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Neurologist said smoking can cause brain lesions - really??

My PPMS diagnosis was changed yesterday to SPMS and one of the main reasons given was that although I have many spine lesions I only have a few on the brain. I am 56 and I gave up smoking 18 years ago - Dr said because I smoked 20 a day for 20 years then it might be that and not the MS. Really??? Anyone else been told this, I was pretty astonished. Also, can I ask does anyone else have what can only be described as spasticity in the lower back muscles? I am pretty sure my extreme back pain is because of this but he said he couldn’t find much spasticity.

No, not exactly. Years ago, my husband asked my neurologist (a learned chap who’s now a world expert on MS) if my smoking was bad for MS (he desperately wanted the answer to be ‘yes, stop immediately’ as he hated me smoking). The neurologist said no it has no impact.

The situation has now changed. Smoking is seen as one of the factors that can, together with all the others (genetics, environment, gender, geographic location, sun exposure, viruses, and more) predispose a person to MS.

And that same learned neurologist now says ‘stop smoking, it’s bad for people with MS’.

But I’ve never heard that nicotine can actually cause lesions. Lesions in the central nervous system are essentially scars from demyelination, either caused by an inflammatory attack (RR/SP), or from progressive demyelination (PP/SP). And demyelination is caused by our immune system getting the target wrong for our fighter cells. So the myelin protecting the nerves is damaged and causes faulty nerve signals / no nerve signals to be transmitted.

So lesions/scars on the brain are either caused by demyelination or not. And if not, then they’re not MS lesions, they’re something else.

This doesn’t mean that smoking is good for you, it’s not (I finally did give up nearly 8 years ago). But I suspect your neurologist was exaggerating just a bit.

Sue

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