Dear Dr. Reder,
Could you give me information on the drug cladribine. I have read that it
showed a reduction in the number of brain lesions seen on MRI imaging in
patients with multiple sclerosis.
Thank You
- May
Dear May,
Yes, it did reduce MRI lesions.
The clinical effect of this type of chemotherapy has been harder to
demonstrate. The first studies showed that cladribine slowed progression
of MS. A later trial, with a different patient population, did not have
impressive clinical results, even though MRI's improved.
Summary: Some patients are helped by this drug. However, it is hard to
predict who they are.
- Dr. Reder.
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Dear Dr. Reder,
I was diagnosed with MS in November, 2000. I have been on Avonex
for seven weeks. Recently I have developed ringing in both ears. It comes
and goes, but can stay for days at a time. Is this eiter a symptom of MS or
side effect of the Avonex?
- Carol
Dear Carol,
Your choices are:
1. aspirin side effects
2. ear problems--see ENT
3. MS
4. Avonex as a cause is unlikely.
- Dr. Reder.
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Dear Dr. Cohen,
Is there any possibility that plasmapheresis might help an older adult in advanced stages of primary progressive ms?
- Frank
Dear Frank,
Plasmapheresis is a technique of filtering blood to remove small substances such as antibodies which may be improtant in causing certain diseases. Although the technique has been shown to be effective in demyelinating peripheral neuropathies, and has been used in some severe exacerbations of MS. it has not been shown to be effective in primary progressive MS. Chronic plasmapheresis is expensive and generally requires placement of an indwelling catheter for vascular access. Potential side effects include drop in blood pressure, bleeding and infection at the catheter site among others.
- Dr. Cohen.
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Dear Dr. Cohen,
I have been reading about Lyme disease and the similarity of symptoms with MS. I have also read that Lyme disease is very difficult to detect and tests often produce false negative results. When I was diagnosed wiuth MS, my neurologists came to that diagnosis not because I clearly tested positive for MS, but because I hadn't tested positive for anything else. My symptoms have continued to worsen since 1998 so I haven't questioned my diagnosis. However I continue to wonder about the possibility of having Lyme disease. Five years ago, I had a target-shaped rash that is typicle of Lyme disease and around that same time, my eye lid began to droop. Should I pursue a second test for Lyme disease? Also, if both diseases are so similar and so difficult to diagnose, why aren't patients given the antibiotic treatment simply to be on the safe side? Thank you so much!
- Evelyn
Dear Evelyn,
It is true that Lyme disease can mimic some of the features of MS and that blood tests in the past were somewhat unreliable. Although there is no specific test for MS, the diagnosis is not one of exclusion but depends on satisfying certain criteria. The rash in Lyme disease is usually an early feature occurring before the neurologic symptoms. Nonetheless, the blood tests for Lyme disease have improved and although still not 100 % sensitive, a repeat test might be reasonable to address your concerns.
- Dr. Cohen.
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