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Chapter 2: Monitoring your MS

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Transcript:

Welcome to Understanding your MS, a series where people living with multiple sclerosis (MS) can learn more about their condition and the journey.

MS-certified Nurse Practitioner, Megan Weigel here.

In this video, I’m going to discuss the three ways that healthcare professionals monitor MS.

This video is brought to you by Biogen, and I am compensated for my time. Your healthcare team is your best resource for information regarding your healthcare and treatment.

First, they use MRI scans to monitor for new or enlarging lesions on your brain and spinal cord. Lesions are areas where nerve tissue is damaged from MS.

Second, they monitor your relapses and symptoms. It’s also important for you to report relapses and symptoms to your healthcare team, including invisible symptoms such as cognitive problems. (In a moment, I will talk a little bit more about relapses and what they are.)

And third, they track your body’s physical abilities. This is to check if physical disability progression has occurred.

Monitoring all three of these can help you and your healthcare team understand how your current treatment is working.

So, let’s talk about lesions. Lesions are areas of damaged nerve tissue. Healthcare professionals use MRIs to look for different kinds of brain lesions.

T2/FLAIR lesions, or scars, give us a sense of the long-term impact that MS has had on your brain over time.

Gadolinium-enhanced (Gd+) lesions (I know it sounds a little technical) are lesions that show current (or active) inflammation in the brain.

T1 lesions appear as dark spots in an MRI scan. These lesions are usually associated with permanent nerve tissue damage and possible permanent loss of function.

Now, depending on the number of lesions, the changes in size of the lesions, and where the lesions appear, this may determine the type and severity of symptoms a person with MS may experience. Keep in mind, MS differs from person to person.

For example, lesions on the cerebrum can cause difficulty with attention, learning, and memory. Mood changes can also occur.

Lesions on the cerebellum can lead to balance and coordination problems.

When lesions show up on the brain stem, this can cause impaired speech, problems with swallowing, and abnormal eye movements.

Lesions can also affect the optic nerve. This can lead to vision problems.

Lastly, lesions on the spinal cord can cause a number of symptoms. These include muscle stiffness, numbness and tingling, pain in the arms and legs, and problems with urinating or bowel movements.

Sometimes, you can have a new lesion that has no corresponding symptoms at all.

I’d like to review a few more points about MRIs (magnetic resonance imaging).

MRIs aid in the diagnosis of MS, but they are also one of the most important ways your healthcare team can monitor your MS and how it’s being managed.

MRIs can detect any new or enlarging lesions, even if you don’t have any outward symptoms.

Lesion activity may occur 5 to 10 times more frequently than relapses. This is why getting regular MRIs is so important.

Also, unlike some other tests, MRIs do not use radiation.

Typically, people with MS have at least one MRI every year. However, this is just an average. It can vary from person to person. Depending upon your specific situation and your healthcare team, you could have an MRI more or less often.

It’s important to schedule regular MRI scans with your healthcare team because new and enlarging lesions might not have any outward symptoms.

MRIs may help determine whether or not you are responding to your current treatment and if it may be time to talk about treatment options with your healthcare team.

Let’s now talk about relapses. So, what exactly is a relapse?

Relapses are when new symptoms not brought on by fever, heat, or infection appear, or when symptoms you already have get worse.

Symptoms occur at least 30 days after a previous relapse.

In addition, relapses may last anywhere from at least 24 hours, to several days, weeks, or months.

Relapses can also cause symptoms that don’t fully resolve, leading to worsening disability.

Your healthcare team may also refer to relapses as “flare-ups,” “exacerbations,” or “attacks.

If you think you’re having a relapse, it’s important to alert your healthcare team right away.

Let me share a scenario:

Samantha is a 38-year-old woman living with relapsing MS. She awakens one morning with weakness in her right leg and experiences problems with walking. She’s never had these symptoms before. The next morning, she doesn’t feel any better and her symptoms persist.

Samantha is having a relapse, because she’s experiencing symptoms she has not had before and they have lasted for more than 24 hours. She needs to alert her healthcare team immediately.

Another way MS is monitored is by tracking disability progression. Your healthcare team has tools and scales to measure, define, and monitor your level of physical ability and/or disability progression.

It’s important to monitor your physical ability and how well you’re doing, as well as alerting your healthcare team about any changes as soon as possible.

Your healthcare team may also track your MS by monitoring your cognitive abilities.

Be sure to alert your healthcare team to any changes in your physical or cognitive ability.

If you’ve found this video informative, watch the next in the series to learn about disease modifying therapies.

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