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Confusion 2 relapses in a year

Afternoon, i have had a diagnosis for the last year, lesions on my mri and the protein in my spinal fluid. My last meeting with the neurologist it was mentioned that before he can think of treating anything he wanted me to think if i had 2 relapses in the last year. Does anyone know why he would be asking this? Before it was properly diagnosed my symptoms were steady but occasionally they would be very severe. Myself and my partner are very confused and are not sure why or what he needs to know. We spoke with the ms nurse today and the recent pain i was having apparently was not a relapse but was an old symptom although it is a regular pain just more severe. My next app is in 2 weeks but we are not sure what we are supposed to be reporting as we left the last app more confused. Do you think he is trying to determine the type or the kind of treatment?

Hi

No, what the neurologist is doing is checking whether you fit the NICE guidelines for prescribing disease modifying drugs (DMDs).

To meet the guidelines, a person should have ‘Active MS’ or ‘Rapidly Evolving Severe MS’.

To fit the criteria for either, you should have had 2 relapses within the last year.

Have a look at https://www.mstrust.org.uk/about-ms/ms-treatments/disease-modifying-drugs-dmds#how-are-dmds-approved-for-use-by-the-nhs

Assuming you do meet the criteria (and most neurologists probably would want you to, because starting treatment early is considered best), you will then be involved in the decision about which DMD is best for you.

The MS Trust has a decision making tool: https://www.mstrust.org.uk/about-ms/ms-treatments/ms-decisions-aid

You aren’t likely to have a completely free choice. You’ll likely have a choice of maybe 3 treatments. But you can help yourself by getting familiar with the various drugs. Your neurologist and / or MS nurse will help in your decision making.

So, before you go to the next neurology appointment, think back over the last year, what symptoms have you had? Have you been having relapses or ‘flares’? Try to write yourself a timeline as to what has happened and when.

Best of luck.

Sue