Question.....just wondering

 

Hello you all,

 I was just wondering, how is it that a neurologist determines what stage of M.S. a person is at??? Is it the number of lesions? The location of lesions?The number of exacerbations? I am really just clueless and feel like such and idiot when I leave my neuro appointments. I am driving down the road home and all these question pop into my head after what he has told me. So the not wanting to know me, just lets everything go.....(kind of an out of site out of mind) type of person. I hate knowing the facts, and I hate researching a facing the facts. Well I know it's a dumb question, but if you all would be so kind as to educate me I would greatly appreciate it. 

Thanks

Hey Life!

Good to see u here again! I hope u'r doing better and getting along well. As far as i understand, it's decided more by what condition u'r in, the number of flares or whether or not they are true defined flares or more of a continual progression. I"m sure i'm not giving u the full details, but this is as much as i'm aware of. I'm sure others will be along soon to correct or expand on what i've said here. Take good care of u'rself and i'm so glad to see u again! :)

Here, from the National Multiple Sclerosis website, is a description of the four "courses" of MS:

http://www.nationalmssociety.org/What%20is%20MS.asp

If this link doesn't work, go to the website and look for a definition of the disease, and this information will appear.

Basically -- it's not the number of lesions, or even the location of lesions, that is a determining factor. It's how the disease specifically affects you, the patient.  If you  have clearly defined episodes, or exacerbations, or flares (all the same thing) where symptoms intensify, maybe new symptoms occur...and then a remission (although there may always be some residual symptoms), then you're in the most common category of "relapsing-remitting". 

Generally over time, folks will start with relapsing-remitting, but then they'll realize that there isn't much remission from the last exacerbation. Then the doctors will decide it's "secondary-progressive".  The treatment these days is pretty much the same: one of the interferon drugs, to slow the progression.

You can have lots and lots of exacerbations, but so long as there is a clear remission between them, you'll be classified as "relapsing-remitting".

How do doctors determine this? By watching the patient over time, seeing how well they recover from flares, see if they still have flares. For example, I'm labeled "secondary-progressive".  I've not had any real exacerbation in years. Sometimes there is a small intensity of symptoms (like, increased spasticity, or loss of bladder control, or wonky vision, or...) and then it will fade in intensity...but it's always there. And I still have MS.  Not worsening significantly, but if measured over time, worse now than when I was labeled secondary-progressive, 12 or so years ago.