[NewsBot]

ST. PAUL, Minn. - With more and more people having brain MRIs for various reasons, doctors are finding people whose scans show signs of multiple sclerosis even though they have no symptoms of the disease.



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(From Topix Neurology)

[lady_express_44]

One more bit of proof that headaches/migraines are quite common in MS.

Cherie

[NurseNancy]

from what i know, IF you're dx'd with MS your CNS will eventually be affected.
some people have sx's and some don't. but just because you don't have sx's doesn't mean the disease is stopping.

MS is a progressive disorder although every person's course is individualized.
that's why i personally believe that meds should be started early.
i've heard many docs say this.

however, there are people on the board who are not on meds. it's a personal choice.

[RedPenguins]

Okay, so this article bugged me. If I have holes showing up in my brain - I want to know - even if they don't want to officially diagnose anything.


This annoyed me:
Until then, we should not tell them that they have MS or treat them with disease-modifying therapies. For now, it's best to remember the wise advice that we 'treat the patient, not the MRI scan.'"

###

Sure, some people die never knowing they had MS - and had no symptoms - it was only found out in autopsy. Fine, great for them. But then what about people who show lesions on brain scans and have no symptoms for 5 years and then suddenly become sicker and disabled - and now their brains are loaded with tons of lesions?? Progression possibly could have been stopped earlier.

Hmm, an ethics question, too. Do we tell people that it's possible they may have a disease when we don't know for sure? And then not treat them?

Then again, I'm a person who always buys warranties on big products...ya know, just in case? I guess my body/my self is a big product!

~keri

[Jules A]

I have no doubt that people have all kinds of strange abnormalities that would show up if everyone were to have a MRI however I don't think that discounts the need to be diagnosed early and given the choice of treatment.
It absolutely is an ethics issue if Docs were to withhold abnormal MRI results from a patient.

I've never been a huge fan of the "many people have MS all their lives and never know it" for several reasons. First I think it encourages people to have false hope. There is too much denial floating around anyway, just my opinion. In any event obviously I am not one of those lucky people so I need to be proactive and for me that means taking a dmd in hopes of stalling what I believe is the impending progression that comes with a chronic disease like MS.

I am also not confident that anyone can definitively diagnose MS solely based on lesions. Imvho there are far too many diseases that can produce lesions even if "they are in the spot that indicates MS". I'd bet that if we compared our MRIs the lesions are all over the place and in no particular spot.

[lady_express_44]

"More research is needed to fully understand the risk of developing MS for people with these brain abnormalities, but it appears that this condition may be a precursor to MS"...

I wonder what they mean by "this condition" and "abnormalties" ...? I guess they might be referring to lesions of some sort, but I know that migraines show similar lesions. Perhaps there is something specific that more clearly indicates MS ...

These people are not Clinically Isolated Syndrome, which to date is the BARE minimum requirement before being put on CRAB. CIS means that they have ALSO shown "outward" or "clinical" evidence of the disease.

So, 30% of this group developed definitive MS within 5 yrs, which means 70% haven't. It doesn't make sense to throw them all on a CRAB though, at least until they have much larger and longer studies to see if the majority (in this case, 29% - 70%) might end up developing MS after 5+ yrs.

As I understand, the rational for starting people on a CRAB early in the disease process, is mostly based on this Betaseron BENEFIT study that showed that in patients with a first clinical demyelinating event and MRI features suggestive of MS . . . "treatment with Betaseron delayed the time to a second clinical event by one year compared to placebo."

http://www.prnewswire.com/mnr/berlex/25881/

NOTE: "BENEFIT is the only trial to demonstrate the efficacy of a high dose, high frequency interferon beta, Betaseron, as an effective treatment for patients with early MS."

There seems to be some merit in treating people with CIS (which includes "clinical" evidence of MS!), but I think we need much more information and evidence before we start treating everyone who shows with "abnormalties" that are perhaps suggestive of MS.

Cherie

[Becca44]

Originally Posted by NewsBot

ST. PAUL, Minn. - With more and more people having brain MRIs for various reasons, doctors are finding people whose scans show signs of multiple sclerosis even though they have no symptoms of the disease.



More...

(From Topix Neurology)

Yep! More indication that it's possible to have MS lesions in your brain and yet, have no MS symptoms ...AND that even with those lesions you may not develop diagnosable MS symptoms. It's something I was told early on and it's always given me hope. A person might call that denial - I don't really care - because it happens to be a medical reality for some and I'm glad to see science is continuing to find proof toward validating this.
Personally, I'm not inclined to take drugs for a lifetime if they're not going to change my MS experience; the drugs come with risks and side effects of their own. Living with MS - or MS lesions - you've got to strike a balance, find a realistic and honest way of assessing and managing risks, and come to a personal therapy decision with the help of a knowledgable neurologist.

a beautiful thing.

[dmplaura]

Good info, but I certainly didn't need a study to tell me that my headache/migraine is connected to my MS.