Diagnosis: You have MS, but what type – and what does that mean?

A leading neurologist has talked about giving patients the news that they have multiple sclerosis and their reactions. He has also described the different types of the disease.

Dr Neil Lava, a neurologist at Atlanta’s Emory University School of Medicine, was interviewed by Everyday Health.

diagnosisEveryday Health, Inc. is a digital media company which owns websites relating to health and wellness. It says it aims to inspire and empower people to live their healthiest lives, every day, through trusted, medically reviewed information and expert health advice from the nation’s leading healthcare providers and patient advocates. (Declaration of interest note: This is one such company for which I have NOT written.)

Dr Neil Lava (pic: Emory Healthcare).

In his interview, Dr Lava tackled the issue of giving patients their MS diagnosis.

He said:They have a symptom. I have given it a name. I haven’t changed anything by giving it a name, but I have changed everything by giving it a name.”

That’s a point that I truly understand. For me, finally knowing what was wrong came as a relief.

Diagnosis sometimes overwhelming

Speaking of reactions, he said: “I am always amazed that when people are first given the diagnosis, sometimes it’s really overwhelming for them. But when they put things in perspective and realise that they are going to live a long productive life, and I am going to help them do that, they actually tend to do very well.

I tell them that 10-15% of patients have what’s called benign multiple sclerosis, where you can have a few symptoms throughout your life, but really never have any significant deficits.”

That’s interesting to me as in April 2002, when I received my MS diagnosis, the neurologist told me that I had benign MS. Now, though, it has developed through relapsing to secondary progressive.

Dr Lava talked about the types of MS that we know well: relapsing, primary progressive, and secondary progressive.

He said: “The most common type, 80-85% of patients have this, (is) relapsing pattern where they will have an attack: a neurological symptom that will last for a period of time and then disappear. And at some other point in time, they will have another symptom.

“At some point they are at risk to become secondarily progressive, meaning that they will have fewer attacks but they won’t recover as well and they will start having more trouble functioning, and very gradually struggle more and have more difficulties.

“But once they become secondarily progressive, I don’t have very effective medicines to slow progression, although we are looking for those.

“About 10% of patients have what’s called primary progressive disease where they will develop a neurological symptom. They may have little trouble walking. Their legs may get a little stiff. They never have attacks. They just have that symptom, and over time that very gradually gets worse and they have more trouble functioning.”

Therapy very early

Dr Lava continued that some people with relapsing MS may never go on to secondary progressive disease. He said: “We have found that the sooner you put someone on therapy, the better off they do in the long run. So, we get them on therapy very early in the hopes of keeping them in that relapsing phase and reducing the number of attacks.”

Dr Lava compared treatment options today with 25 years ago, and looked to the future. He said: “It’s a very different disease than when I first started treating patients. In 1993, we had our first medication that was FDA-approved for MS. Before that, we had nothing to do for patients. We have so many choices now, it’s really exciting.

“What we are waiting for are things that maybe stimulate myelin, and of course the real thing is, can we regrow brain cells? I mean, can we stimulate them? Is there a way to create new pathways to compensate for the damage that’s been done through the brain and spinal cord? That’s probably going to be the most exciting thing.”

Dr Lava’s full interview by Dr Sanjay Gupta, for Everyday Health, can be found here.

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Affiliate disclaimer: This affiliate disclosure details the affiliate relationships of MS, Health & Disability at 50shadesofsun.com with other companies and products. Read more.

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50shadesofsun.com is the personal website of Ian Franks, a freelance medical writer and editor for various health information sites. He enjoyed a successful career as a journalist, from reporter to editor in the print media. He gained a Journalist of the Year award in his native UK. Ian received a diagnosis of MS in 2002 and now lives in the south of Spain. He uses a wheelchair and advocates on mobility and accessibility issues.

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Note: Health-related information available on 50shadesofsun website is for your general knowledge only. It is not a substitute for medical advice or treatment for specific medical conditions. I am not a doctor and cannot and do not give you medical advice. You should seek prompt medical care for any specific health issues. Also, consult a doctor before starting a new diet or exercise programme. Any opinions expressed are purely my own unless otherwise stated.


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