Welcome, My MSAA Community, to our Ask Me Anything with Dr. Annette Okai! We are excited to have Dr. Okai joining us to answer YOUR questions about Relapse Management.
Annette Okai, MD is a neurologist in Dallas, Texas and specializes in multiple sclerosis. She is affiliated with Baylor University Medical Center.
For the next hour, please feel free to ask Dr. Okai your burning questions about multiple sclerosis relapses as a reply to this post. Don’t forget to keep refreshing the page to see the latest questions and responses.
Hit us with your questions!
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A relapse is a new symptom that occurs or a sudden increase in prior symptoms that have been stable. This is in the absence of fever, infection, fatigue or high stress
What about new symptoms that do not improve (facial numbness/drop) after steroids? Is there a way to distinguish relapse from progression in progressive forms of MS? Thank you for your time, Doctor.
Some symptoms may not improve, but are stable over time. A sudden worsening in the absence of other external factors indicated above, may indicate a relapse. Most progressive forms of MS do not experience relapses but just increase in disability over time
Depending on the severity of the relapse, they can typically last from days to weeks. There are instances where post recovery can take longer and patients may need rehab services for longer periods of time
Do steroids prevent damage to the body when used for a relapse or do they only shorten the duration of the relapse?
Great question. We are aiming for minimal or no disease activity when treating patients. Multiple relapses and MRI changes is a sign that you may not be responding as well to the current therapy. Your health care provider can decide if some activity is acceptable.
Joc-42 I was a long distance bicyclist right up until the day I went numb. Had 2 courses of steroids while they were running tests to find out what was going on. They reduced the numbness tingling. Now over 18 months later, I have to walk with a cane and then only short distances.
A question from Missyoregon - Can you have progression of the disease without having a flair? My mri doesn’t show any new lesions but I continue to have spasms and muscle weakening in my left leg.
Are periodic MRIs necessary if there seem to be no actual relapses? It seems that damage/new lesions can accumulate without symptoms, possibly showing the need for a new DMT.
Periodic MRIs are necessary to monitor disease activity and medication effectiveness. There may be MRI activity without symptoms and treatment options may need to be discuss based on that as well.
I was told via an MS counselor that progression of disease usually doesn't happen after the later 60s. I was diagnosed at age 69 and now am 76. I've been on copazone and have had no relapses. Is it true that one is more stable in later years?
Hi Emily! I want to know if it's normal if sitting for like about 10 minutes in the car for my legs to quickly fall asleep? When I situate them it stops. But it just feels funny. ☺
Thank you. I just feel as if I can't sit for to long. I was paralyzed in November 10, 2015 and I didn't get out of the hospital until January 12, 2016, and every time my legs fall asleep even if it's just for a little bit, it just makes me feel and think that I might be paralyzed again and it's not an experience I want to have again.
common symptoms can be blurred or double vision, weakness or numbness and tingling on one side of the body, vertigo or dizziness, or difficulty with speech. These are common and can vary.
Most symptoms have to be continuous for more than 24 hours to be considered a relapse
I was healthy, very active senior citizen, riding bicycle up to 200 miles a week, swimming laps and walking after dinner. At 68 yrs, went numb, diagnosed MS 6 months later. 20 plus white spots in brain, lesions T2-T3. Doc calls spine lesions MS. No changes or new spots in brain so he won't diagnose those. It's been over 18 months, and he won't tell me a stage. Is that common, to not be told a stage? My symptoms are being treated with Gabapentin, Baclofen, Modafinil. As the just are lessening the symptoms, not stopping them and we've gradually increased the dosage. At almost 70 yrs, I want to have the best quality of life for whatever I have left, do you think I should consider a DMT? Doc had mentioned Rituxan at last visit. I have visits and MRI's every 6 months. There has been no noticeable changes in brain or spine.
There are lots of symptoms that are common between patients and most healthcare providers treat MS based on the patient's history. Please discuss your concern with the doc as I don't know your full history and can't make a recommendation
On behalf of everyone here at MSAA, we want to thank Dr. Okai and our My MSAA Community members who have participated and asked questions! For more information about relapse management, please be sure to check out MSAA’s MS Relapse Resource Center at relapses.mymsaa.org/ and MSAA’s MS Relapse Toolkit at mymsaa.org/publications/ms-...
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