Brief Answer:
MRI Interpretation and management

Detailed Answer:
Hi XXXX, thanks for asking from HCM.


I can understand your concern. This MRI report is suggestive of

- Multiple Sclerosis - A kind of autoimmune demyelinating disease
It most commonly involves periventricular areas in brain just like your husband's brain. Active lesions mean disease is evolving.

Now I will explain you what is demyelination

Some nerves in brain are covered by a sheath. This sheath is 'myelin". It is made up of fat. This sheath is needed to fasten the nerve speed.

In Multiple sclerosis , this sheath or cover is damaged and it is known as demyelination.

Its consequences
- Most of the brain functions become slow. The symptoms are

- Easy fatiguability
- visual complaints
- Progressive and gradual weakness of all limbs
- Incontinence
- sexual impotence
- tingling sensations in extremities
- imbalance,
- pain and spasms in limbs
- later on depression, psychosis, anxiety, forgetfulness, behavioural abnormality


If your husband is having any of such findings also, you must take him to neurologist. The neurologist will examine him and confirm the diagnosis by

- MRI findings
- Spinal tap and collecting brain fluid. The brain fluid (CSF) will show increase in M proteins.
- Evoked potentials to know about nerve function
- Fundus and complete eye examination to see areas of demyelination

Final treatment will depend upon confirmation and symptoms. The treatment is medical management. Few drugs which suppress immune symptom and drugs
which help in regeneration of nerves are prescribed like

- For acute attack - Methylprednisolone and plasmapheresis are recommended. They are given to prevent serious morbidity and mortality

- For relapsing type MS (occurring repeatedly) - Immunomodulators are given likenterferon beta-1a, Interferon beta-1b
Peginterferon beta-1a, Glatiramer acetate, Natalizumab, Mitoxantrone, Fingolimod.

- In severe cases steroids like methylprednisolone is given along with immunomodulators.

Hope you will find it informative and helpful. If still in doubt, do let me know.
Thanks. Take care.

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Brief Answer:
MS treatment

Detailed Answer:
Hi XXXX, welcome back.


Nowadays, MS can be controlled to a great extent. As I mentioned in last answer, steroids and immunomodulators are used to treat its symptoms. And there is good response. You can discuss it with your doctors. He will most probably start your husband on

- Methylprednisolone - A type of steroid
- Interferon beta - 1b - an immunomodulator.
These medication will control his symptoms. These can be started even without spinal taps if symptoms are severe. In acute severe state, sometimes plasmapheresis is also done. You can discuss this option also.

MS prognosis also depends upon its type e.g.

-Relapsing-Remitting MS (RRMS). This is the most common form of multiple sclerosis. People with RRMS have temporary periods called relapses, flare-ups or exacerbations, when new symptoms appear.

Secondary-Progressive MS (SPMS). In SPMS, symptoms worsen more steadily over time, with or without the occurrence of relapses and remissions. Most people who are diagnosed with RRMS will transition to SPMS at some point.

Primary-Progressive MS (PPMS). This type of MS is not very common, occurring in about 10% of people with MS. PPMS is characterized by slowly worsening symptoms from the beginning, with no relapses or remissions.

Progressive-Relapsing MS (PRMS). A rare form of MS (5%), PRMS is characterized by a steadily worsening disease state from the beginning, with acute relapses but no remissions.

Confirm the type of MS from your doctor.

Hope it will him. If still in doubt, do let me know.
Thanks. Take care.

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