Respiratory Dysfunction in Advanced Multiple Sclerosis

What respiratory problems are common in advanced MS?
A common symptom of MS is muscle weakness which may affect the muscles that control breathing. Muscle weakness can make breathing difficult and shallow breathing may contribute to pneumonia. Muscle weakness can also affect swallowing which may lead to aspiration pneumonia. It’s important to remember that patients with MS may have difficulty fighting infection caused by bacteria or viruses.

What are early signs of respiratory muscle weakness?
Symptoms may be subtle such as shortness of breath or a gradual increase in coughing when the person with advanced MS eats or drinks fluids. Increased coughing or total obstruction of the airway may occur when eating solids. Medications that cause drowsiness may affect a person’s ability to control swallowing as well. Or symptoms might emerge when the muscles that control breathing are under increased pressure, such as when you may be standing in chest-high water.

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Living with Advanced MS: Respiratory Care

Ocrevus Receives Breakthrough Therapy Designation

Genentech and Roche announced that the Food and Drug Administration has granted Breakthrough Therapy Designation for the investigational medicine ocrelizumab (Ocrevus™) for the treatment of people with PPMS. Breakthrough Therapy Designation is designed to expedite the development and review of medicines intended to treat serious or life-threatening disease and for which preliminary clinical evidence suggests that the drug may demonstrate substantial improvement over existing therapies. Remember that PPMS has no approved therapies.

Breakthrough Therapy Designation was granted to ocrelizumab based on positive results form a pivotal Phase III study (called ORATORIO) which showed treatment with ocrelizumab significantly reduced disability progression and other markers of disease activity compared with placebo in patients with PPMS. Top-line results were of ORATORIO were presented at the 31th ECTRIMS conference in October 2015.

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FDA Grants Breakthrough Therapy Designation to Treatment for Primary Progressive MS

Being In MS Limbo

The road to diagnosis for MS can be long and winding for many patients. I’m happy for patients who receive their official diagnosis within just a few doctors’ visits. Not happy that they have MS, but happy that they can jump right in and get on with things; attacking the beast with medication, therapy, and determination.

For those of us who are not immediately diagnosed with MS, the feelings involved with the ‘not knowing for sure’ can be frustrating. Especially disturbing is when you suspect that your doctors do not believe you or your symptoms. The worst part may be when there is some clinical evidence that ‘something’ is not quite right, maybe there are lesions in the brain and obvious neurological symptoms, but your tests do not meet the standard diagnostic criteria for an official MS diagnosis.

That’s when the waiting game begins.

I was one of those patients who didn’t receive an immediate diagnosis. In fact, it took more than five years from what was my first obvious and debilitating attack (blinding optic neuritis) to the relapse that prompted additional testing that led to a diagnosis.

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What Is It Like to NOT be Diagnosed with MS?

Intimacy and Relationships

Intimacy isn’t something that is confined to physical affection or sexuality. Intimacy is about so much more! Intimacy is a process; ever changing and evolving. Four commonly accepted forms of intimacy include cognitive or intellectual intimacy, experiential intimacy, emotional intimacy, and sexual intimacy. 



Cognitive intimacy describes a form of activity where two or more people exchange thoughts, share ideas, or explore similarities or differences of opinion. Many of the discussions and story telling we do here at HealthCentral involve this very personal form of intellectual intimacy.

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What Does Intimacy Mean To You

MS Lesions With Central Veins Lead to Faster Diagnosis

Researchers in Nottingham, UK, have been trying to find a quicker and more accurate way of identifying MS in patients with an unclear diagnosis. To do this they have focused on T2-weighted MRI scans that can show both hyperintense MS lesions and their central veins, which appear hypointense in contrast. Lesions with central veins are called perivenous lesions. In reading your MRI report, you might see reference to periventricular lesions. These are lesions located near cerebral ventricles (a series of interconnected, fluid-filled spaces in the core of the forebrain and brainstem) that are common in MS.

What the researchers have found is that the percentage of lesions that are perivenous can predict whether a patient has MS. Using an ultra-high-field 7T MRI machine for a 2013 study, Mistry et al found that patients for whom more than 40 percent of their lesions had central veins developed MS. Those who had fewer than 40 percent of perivenous lesions did not have MS. This was true for 100 percent of the 29 patients included in the study.

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New Way to Evaluate MRI Scans May Lead to Faster MS Diagnosis

#KissGoodByeToMS

In a social campaign that spans the globe, people with MS and their friends and loved ones are joining forces to “Kiss Goodbye to MS.” Originally begun by MS Research Australia - an organization dedicated to accelerating MS research toward the prevention, better treatments, and ultimate cure for MS - the #KissGoodbyeToMS campaign has been so successful in raising awareness and funds for research in recent years that this year it’s gone global.

The Multiple Sclerosis International Federation (MSIF) combined forces with MS Research Australia to invite other MS societies to pucker up and hit the social media streets with a fun, positive, and empowering message. In 2016, MS communities in New Zealand, Denmark, Ireland, United States, Sweden, Argentina, Mexico, and France join Australia in vowing to #KissMSGoodbye. Next year, the campaign may expand to an additional 14 other countries.

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Kiss Goodbye to MS Around the Globe