http://msviewsandrelatednews.com/blog5/ MS (Multiple Sclerosis) Related Articles, containing info on Interferons, Rebif, Tysabri, Copaxone, Betaseron, Avonex, Serono, Biogen, Teva, Bayer, Vertigo, MRI, MS Society, Dirucotide, stem cell, en-us Nucleus CMS v3.32 © Weblog http://backend.userland.com/rss http://msviewsandrelatednews.com/blog5//nucleus/nucleus2.gif http://msviewsandrelatednews.com/blog5/ http://msviewsandrelatednews.com/blog5/index.php?itemid=1238 Headaches as a Symptom of Multiple Sclerosis
(( Stuart Schlossman Can Identify with this Major Symptom, "Headaches" ))

Written By: Julie Stachowiak, Ph.D., About.com
Updated: June 17, 2008
About.com Health's Disease and Condition content is reviewed by Suman Jayadev, MD


Everybody has a headache occasionally. However, people with multiple sclerosis (MS) are much more prone to migraine-like or cluster headaches than people in the general population. While the cause of most headaches is a mystery, some headaches in people with MS can be caused by lesions, depression or specific medications that they are taking. You should see your doctor for: Any type of unusual headache, a headache that keeps recurring, or one that lasts for a long time.

What Do MS-Related Headaches Feel Like?

Headaches that are directly associated with MS have been described as: Migraines

These seem to be more common in people with relapsing-remitting MS. They can be described as:

Often preceded by an aura (blurry or distorted vision signaling that a headache is about to begin) or prodrome symptoms (including fatigue, hunger or anxiety)
Throbbing on one or both sides of the head
Can be accompanied by sensitivity to light or sound
Typically accompanied by nausea, vomiting or loss of appetite
Residual pain and discomfort often follow headaches
Lasting from 4 to 12 hours
Cluster

Cluster headaches have the following characteristics:

May begin as a severe burning or stinging sensation on one side of the nose or deep in one eye
Pain peaks rapidly
Feels like electric shocks or “explosions” in or behind the eye
Only on one side of the face
Comes on without warning (unlike many migraines)
Tend to recur at the same time every day (often soon after falling asleep), usually for a period of several weeks
Can cause eye to water, nose to run or eyelid to droop
Pain completely resolves after headache (until next headache)
Lasting from 15 minutes to 3 hours
Tension-Type

These headaches are the most common in the general population, and can be described as follows:

Rarely causing severe pain, more often moderate or mild
Constant, band-like aching or squeezing sensation
Pain is either right over the eyebrows or encircling the head
Comes on gradually
Can happen any part of the day, but usually occurs in the latter part of the day
Lasting from 30 minutes to all day
How Common Are Headaches in People with MS?
Up to 58 percent of people with MS experience chronic or recurring headaches, compared to 16.5 percent of the general population. Of course, almost everyone (over 90 percent of people, MS or not) gets occasional headaches.


What Causes Headaches in People with MS?
Many different things can cause headaches in people with MS, including:
Lesions: A study looking at 277 MS patients suggested an association between number of midbrain lesions and migraine headaches. Interestingly, cluster headaches in people with MS have also been shown to be linked with lesions in this area of the brain, where the trigeminal nerve, which is also called the fifth cranial nerve, originates. (The 12 cranial nerves emerge directly from the brain instead of from the spinal cord.) This is the nerve that is involved in the other “most painful MS symptom” – trigeminal neuralgia or tic doloureux. However, most headaches are not associated with MRI findings.

Optic Neuritis: Headaches are also common during episodes of optic neuritis. These headaches are usually only on one side and worsen when then eyes are moved.

Depression: Depression, a very common MS symptom, has also been associated with headaches in people with MS. Depression and migraine headaches are both linked to low serotonin levels.

Medication Side Effects: The interferon-based disease modifying therapies (Rebif, Betaseron and Avonex) can cause headaches or make pre-existing headaches worse. Provigil, Symmetrel and other drugs used for fatigue also have headaches as a primary side effect.

How Severe Can Headaches Get?
Headaches can be extremely disabling. Migraine headaches can be incredibly painful, and the accompanying light and sound sensitivity can lead to people withdrawing to a quiet, dark space for hours at a time. Even when the migraine has passed, people are often left with residual symptoms (called the postdome phase), which include fatigue, irritability, problems concentrating and dizziness.
Cluster headaches are often described by people as the worst pain they could ever imagine, akin to “a burning ice pick being plunged into their eye.” The pain from cluster headaches causes many people to fall on the floor, pull at their hair, bang their heads on the wall, rock back and forth, scream and weep. Although the pain from cluster headaches resolves (no lingering effect like with migraines), people often feel completely exhausted after each headache. Just as disabling as the headaches is the fear and dread that people feel, knowing there is a good chance that another one is coming within hours or the next day. This anxiety can interfere with daily activities or social contact, as well as lead to insomnia, as people avoid falling asleep (most cluster headaches occur at night).

Additional Points/Information
Naps: Some people find that a long nap (5 or more hours) following a migraine helps relieve some of the residual symptoms.

Take Notes: It is helpful to keep a symptom log where you record the specifics of your headaches, including time of day they started, how long they lasted, any triggers that you might have noticed and anything that you did (including medications) that helped. This will help your doctor to determine what might be causing the headaches, what type they are and what kind of treatment to try.

Sources:

Rae-Grant AD, Eckert NJ, Bartz S, Reed JF. Sensory symptoms of multiple sclerosis: a hidden reservoir of morbidity. Mult Scler. 1999 Jun;5(3):179-83.

Gee JR, Chang J, Dublin AB, Vijayan N. The association of brainstem lesions with migraine-like headache: an imaging study of multiple sclerosis. Headache. 2005 Jun;45(6):670-7.

Gentile S, Ferrero M, Vaula G, Rainero I, Pinessi L. Cluster headache attacks and multiple sclerosis. J Headache Pain. 2007 Sep;8(4):245-7.

Original Article can be found by clicking this LINK
]]> News from About MS .com http://msviewsandrelatednews.com/blog5/index.php?itemid=1238 Thu, 28 Aug 2008 14:12:07 -0400 http://msviewsandrelatednews.com/blog5/index.php?itemid=1237 Coughing and Shortness of Breath as Symptoms of MS

Written By Julie Stachowiak, Ph.D., About.com
Updated: June 11, 2008
About.com Health's Disease and Condition content is reviewed by Suman Jayadev, MD
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~

Just when you thought that the tingling and numbness, the fatigue, the MS hug and the memory problems were enough, turns out that people with multiple sclerosis (MS) are prone to respiratory problems, as well. In fact, most of us would test pretty low on pulmonary function tests designed to assess the strength of our respiratory muscles.

Fortunately, for most of us, these problems are not noticeable or do not impede us in any significant way. Even better, it turns out there may be exercises that we can do to prevent this from getting worse.


What Do Respiratory Problems in MS Feel Like?
MS-related respiratory problems can take several forms, including:
Shortness of breath
Difficulty breathing deeply
Hiccups
Cough
Frequent sighing
Not enough airThese are often described as:

Trying to breathe with a blanket over your head
Having a heavy weight on the chest
Inability to take a deep breath
Anxiety

How Common Are MS-Related Respiratory Problems?
Breathing difficulties are reported by 20% of people with MS. In one study, 32% of people with MS reported mild dyspnea (painful breathing or shortness of breath) under moderate exertion.

What Causes Respiratory Problems in People with MS?
It has long been thought that respiratory problems occur later in the disease process. However, recent studies fail to correlate these symptoms with duration of MS. Rather it is the severity of MS (disability levels) that is a good indication of how severe the breathing difficulties will be. Breathing difficulties in MS can be caused by one or more of the following factors:
Sensory Problems: It is now thought that these symptoms may be the result of abnormal respiratory sensory information.

Muscle Weakness: Many people with MS score low on measures of respiratory muscle strength, such as mouth pressure tests (see below).

Side Effect of Medications: Some drugs prescribed to help with MS-related pain or spasticity can cause breathing to be slower and shallower. These include muscle relaxants, tranquilizers and opioid-based pain medications.

Aspiration Pneumonia: This is caused when food particles, liquid or mucus enters the lungs. This can be a cause of breathing difficulties in people with MS, due to MS-related swallowing difficulties or inability to clear mucus from nose or throat.

How Severe Can It Get?
It is extremely rare that MS-related breathing difficulties become so severe as to require breathing assistance (breathing tubes or supplemental oxygen) or become life-threatening. However, even fairly mild breathing problems can cause severe fatigue, further contributing to other sources of MS-related fatigue. In addition, the feeling that you can’t get enough air can lead to panic attacks and severe anxiety.

Additional Points/Information
“Panting” and MS: Patients with MS tend to have a more superficial (shallower) and faster breathing rate than people in the general population.

Lower Mouth Pressure: Mouth pressure is a measure to assess the functioning and strength of respiratory muscles by testing maximum inspiratory (breathing in) pressures and maximum expiratory (exhaling) pressures. These were found to be between 60 and 70% of normal even in patients with low disability (EDSS scores of 1.5 to 5.0).

Respiratory Therapy: Breathing exercises to prevent respiratory complications during later stages of MS as well as improve overall respiratory function appears to be successful at improving breathing capacity.

My Experience
Although I have not had my respiratory function formally evaluated, I am pretty sure that it is impaired. The way that it manifests itself for me is that whenever I get an infection that is accompanied by coughing, I will continue to cough for a long time, even after the infection has passed. Coughs that should be “productive,” meaning bringing up mucus, just don’t seem to clear out my throat and chest like they should. I just have this constant hacking, which sometimes turns into a big coughing fit – often making me feel like I am on the verge of passing out. Eventually, the cough will pass, but even physicians are surprised at how long this takes and how resistant the cough is to different remedies or supressants.

I also need to chew slowly and carefully, as I can set off a coughing/choking spell if I talk or laugh too much when eating. I have also noticed that it doesn’t take much exertion on the treadmill or going up stairs to get me winded, which I had previously attributed to simply being out of shape. My lack of fitness probably does play a big part of feeling winded, but it just seems out of proportion to how hard it is to catch a breath sometimes.

Sources:

Rae-Grant AD, Eckert NJ, Bartz S, Reed JF. Sensory symptoms of multiple sclerosis: a hidden reservoir of morbidity. Mult Scler. 1999 Jun;5(3):179-83.

Gosselink R, Kovacs L, Decramer M. Respiratory muscle involvement in multiple sclerosis. Eur Respir.1999; 13: 449-54.

Mutluay FK, Gürses HN, Saip S. Effects of multiple sclerosis on respiratory functions. Clin Rehabil. 2005 Jun;19(4):426-32.


Original article can be found by clicking this LINK

]]> News from About MS .com http://msviewsandrelatednews.com/blog5/index.php?itemid=1237 Thu, 28 Aug 2008 14:04:26 -0400 http://msviewsandrelatednews.com/blog5/index.php?itemid=1236

Wednesday, August 13, 2008

We are getting closer the release of the first oral medicines in the treatment of Relapsing-Remitting MS (RRMS) with the goal of preventing relapses (and hopefully progression and disability). Altruistic patients worldwide are taking part in multiple clinical trials testing the safety and efficacy (effectiveness) of these new forms of medicines.

Read Complete Story: Click Here
]]> General http://msviewsandrelatednews.com/blog5/index.php?itemid=1236 Wed, 27 Aug 2008 09:51:26 -0400 http://msviewsandrelatednews.com/blog5/index.php?itemid=1235 Chicago Tribune

By Terri Yablonsky Stat | Special to the Chicago Tribune
August 26, 2008

Michaelene Needham, 44, of Northbrook has multiple sclerosis and relied on a cane and then a walker for years. Now the mother of three is finding new mobility and energy for her busy life.

Needham, like other people with upper motor neuron injuries including stroke, spinal cord injury and cerebral palsy, can now walk with greater ease using the Walk-Aide System. The WalkAide is an orthotic device made by Innovative Neurotronics that helps people with foot drop, a condition that inhibits a person's ability to raise the front part of the foot.

Approved by the U.S. Food and Drug Administration in 2006, the WalkAide uses advanced sensor technology to analyze the movement of the leg and foot. The system sends electrical signals to the peroneal nerve, which controls movement in the ankle and foot. Gentle electrical impulses activate the muscles to raise the foot at the appropriate time during the step cycle.

The device, which is the size of a pager and fits just below the knee, includes a control unit, a flexible cuff and two electrodes. It must be prescribed by a doctor and, in Illinois, fitted by a licensed orthotist who has completed the WalkAide training program.

"This is the biggest breakthrough in orthotics in 25 years," said Michael Oros, president of Scheck & Siress, the Chicago-based orthotic and prosthetic company that fitted Needham for the WalkAide. Patients with foot drop typically have used a plastic brace that fits inside their shoe and holds the foot at a 90-degree angle. "But with the WalkAide, the patient's own musculature pulls the foot up. It's a powerful feedback mechanism for patients. The WalkAide allows the patient to use their own muscles that in many cases have been dormant for 10 to 12 years."

In addition to improving the patient's gait, the WalkAide increases mobility and independence, increases range of motion, reduces atrophy and improves circulation, said Oros, a board-certified prosthetist and orthotist.

Needham, who was diagnosed with MS in 1991, started using a cane in 2004 and switched to a walker last September after she fell in her home. "That's when I started deteriorating," she said. "I couldn't walk far. I hung on to the walker and my legs dragged behind me. Because of the dragging, I was fatiguing. I could barely get through the grocery store."

She was fit for the WalkAide in April after her doctor determined she was a candidate. Those eligible for the device must not wear a pacemaker, nor can they have a history of seizures, have a metal implant in or around the lower extremity or be pregnant. In addition, patients need an intact peroneal nerve for the device to work. People with progressive diseases such as MS may use it indefinitely, Oros said.

"I keep it on all day, from 7 a.m. to 10 p.m.," said Needham. She uses the walker when walking long distances too. "I'm so excited about being able to do more. I'm building muscles and getting my strength back. My posture is better. ... It's finding all these muscles that didn't work for a while.

"When I'd go to the grocery store I had to sit in the car and rest before going home, where I'd lie down again. Now I come home and I'm able to go to my next errand."

Although the youngest person Scheck & Siress has fitted for the device is a teenager, Oros said children with cerebral palsy could benefit from the device. "Their gait is improved, they have better balance and they improve walking speed over time."

The WalkAide costs around $5,000 for one foot and is currently not covered by insurance, according to Mary Ann Schultz, spokeswoman for Blue Cross and Blue Shield of Illinois, the state's largest insurer. The device gets a thumbs-up from Dr. Dusan Stefoski, professor of neurology and director of the Multiple Sclerosis Center at Rush University Medical Center. "I am astonished by the WalkAide," he said. "I've been in the field of MS since the late '70s and what I see is quite beautiful from a functional point of view."

ctc-tempo@tribune.com

]]> Assistive Devices / Equipment http://msviewsandrelatednews.com/blog5/index.php?itemid=1235 Tue, 26 Aug 2008 14:19:43 -0400 http://msviewsandrelatednews.com/blog5/index.php?itemid=1234 Date Published: Monday, August 25th, 2008
NewsInferno.com

Federal regulators informed healthcare providers today that monotherapy with Tysabri has been linked to two new European cases of progressive multifocal leukoencephalopathy (PML). The U.S. Food & Drug Administration (FDA) said it is working with Elan and Biogen Idec, the manufacturers of Tysabri, to amend the product labeling to inform prescribers and patients that cases of PML have occurred in patients taking Tysabri as monotherapy.

In the U.S. Tysabri was taken off the market in 2005 after three patients in clinical trials developed PML. But the dug was reapproved in 2006, although it was subject to restrictions. Tysabri is now available only to patients with relapsing multiple sclerosis (MS) or Crohn’s disease (CD) who are enrolled in the risk minimization plan called the TOUCH Prescribing Program. Under the TOUCH Prescribing Program, every Tysabri-treated patient is closely monitored and followed for the occurrence of PML and other serious opportunistic infections.

It was once thought that taking Tysabri alone - known as monotherapy - lessened the risk of developing the brain disorder. But in both European cases, the patients - who were receiving Tysabri to treat multiple sclerosis - were not undergoing any other therapy. According to the FDA, one patient had been treated with Tysabri for 14 months, while the other received it for 17 months.

PML attacks the brain and central nervous system and is usually fatal. It is caused by a polyomavirus, called the JC virus. The JC virus is often acquired during childhood. Most adults have been infected with the JC virus but do not develop PML. The virus appears to remain inactive until something (such as a weakened immune system) allows it to be reactivated and start to multiply. People with a weakened immune system or people taking drugs that suppress their immune system (immunosuppressants) are most likely to get the disease. Symptoms include vision problems, loss of coordination, and memory loss. Patients who survive the disease are often permanently disabled.

In 2005, the law firm Parker Waichman Alonso LLP was retained by the estate of Anita Smith, a patient who died from a confirmed case of PML while taking Tysabri. In 2002, Smith, who had been diagnosed with multiple sclerosis, was enrolled in a clinical trial involving Tysabri along with 1,200 other patients. In November 2004, while her health was rapidly deteriorating, Tysabri gained a coveted “fast-track” approval FDA. Despite her PML symptoms, Smith was allowed to continue receiving treatment in the Tysabri trial, and took her last IV infusion of the drug in January 2005. On February 24, 2005 she died of from PML. Four days later, Tysabri sales were halted.

In its 2005 Annual Report, Elan Inc. informed shareholders that it had entered into settlement talks with the lawyers representing Anita Smith’s estate. When contacted, Jerry Parker, the managing partner of Parker Waichman Alonso LLP said the Anita Smith Tysabri case had been resolved, but that the case was confidential.

This entry was posted on Monday, August 25th, 2008 at 12:33 pm and is filed under Legal News, Pharmaceuticals.


Have a Comment? Leave at Stu's Views MS Blog]]> Tysabri Related http://msviewsandrelatednews.com/blog5/index.php?itemid=1234 Tue, 26 Aug 2008 09:03:13 -0400 http://msviewsandrelatednews.com/blog5/index.php?itemid=1233 MSFriends is the first and only 24/7 telephone peer support Initiative for people living with Multiple Sclerosis. All of our highly trained volunteers are living with MS themselves so they understand and care about each caller. MSFriends was created to help end the isolation and fear that comes with a diagnosis of Multiple Sclerosis. We are here any time of the day or night to take your calls at 1-866-673-7436 (1-866-MSFriends). Please call us and visit our website at www.msfriends.org, we are here for you!


If you are interested in becoming an MSFriends telephone peer support volunteer, please read the requirements on our website at http://msfriends.org/index.php?pg=volunteers.


If you feel you meet the requirements, please email szachary@msfriends.org.

~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
Information contributed to MS Peers by Stuart Schlossman of "MS Views and Related News"

Be sure to read more educating topics relating to MS by opting-in to receive our weekly e-newsletter.

````````````````````````````````````````````````````````````````````````````````]]> ADDITIONAL MS Resource Sites http://msviewsandrelatednews.com/blog5/index.php?itemid=1233 Mon, 25 Aug 2008 17:05:55 -0400 http://msviewsandrelatednews.com/blog5/index.php?itemid=1232 Medical News Today
Article Date: 23 Aug 2008 -

Study Highlights Link Between Vitamin D And Multiple Sclerosis

Vitamin D, the principal regulator of calcium in the body, may prevent the production of malignant cells such as breast and prostate cancer cells and protect against specific autoimmune disorders including multiple sclerosis (MS) according to an article by Sylvia Christakos, PhD, of the UMDNJ-New Jersey Medical School.

In the article, Christakos reports that research shows that the incidence of MS decreases as the amount of vitamin D available to the body increases, either through sunlight exposure or diet. The article notes that MS is "for the most part, unknown in equatorial regions" and that the prevalence of the disease is lower in areas where fish consumption is high. The study is available online in the Journal of Cellular Biochemistry."Since vitamin D is produced in the skin through solar or UV irradiation and high serum levels have been shown to correlate with a reduced risk of MS, this suggests that vitamin D may regulate the immune response and may promote a host's reaction to a pathogen," Christakos said.

Christakos' report focuses on the immunosuppressive actions of the active form of vitamin D, which may inhibit the induction of MS, and emphasizes the importance of maintaining a sufficient vitamin D level.

"Evidence has shown that the maintenance of an adequate vitamin D level may have a protective effect in individuals predisposed to MS," Christakos said. "One device of vitamin D action may be to preserve balance in the T-cell reaction and thus avoid autoimmunity."

Despite the significant evidence of the benefits of vitamin D relative to MS and other autoimmune diseases, Christakos cautions that further studies are needed to determine whether vitamin D alone or combined with other treatments is effective in individuals with active MS.

The University of Medicine and Dentistry of New Jersey (UMDNJ) is the nation's largest free-standing public health sciences university with more than 5,500 students attending the state's three medical schools, its only dental school, a graduate school of biomedical sciences, a school of health related professions, a school of nursing and its only school of public health, on five campuses. Last year, there were more than two million patient visits to UMDNJ facilities and faculty at campuses in Newark, New Brunswick/Piscataway, Scotch Plains, Camden and Stratford. UMDNJ operates University Hospital, a Level I Trauma Center in Newark, and University Behavioral HealthCare, a mental health and addiction services network.

University of Medicine and Dentistry of New Jersey (UMDNJ)
Stanley S. Bergen Bldg., 65 Bergen St., Fl. 13
Newark, NJ 07101
United States
http://www.umdnj.edu ]]> M.S. Research Study Reports http://msviewsandrelatednews.com/blog5/index.php?itemid=1232 Sun, 24 Aug 2008 18:56:26 -0400 http://msviewsandrelatednews.com/blog5/index.php?itemid=1230 Rising bill for new drugs threatens to overwhelm patients, employers

Putting a strain on mutual cashflow
BY CAROL M. OSTROM
The Seattle Times


SEATTLE --Sally Garcia, a 53-year-old lawyer disabled by multiple sclerosis, was torn.

A new-generation medication, Copaxone, was really working for her. After two decades of being in and out of hospitals, Garcia was taking steps to work again.

Her wallet, though, was in severe distress. Under her Medicare prescription plan, Garcia's share of the expensive drug was $330 per month. All together, medications were taking a third of her disability payments -- her only income -- and she couldn't swing it.Copaxone, Enbrel, Remicade: For some patients, such new-generation drugs, often called "biologicals" or "bioengineered" when they are created by genetically modified living cells, have performed magic. In some cases, they work when other drugs have failed, or for diseases that previously had no drug treatments at all.

But they cost a lot -- often $2,000 to $3,000 per month.

And in a double whammy, some insured patients who previously paid a fixed amount -- likely $30 to $50 even for the most expensive, brand-name drugs -- are suddenly finding the rules have changed.

For these new drugs, an increasing number of patients must pay a percentage of the tab, generally 25 to 30 percent. For many of those patients, that can mean a bill of $600 to $900 a month for a drug that they may need for many years.

"The idea of insurance is to protect people from catastrophic costs," says Gary Claxton, director of the Healthcare Marketplace Project for the Kaiser Family Foundation.

"At some point, people aren't going to consider themselves insured if they're at risk for a huge amount out-of-pocket just because they have one disease rather than another."

In 2007, the tab for bioengineered and "specialty" drugs was nearly $59 billion. Industry analysts predict it will reach $98 billion by 2011.

"The reality is that this is where the pharmaceutical industry is focusing their research," says Jim Carlson, Group Health Cooperative's pharmacy director.

Typical bioengineered drug treatments for rheumatoid arthritis now run about $16,000 a year, says Dr. Philip Mease, director of rheumatology research for Swedish Medical Center.
]]> General http://msviewsandrelatednews.com/blog5/index.php?itemid=1230 Sun, 24 Aug 2008 17:49:32 -0400 http://msviewsandrelatednews.com/blog5/index.php?itemid=1229
By the Accordant Medical Team

What is Plasmapheresis?
Plasmapheresis means "plasma separation." This medical procedure consists of exchanging a patient's blood plasma (the watery part of blood) with a replacement solution. First, blood is withdrawn so that the plasma can be separated from the blood cells. Once separated, the blood cells are recombined with a replacement solution that resembles plasma, and the new mixture is then transfused back into the patient. Plasmapheresis is also called plasma exchange.Why is Plasmapheresis Used to Treat MS?
Blood plasma contains antibodies and other substances that play a role in many autoimmune/immune mediated diseases.

Plasmapheresis has been successfully used for decades to treat many conditions, including autoimmune diseases like myasthenia gravis (a rare muscle disease) and Guillain-Barre Syndrome (a disease thought to result from an abnormal immune response to a virus).


Because MS is also an immune mediated disease, plasmapheresis is a very promising treatment. This procedure was used occasionally to treat severe MS in the early 90's, and recently gained attention when Mayo Clinic researchers noted "moderate to marked improvement" in 42 percent of patients treated. Some patients with severe problems, including paralysis and the loss of speech, experienced dramatic improvement, regaining full use of their arms, legs and speech.

Plasmapheresis is not a cure for MS, nor is it recommended for most patients. At this time, plasmapheresis is performed only on patients whose severe attacks are unresponsive to other treatments--only a very small proportion of those who have acute flares. Researchers hope to learn why this procedure works for some people and not for others. Some speculate that plasma exchange dilutes the damaging immune factors in the plasma.

How is Plasmapheresis Done?
Plasmapheresis is conducted while the patient reclines in a chair or lies on a bed. The patient may experience some discomfort, but the procedure is not painful.

A catheter is used to draw blood from a vein, usually in the crook of the patient's arm. The blood is then placed in a device known as a cell separator. The cell separator either spins the blood at high speed to separate the cells from the plasma or it passes the blood though a membrane that filters out the cells and allows only the plasma to penetrate.. The antibody-containing plasma is thrown away. The cells are combined with a replacement fluid (usually albumin or a synthetic fluid that mimics plasma) and returned to the patient through another tube connected to the hand or foot on the opposite side of the body. This arrangement allows the patient to have one hand free during the procedure, which takes several hours.

The patient is given an anticoagulant drug during plasma exchange to keep the blood from clotting. At any given time during the procedure, the amount of blood outside the patient's body is similar to the amount one would donate at a blood drive.

What are the Risks?
Dropping blood pressure is the most common problem experienced during plasmapheresis. Patients whose blood pressure is falling may feel dizzy, faint, cold or sweaty, or experience blurred vision or abdominal cramps When these symptoms are reported, those attending the patient will assist by lowering the patient's head, raising the legs and administering IV fluids.

The anticoagulant medications given during the procedure can sometimes cause bleeding. These medications can also cause more serious reactions, such as an irregular heartbeat or seizures. These reactions can be avoided, however, if the patient reports the symptoms known to occur before the seizures or changes in heart beat: a metallic taste in the mouth, tingling around the mouth or limbs, or muscle cramps.

The most serious possible reaction is an allergic reaction by the patient to the plasma replacement fluids or the sterilizing agents used on the tubes. Itching, wheezing, or the eruption of a rash are signs of a medical emergency. If any of these symptoms occur, the procedure must be stopped immediately and IV medications administered.

Are There any Side Effects?
Sometimes blood clotting problems continue after plasma exchange. Infections are also more likely at this time because the immune system may be extremely suppressed. This is because the desirable antibodies have been filtered out along with the undesirable ones. The body will eventually recreate the necessary antibodies, but patients need to be especially careful to guard against infections right after plasmapheresis. Antibodies can be administered intravenously, if necessary.



References

1. "Multiple Sclerosis" Mayo Clinic.com Web site (http://mayohealth.org/home?id=5.1.1.13.8)
2. "Plasmapheresis (Plasma Exchange)," From The MS Information Sourcebook posted on the National Multiple Sclerosis Web site (http://www.nationalmssociety.org/\Sourcebook-Plasmapheresis.asp)


Reviewed by a member of the

First published October 1, 1999
Last updated May 3, 2003
Copyright © 1999 Accordant Health Services, Inc. All Rights Reserved.

>>Source LINK <<]]> Alternative Therapies http://msviewsandrelatednews.com/blog5/index.php?itemid=1229 Fri, 22 Aug 2008 19:28:41 -0400 http://msviewsandrelatednews.com/blog5/index.php?itemid=1228
The Swank Low-Fat Diet for the Treatment of MS, developed by Roy L. Swank, MD, Ph.D., is backed by over 35 years of research. Read actual patient testimonials and join our message forum.

www.swankmsdiet.com ]]> Alternative Therapies http://msviewsandrelatednews.com/blog5/index.php?itemid=1228 Thu, 21 Aug 2008 18:13:12 -0400