gar  is not dead, that is wicked to pronounce her dead while she is still alive until today Nov 23rd 2014 

  • PinkRoses says:

    I can't watch anymore of this video because she says, 'um' a thousand times and it very annoying. She does speak clearly which I did like.

  • michael martin says:

    she talks t mutch i wont to know 

  • Daniel Carter says:

    Look at the known health effects of Mercury and compare those with MS symptoms.

  • bcolsant says:

    Can anyone weigh in on competitive athletes and return to play after initial diagnosis of MS.  Can they return to NCAA football? Is there any evidence of correlation to vaccines? Any correlation to head trauma?  Thank you

  • Lori Favela says:

    You can't hear the sounddd.  Make a new video

  • Animated Multiple Sclerosis Patient says:

    Great educational presentation, thank you! If you don't mind we would like to share with you our web site http://www.AnimatedMSPatient.com where you can find a variety of helpful animation and video resources on diagnosing, treating & living with MS.

  • Andrew Skevington says:

    excellent insight.

  • A K Bharadwaj says:

    Very nice video. Cure symptoms

  • Tosha Scott says:

     This girl says "um" way too much for someone with such a high education. 'merica folks. God bless us all.

  • Medical Institution says:

    Here is a video tutorial that explains MS as well as its signs and symptoms, diagnostic tests and treatment. I hope you guys find it useful.
    https://www.youtube.com/watch?v=kM5bvRkqHBs

    #MS   #multiplesclerosis   #neuroscience   #neuro  

  • Brandin Shaeffer says:

    Since it's a disease that revolves around inflammation, wouldn't you also suggest patients decrease their intake of inflammatory foods?  I can't believe that's not mentioned.

  • marcie schonborn says:

    You do go B this is one of the up lifting kind of information, education i want to see.  I would love to get one of our shirts  So proud of you girl.

  • Todd Sloan says:

    I believe 30:09 she is talking about a schedule two substance….

  • ManesandTails says:

    I have had MS for 20 years and I have lost the use of my hands and my ability to walk. I am sick of this rancid disease. I took Copaxone and all it did was make dents in by arms and legs from the daily injections.

  • Advensa says:

    If you've been diagnosed, consider yourself lucky. I am TIRED of huge medical bills piing up, visiting all sorts of doctors all the symptoms happen with me and doctors always come up with some other crap than MS…….now I was told I have neuromyopathy when I have "flares" when I can't walk and my hand goes numb.  Just did MRI hope it proves that i've had it for years but doctors ignored my multiple symptoms. I told one doctor I had burning unexplained pain in my spine she was treating me for flu and cold when I was fine and had no other symptoms…wtb good doctors.

  • фелер шилд says:

    dig the seinfeld bass. fitting. it's like a really elaborate antihumor show.

  • Melora Montanez says:

    I THINK I MIT HAVE M.S.

  • Eric Stefko says:

    wonderful presentation , thank you

  • jpmfx says:

    thank you so much

  • calvin owens says:

    Thanks for the great information. It allowed me to rule out MS in my own self-diagnosis. If I can make a suggestion… and this applies to all of you ladies out there… try to not say "um" when you are giving a presentation, I have noticed that many women have this habit… it is distracting. Christina said "um" over a 110 times within an hours time. It would be better just to be momentarily silent while you are gathering your thoughts for your next statement.

  • Henry D says:

    no one mentions twitches , nerves. thou I got some numbness . I can possible count this possible problem to my anthrax shots I got for my rotation in Egypt and Iraq. Been 10 years since my first rotation , my last in 2008. Hmm.

  • Denise Horn says:

    I developed a common UTI infection in 1992; but, I felt seriously ill.  I worked in an imaging facility (radiology); I thought perhaps there  had been a leak; I was so sick.  I was diaphoretic (sweating profusely) and had leg weakness; etc. I was eventually admitted to the hospital with a 105.6 fever and mononucleosis; diagnosed with EBV.  I felt better after a few weeks, but was warned of cancer; MS; infections, etc.  It has been 23 years.  Six months ago I felt like I had come down with EBV; severe weight loss (40 lbs); severe sinus infection; dizziness; wanting to just "drop" in the middle of walking.  No doctor seems familiar with any of this, so I was sent home with a "pill" for "anxiety."  I know better than this!   I finally found a nurse practioner who is far more educated than the doctors I have seen.  I just discovered how a long-reaching EBV infection can cause multitude of problems…especially over 55 years of age.  I have a low vitamin D level.  I have an MRI next week; severe sinus infection, and vision loss, along with the rest.  I also  have h. pylori, which can also accompany EBV; bacteria.  I have been disabled after a lucrative career for the past 15 years.  I pray I get an answer.  Hang in their people; you are not alone!!!

  • Denise Horn says:

    Since I was diagnosed in 1992, technology has come a long way.  I did have a spinal tap; and that was horrendous. There are new methods now.  When I was diagnosed, there was a "dismiss" of EBV.  I found a book called "Osler's Web" that stated the complete opposite of what the traditional medical establishment was proclaiming at that time; similar to "Gulf-War" syndrome, which was also blown off.  It is a whole different ballgame now,, but I ignored EBV because it was not taken seriously at that time.  Life went on until about six months ago when I  had the extreme weight loss; vision loss; dizziness; and overall taxation of my body.  Don't think that it is in "your head" when your ADL (activities of daily living) are compromised, but you have the same ambitions; duties; no one wants to be sick, but if you are, people will have to understand; EBV must be taken seriously, and a good diet and a positive attitude will help.  Love you all–fight it!

  • Denise Horn says:

    According to Osler's Web (book) EBV was seriously prevalent in Las Vegas, Reno, NV, area.  I lived there.  But, I also frequented Deep Creek, Hesperia, CA,, in the late 70s; water was contaminated.  Who knows where or why this virus has emerged???; it is up for questioning.  It is extremely important that the medical community obtain a full and complete history (hx) of patients.  This virus could explain so much; the study of it could immensely help the diagnostic medical community and prevent other people from ever breaking out with mono or full-blown EBV.  There is an answer; of that, I am positive.  EBV appears to be a link to many diseases.  So, to target the EBV would prevent useless tests; confusion, and could lead to a cure, or at least some form of prevention, thus preventing a worse disease process.

  • Denise Horn says:

    I am probably a "test case."  Most people are more recent cases of EBV; I am 23 years since diagnosis.  I dismissed the virus because in the 90s, it was not taken very seriously; in fact, I felt like a mental case.  So, I hid it for years and years and years; I thought it was stress; I blew it off to diet, so I modified my diet; I thought the immense reaction to stress was from environmental issues; still confusing because the people I knew and loved ate the worst foods possible; never cared about their health, but they seemed to be "just fine."  Here I am watching every thing I can; making good decisions so I do not burden myself further down the line with more "stress"; although I now realize it was not actually "stress", but the virus.  It actually "rapes" you; so you have to be prepared to fight it.  Being without armor against this virus is slaughter on the battlefield.  I thank, sincerely, the medical community for isolating this evil little monster; who loves to disrupt the basic functions of life,, finally have a  grip that a single virus can cause almost every disease on earth.  Now, I am pissed off, for not be armed when I should have been; for insurance companies for "paying out" rather than research and isolating culprits of disease.  It is high-time that we all realize how easy it is to lose your life over a little virus; a monster that tries, repeatedly, to invade your life and destroy it!  Now that I realize the truth; I have to give up being alone in this fight; I will take the "interferon" and other drugs to suppress this monsters, and try to live the best life I can.  As it states, over 55, it really strikes!!  Fight it now; don't be like me who refused to ever see a doctor; who believed (and I still do) that God has a plan.  Maybe my case will "impress" the medical community to isolate the root cause of so many diseases, rather than waiting for them to appear.

  • jackchorn says:

    Please respond if you can. What is the accuracy with MRI and lumbar puncture for diagnosis of MS? I've had one MRI- I was diagnosed with chronic fatigue- but I continue to degrade. Many of my symptoms are same as MS- even Lhermitts-what are the odds I have that unusual condition and all the other symptoms?

  • saffy blu says:

    I have SO MANY WIERD symptoms of who knows what! Problem is I have back problems.All is blamed on that.The numbness in part of my foot & leg, the burning & pins & needles & sharp sudden stabbing pains in my feet (recently, my other leg/foot has been affected) It used to all be on my left side for the most part.Have been in pain for decades!

  • saffy blu says:

    Hope you all feel better soon.Hope they figure it all out soon.

  • saffy blu says:

    can anyone out there tell me exactly which sort of tests should be taken for this? Would be greatly appreciated cuz every symptom I seem to have & it scares the heck outta me.

  • Janet Wilham says:

    BAD VIDEO—THEY BEAT AROUND THE VUSH DO NOT TELL SPECIFIC SYMPTOMS OF MS.

  • Sphinx Hutc says:

    Google nutritional muscular dystrophy in sheep it is caused from a deficiency of selenium in vitamin E muscular dystrophy has been a scam for years there is a cure a hundred percent sure do your homework walk away from the f**** medical system that keeps you tied to it they have known this for years dr. Joe Wallace research pathologist discovered the cure while working with the primates at NASA when he tried to bring this information Ford he was fired he along with Jerry Lewis because he got Jerry Lewis involved Jerry Lewis went to the Muscular Dystrophy foundation and said please review this information Jerry Lewis was also fired this is crimes against humanity the f**** medical system is poison you need to do your homework they will not allow you to be cured you have to do your homework selenium is a weapon of mass destruction against disease in the body it cures cancer cystic fibrosis AIDS HIV autoimmune it activates your killer cells in the body to destroy disease but it must be selenium in a plant-based form not the poison ionic form selenite or selenate. You can get selenium and Brazilian nuts about 50 micrograms in each however you are going to need 200 micrograms three times a day look up Dr Joel Wallach he has the nutrients available he was part of a study where the USDA spent 200 billion dollars to figure out how to keep animals from disease and this is part of it he alone sued the FDA several times because of the information not being published so hold your chin up your worlds about to change there is 100% cure for these debilitating diseases but you must get with a nature pathic doctor stay away from the American Medical Association it is a scam the Hippocratic Oath changed in 1964 it does not include healing they can only treat symptoms and treat symptoms with medication Hippocrates which was the father of medicine his quote 3000 years ago is as such "let food be thy medicine and medicine be thy food "this is true healing power and it is suppressed

  • Ingrid Gagnon says:

    Sphinx, that may be true if the cause of the disease is a nutritional deficiency. Mine is from massive amounts of the metal lead, PCB's, TCE, and a variety of other poisons. The Army and EPA knew they were exposing my Army unit to them but declined to say anything until I did an FOIA request and got proof. My nutrition is fine – I track every bite on sparkpeople dot com so I know there aren't deficiencies

  • George Kafantaris says:

    treatments are not a fix,they are waste of time

  • Jonathan Thomason says:

    8 W 1 MHz ultrasound from a massage device bought from Amazn, for 30s to each sie of teh head totally clears the condition

  • In19944 says:

    There are sooo many non pharmacological modalities now for reducing these neurological diseases such as ketogenic diet, kinesiology, even some antibiotics in some instances. She does a good job by admitting there are root causes & MS isn't a mystery like most neuro's have told me. It's sad that mainstream medicine concentrates on pulling back the immune system, which is such a symptomatic & antiquated answer. But these drugs make so much money that profit trumps morbidity & quality of life.

  • Yveth Lundgren says:

    I'd really need to hear this, why bother with this bad sound? No one can hear this…. Buuu

  • Coco Loco cb says:

    so after more than 10 years of medical school she says they dont know why you get MS and that they have more drugs for you. problem is that all drugs have side affects.

    Multiple Sclerosis and Low Level Laser Therapy

    November 12, 2013 David Rindge Laser Articles
    Dr. Peszynski-Drews
    Dr. Peszynski-Drews
    “Our results from the use of laser therapy on multiple sclerosis cases shows that laser biostimulation is a successful and effective method by which to treat patients,” said Dr. Cezary Peszynski-Drews, director of the Laser Diagnostics and Therapy Center of the Technical University of Lódz, Poland. Dr. Peszynski-Drews, also noted, “While it does not prevent multiple sclerosis, it makes patients significantly stronger, even in the most advanced stages of the disease. After treatment patients are able to move around on their own, walk short distances, and make their own breakfast. They are not totally dependent on someone else to help them and this in itself is a personal success.”

    i have seen phenomenal results from laser therapy or photobiomodulation please do some research please.

  • Verona Jianni says:

    She is so awesome.

  • Amazigh AFRICA says:

    what are the symptomes

  • Kenny White says:

    Great video. Thank you.

  • srhhsrj says:

    this young pretty doctor doesnt think with her own head, thinks 30% (actually 29%) interferon is the best out there and tries to put as much patients on that, like she is so certain she is doing them a favor. what if (as documented) many of those MS patients have Lyme disease as a cause of their illnss, via molecular mimicry of bacteria borrelia, and you supress their immunity with Interferon? Srsly, start thining with your mind, you're not MD to be nice, you're there to think logically.

  • srhhsrj says:

    IF you have MS, rather check – Dr COIMBRA AUTOIMMUNE PROTOCOL WITH HIGH DOSE VITAMIN D – 90% rate of REMISSION. not slowing down disease – buut remission. MANY, testimonies on yt, many fb groups from Brasil, Porttugal, Italy, new book by Ana Claudia, documentaries on yt..

  • Shad Wilde says:

    Multiple Sclerosis took the life of J. K. Rowling's mother. I even created a find a grave article of her mother. http://www.findagrave.com/cgi-bin/fg.cgi?page=gr&GSln=Rowling&GSbyrel=in&GSdyrel=in&GSob=n&GRid=166728093&

  • ekbal desoky says:

    thank you

  • The Dude says:

    A lot of people with ms have lyme disease.

  • MsBeachboxer says:

    I am a 60 yr young woman who has been athletic and looked/felt 20yrs younger until this last yr when I developed ALL the symptoms of MS (except the eye probs) Never gave MS a thought. I have PTSD and wrote my symptoms off to Stress & Meds.& death of Mom. 2 yrs later everything keeps increasing tremors,poor coordination. I lost 40lbs unrelated to Mom or stress – worse stress my whole life w/o these symptoms.Muscles twitching.hands getting tight, weakness everywhere,Fatigue for yrs,(thought was leftover fm Depression) My GP also wrote off all I told him every appt until the one 2 wks ago when I failed the drunk walk test on the first step! Then I remembered how I am bumping into everything at home, walking jerky and my right foot is kinda flopping like a duck sometimes. I have been dropping plates, unable to spread butter on my toast etc for ages..He didn't listen. When he actually saw my muscles twitching constantly (no pain thank goodness) he fienally sent me for a CT scan- w/in a wk – (usually takes 6 mo) & Neuro appt w/in 3 wks!!- usually takes a yr where I live!! – I was thinking brain tumour or something!! I called them back for something and they answered "MS CLINIC" Holy CRAP!' so I came on here and in my mind, because all these symptoms have never relented, just got worse…to ME, IF i do have MS, it would be PPMS.(Late onset-I'm 60) I hate that everyone just writes that off. No treatment – so lets ignore it 🙁 Here is hoping there is something else that coves these symptoms that my Family Doctor kept dismissing. 🙁

  • Alexis Alexander says:

    what if you don't want to take dangerous pharmaceutical drugs what therapy is there.

  • Elsa Kristian says:

    What a wonderful and informative video by a compassionate and caring young doctor.  This is the internet at it's finest.  Makes up for all the quacks and fools trying to take advantage of people on YouTube.

  • jatinder kala says:

    Very nice presentation

  • Sienna Patra says:

    I'm a multiple sclerosis sufferer and in dire need of a mobility scooter, please help

    https://www.gofundme.com/2t8cjs4

  • TheTruth says:

    I was misdiagnosed as having MS by a charlatan, a Mayo Clinic trained neurologist, told me he was positive I had it & tried to start me on Tysabri, which has a terrible record & was pulled from the market at one time,  and Ampyra which was new & derived from bird poison.   Tysabri must be give by IV in the doctors office.  It is very expensive.  The bird poison cost a lot too, but not as much.  Luckily, he referred me to an excellent neuro-surgeon who told me I didn't have MS , that all my symptoms were due to a herniated disc in my neck.   He did a laminectomy & fusion & I have done nothing but get better and better ever since.

  • Lynnie Heal says:

    NO  MS  drugs cure  MS  and never  ever  will  either .Research  all  MS  drugs thoroughly  one  even has   furniture  polish  added  to it .

  • steven propp says:

    I was just about to stop my copaxone at this week. after years with it, after the 2 other injectables in the past ,at 60yrs.old diagnosed in 98 still walking, mostly. Your presentation changed my mind.

  • Alfred Miller says:

    Does anyone know why the incidence of Multiple Sclerosis is twice the national average for residents of Vermont ?
    I know why.
    Alfred Miller,M.D.

  • Joshua Brabble says:

    This 3 year old, but so informative. Thank you for putting this up!

  • The Artificial Society says:

    Dr Roy Swank had the best success so far using a whole food plant based diet. Dr McDougall tried to replicate the results with limited success mostly by reducing fatigue. But with McDougall plant based diet, they only got to 15% calories from fat and maybe needs to get lower or only organic foods should be used. So the dietary cause remains a mystery.

  • unclevroomvroom says:

    Thank you for this. Very informative. I just uploaded my Brother's PPMS story. Please check it out if you have time.

  • ujustgotpwned2008 says:

    Lol why do 90% of MS videos have snazzy music at the start? "YOU'VE GOT M-SSSSSSS DOOO BEEE DOO DOO DO DAH DAH"

  • J. Svensson says:

    I wish I'd had her for my neurologist. My diagnosis was totally screwed up. The neurologist told me on the phone I do have it, but he put in my records that I am 100% fine. I don't have the energy or courage to face more medical nonsense.

  • Gloria Flores says:

    search vitamin d protocol north America on Facebook for ms

  • Brian Shive says:

    MS is best cured by a fecal transplant. Your Microbiome regulates your immune system. Restoring your Microbiome balance is the best, easiest and most enduring way to treat MS. Study the Microbiome in your gut and learn how God created your body. Knowing the truth of how your body works is a good idea.

  • D J Reis says:

    "you can still live a FULL life." – cause you're life SPAN isn't abbreviated much. really?????? WRONG, WRONG WRONG.

  • Kathleen Gustafson says:

    Lyme disease attacks the myelin sheath resulting in nerve damage such as explained here. Often treating this multiple factor disease is critical to halt the worsening. Lyme runs in families! Lyme connection described by Dr Alan MacDonald, google him. One of the Lyme bacteria related diseases was called relapsing fever in olden days, I.e. Trench fever in World War One. Too bad real microbiology isn't done so much today. Research money also has not been channeled to Lyme.

  • deanna reifsnyder says:

    3 years ago they found a lesion on my brain, indicative of MS. 3 specialists told me it was MS, my Neurologist told myself and my MD, we were hypochondriacs and said have a good day and left the office. Now, 3 years later, I have had a new MRI, which shows the SAME lesion, AND another. Now they want me to go back and see this same neurologist!! I have been textbook symptomatic for all this time, now having new and worsening symptoms.  I just want to go back to him and say Ha! FU and your hypochondriac diagnosis…but I also don't want to waste my time dealing with him. Unfortunately, he is the only one I can get in to see before the end of September.

  • Laurence Robb says:

    And where is Canada?

  • Kelly Stone says:

    I couldn't get past all the "ums". Very offputting.

  • Dark Wine says:

    Thanks for a very interesting post, Some of the natural cures for ms are…
    Get a lot of rest
    Exercising, yoga, tai chi, meditation, deep breathing, hypnosis,
    make use of green juice, chlorella, spirullina, fruit and veg – organic are best evening primrose oil etc.
    Some things to avoid if you have multiple sclerosis are alcohol, dairy products, eggs, commercially prepared and fast foods, margarine, milk, red meats, sugar, aspartame.
    (I learned these and the reasons they work from Denelle multi care website )

  • Jan Bouchard says:

    I wish she was my neurologist. I only have a few lesions on my brain. But I have so many symptoms. Because I had a normal spinal tap and vision test she won't consider the fact that I may have MS. My last MRI was three years ago. My symptoms have increase and gotten worse. But she won't ok another MRI for me to see if I have more lesions. Please don't get me wrong. I don't want MS. I just want one more MRI to be reassured. The doctor in the video seems very caring.

  • marcel van hooijdonk says:

    It is a terrible disease, we should help to find a medicine.

    https://www.sterktegenms.nl/actie/marcel-van-hooijdonk

  • Yashwant Ranshevre says:

    excellent interpretation

  • spice_girl says:

    It is not a fact that Lena Horn had MS.

  • Josie Zaldana says:

    No thank you

  • Cristina Michaels says:

    (MUST READ)
    I was diagnosed of ALS (Amyotrophic Lateral Sclerosis) 2016 at Parkland hospital, Dallas. Where i was given medications to help my symptoms. In August 2017 my symptoms worsened, with no hope of a cure from the hospital i looked out for an alternative treatment. I read on a website about Perfect Cure Herbal Clinic and their successful herbal treatment for ALS and some other viruses, i immediately contacted them via their E-mail and purchased the ALS herbal remedy. I used the herbal remedy for 9 weeks, all my symptoms including difficulty in walking, weakness in legs and arm, slurred speech etc miraculously disappeared, my speech is understandable now, its unbelievable.
    You can also contact them, if you have ALS too. Email: [email protected] gmail.com.
    I had stopped working since i was diagnosed of ALS, and now i have resumed working again after their herbal treatments. I have control of my body once again!
    Email: [email protected]
    Whats-app: +2348118184266

  • Phil Davies says:

    Wow! Thank you. I have some symptoms that I suspect are MS and this talk has been very informative and has answered a lot of questions!

  • EC 762 says:

    Stone cold fox

  • Matt Macintosh says:

    thank you you answered a lot of my questions

  • NK says:

    Good presentation except physicians are still continuing to spread that misinformation regarding MS as it relates to black people. It is actually more common among blacks than earlier perceived. Blacks have a 47 percent increase of developing MS compared to whites. And black women have a triple risk of MS compared with men. The previous statistics dating back to 2012 are inaccurate because most black people were not given the opportunity to participate in the research studies conducted. Do your research. Free Your Mind.

  • D Hoosier says:

    Approximately 75% of the USA (& world) is deficient in vitamin D.

  • Maurice Battle says:

    Auto immune disease's don't exist! Jesus Walks

  • taras Smith says:

    Splat, what do you do when you cant absorb a presentation, when you are devastated in the moment, god cut to the quick, .

  • Lexi Hugea says:

    My mother was diagnosed with multiple sclerosis in 2016 after a 2nd bout with optic neuritis (right eye). Same neurologist/same treatment (Avonex) until just January ! So many other doors are open since seeking a specialist.our home doctor introduce us to Total cure herbal foundation where we finally get the right treatment for this disease, we have been on 3 different types of medications so far, but none seems to help me. Either I can't tolerate it or one didn't give any results.there is a herbal approach that has worked across Africa and China for centuries, this herbal approach has recorded a tremendous success stopping the disease progression and gradually alleviate all symptoms for MS.in other to purchase from them kindly visit their online website totalcureherbsfoundation.com
    Good luck to each and every one of that's trying this herbal formula

  • Vicki Slaar says:

    Its too late, why keep us alive.

  • Kimberly Wright says:

    The money is not in the cure. The money is in the continual supposed treatment and pharmaceuticals

  • MrTrainer1200 says:

    I think I have it. Yesterday I felt fatigued and dizzy, I also felt numb everywhere and had a headache. I also had tremors.

  • Iain Miller says:

    WTF!

  • Jefff says:

    I started on Rebif but developed antibodies. I was Copaxone for several years. It worked well but I developed skin issues. Then Tecfidera but low lymphocytes caused that to end. Aubagio wasn't strong enouph as I had my first relapse in 7 yrs. Now I'm on Gilenya.

  • Jefff says:

    BTW if you are a US Military vet and have been diagnosed within 7 years of your military service, you may qualify for VA compensation!

  • Ane127 says:

    None of the neurologists tell us that it isn’t actually a neurological disease. The lesions are just a symptom. MS is a lipid metabolism disorder, which can be reversed and healed using one of the many MS diets. The drugs don’t stop progression because the issue is DIET.

  • nnr2d m says:

    (I've never been diagnosed with MS or anything else- but a lot of strange symptoms)

    I've cured foot drop with magnesium I can now walk on both heels if I wish- impossible before.

    My seizures have gone I've not had to buy headache tablets for a year I get no more arthritis type pains I have normal blood pressure and normal sugar blood levels (all were borderline high before) I wake up naturally now without brain fog (it clears within 5 minutes used to take 2 hours) –

    I could go on and on but my point is I eat full fat eggs (15 a week) fish 3 times a week I've cut out rubbish foods and high sugar (the real culprit and evil) or significantly lowered them- I have normal chlorestral (if I eat more dietary chlorestral my body makes less) gloconeogenisis takes care of sugar (our bodies make all we need).

    I had nerve conduction studies mri blood urine CT scans all normal but I knew I was not right- did I mention chest pains like angina and strange head pains (beyond normal head aches). Gone.

    My sister in law passed with MS she was vegan (possibly no correlation to why she had ms) but I think it did contribute –

    It's what you don't eat that counts- mineral and vitamins amino acids and fatty acids are vital especially the ones our bodies can't make-

    I'm medication free I feel the best I have in 20 year and I'll do all in my power to avoid what my late mum and dad went through with pharmaceutical drugs.

    Lastly it's what you absorb- I had low stomach acid symptoms so was not absorbing the minimal nutrients I did eat in the past 20 years of heartburn gone with sea salt (not normal table salt) and a very small amount about half teaspoon a day. Sometimes a lot less-

  • Naturalbeautytoo says:

    Awsome presentation!

  • Ernst Muller says:

    The best natural treatment for Multiple Sclerosis is Karnozin Extra give it a try it helped a lot of people to reduce the tremor and gain strength!

  • Sara Dee says:

    My dad has MS … Sad times..sad times..

  • LoosingAHWF Fanboy says:

    Marijuana

  • springalingading says:

    I’m sure this is another created disease. So is it from the food, meds, chemtrails? My son took an antibiotic for an infection and has never been the same. This is a created ailment like cancer. I totally believe this. Is it really Lyme? Who knows but those who created it and God.

  • Johnny Shido says:

    Is pain all the time a normal thing for ms or is it just a old body?

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