Lack of awareness impacting MS diagnosis, says neurologist
POINTING out that diagnoses for multiple sclerosis (MS) are sometimes overlooked, one local doctor is insisting that there needs to be more awareness about the condition.
Neurologist and medical director of Caribbean Neurology Pain and Headache Center in Kingston, Dr Michele Lee Lambert, told the Jamaica Observer ahead of today’s recognition of World MS Day that even though a lot of Jamaicans have MS, for years there was a misconception that Caribbean people have it at a much lower rate than people in northern countries or do not have it at all.
“Because there is lack of awareness of this disease in Jamaica, the diagnosis is sometimes overlooked and not made. It is important that the public and health-care professionals know the signs and symptoms of MS; this will allow for earlier diagnosis, earlier treatment, and thus better prognosis,” the American Board of Psychiatry and Neurology-certified doctor said.
She said, too, that some people with MS are misdiagnosed with neuromyelitis optica spectrum disorder — a rare but chronic disease of the brain and spinal cord — which the neurologist described as a serious mistake, as it has different treatment options and prognosis.
Defined as a potentially disabling disease of the brain and spinal cord, in which the immune system attacks the protective sheath (myelin) that covers nerve fibres and causes communication problems between the brain and the rest of the body, by non-profit academic medical centre Mayo Clinic, MS currently affects 2.8 million people around the world according to the MS International Federation.
The condition, according to MS International Federation, is the most common disease of the central nervous system in young adults and it is two to three times more common in women than in men.
Dr Lee Lambert told Your Health Your Wealth that some of the symptoms include loss of vision, double vision, numbness, or weakness in the face, arms or legs, difficulty walking, loss of balance, poor coordination, and slurred speech.
“Patients present with neurological deficits which are usually transient, which means that it will last for days or months, then the symptoms improve; this is termed relapsing-remitting MS. Some people have progressive MS, where it does not remit,” she explained.
The neurologist explained each MS patient is different, in relation to how debilitating the effects of the condition can be, and will have “a minimal disability such as occasional numbness or paraesthesia, which is a ‘pins and needles sensation’, while some patients have more severe symptoms such as not being able to walk”. “The good news is that if patients get early treatment, they may have less disability,” she added.
While MS is not hereditary, Dr Lee Lambert said the families of patients who have MS tend to have other autoimmune diseases like lupus.
“There is probably a genetic susceptibility and non-genetic, such as a virus and low vitamin D, and the environment,” she said.
The neurologist told Your Health Your Wealth that treatment for MS is divided into management for acute symptoms and disease-modifying therapies.
“Patients can get muscle relaxers for stiffness in arms or legs, including botox injections. They can also get neuropathic pain relievers for nerve pain, which feels like burning or pins and needles sensation, and if they have lost their vision due to optic neuritis, they may get intravenous steroids to help make the recovery faster,” she said.
The doctor pointed out, too, that there are excellent drugs that can be used to modify the course of the disease, which are called monoclonal antibodies.
“These drugs have now become the preferred treatment and they are available in Jamaica. Rituximab and Ocrevus are two of the drugs; they are not inexpensive but are very effective. Initially, the drug is administered twice over a two-week period and then every six months. Therefore, the patient will not need to take daily medication,” said Dr Lee Lambert, adding that other disease-modifying drugs are called interferons, such as Betaseron, which are subcutaneous injections taken every other day.
— BRITTNY HUTCHINSON
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