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Rare Aggressive MS Diagnosis

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    Rare Aggressive MS Diagnosis

    Hi,


    My fiancée is 25 years old and has always been fit and healthy. In August 2017 he suffered from bladder retention, which resulted in a trip to the hospital to get a catheter fitted. Over the next few days his legs became increasingly weak to the point of having a bad fall on the way to his GP and having to return to hospital where he has remained since.

    His first MRI scan showed lesions in the CNS leading to an MS diagnosis and a course of steroids. Despite the high dose of steroids, he continued to get worse and each MRI he received showed multiple new lesions. Within 2 weeks of his admission to hospital he had lost all movement in his legs and arms, lost all bowel and bladder function, began to lose his eyesight and was transferred to the High Dependency Unit and put on oxygen as his breathing had deteriorated.


    After multiple failed treatment attempts he began to receive Cyclophosphamide and 5 months on we are seeing very slow improvements. We have had mixed opinions regarding diagnosis, some say it is a very rare, aggressive variant of MS and others say their gut feeling says it is something else. Either way everyone who has seen him has agreed they have never seen a case like it.


    Research on the subject is limited, so if there is anyone who has had a similar experience with aggressive MS, or anyone with any knowledge or advice, we would appreciate anything you can tell us.


    Beth

    #2
    Hi Beth,
    Welcome. Sorry you have to be here but glad you found us. I'm hoping he is being cared for by a MS specialist. Since it is rare hopefully his neurologist is reaching out to colleagues in an effort to gain insight through collaboration.
    Sending good wishes your way. I hope he continues to improve.
    He is your friend, your partner, your defender, your dog. You are his life, his love, his leader. He will be yours, faithful and true to the last beat of his heart. You owe it to him to be worthy of such devotion.
    Anonymous

    Comment


      #3
      There can be light at the end of the tunnel

      Hi Beth,

      I just read your post about your fiancee and I am really sorry this has happened. It must be very scary and overwhelming for both of you.

      I had an onset and diagnosis similar to this but not as extreme or drawn out. I was 28 and had just given birth to my first child. About 5 weeks later I noticed some problems with my vision. I kept bumping into things and even had a car accident where I ran into a pole when I was parking as I couldn't judge distances properly. A few days later I woke up one morning and couldn't stand, was dizzy and was vomiting all the time. I was visited by the doctor and given antibiotics. But I didn't get better.

      A few days later I couldn't control my eyes at all (one was looking at the ground, the other at the sky). I had lost all awareness of my limb placement (ie if they said touch your nose I couldn't do it). I couldn't feel or control my left side. Unable to walk, talk properly, see or really do anything I was pretty stuffed and ended up in hospital. They thought I had had a stroke and told me I would not recover at all. I continued to worsen and spent 3 months in hospital. About 6 weeks in I was told that there was a chance that they had got it wrong and I was sent for an MRI. I remember them holding it up to a light box and saying see all these white spots. They shouldn't be there. There was too many to count. After this I was informed that it was likely to be MS but it was another year until I was diagnosed. When I left hospital I went to rehab to learn to do everything again. It took me about 2 years to stabilise and return to a point where I could function.

      That was 19 years ago now and I have had many relapses since then. I never recover fully but I learn to adjust to a new normal. Most people would never guess that there is anything wrong with me now.

      I was made permanently disabled at diagnosis and let go from my job. It has been a struggle financially especially since my husband had to become my carer. We went on to have 2 more children and life has been good.

      I have been on various MS treatments over the years. I underwent treatment with Lemtrada (which is a chemo treatment used in Australia for MS) last year and have a second treatment due in May this year.

      Back when I was in hospital I couldn't imagine a future but things did gradually turn around. I hope the same happens for you both.

      Best Wishes,
      Angela
      Angela

      Comment


        #4
        Beth,

        I am sorry to read about your fiancée's medical condition. I am also sorry that you too have been thrust into an inconceivable nightmare.


        MS is a differential diagnosis so all other reasonable possibilities should be ruled out prior to diagnosis. It's disturbing that this remains an open question nearly 6 months after onset. Maybe your doctor's can consult with an expert like Gavin Giovannoni. Here's his blog site:


        http://multiple-sclerosis-research.b...group.html?m=1



        Do the physicians believe he is still in a flare? I believe there are documented flares that lasted in the 2-year range before remitting.


        High-dose steroids are not intended to overcome a flare up, but quickly reduce inflammation trying to minimize damage. Did they stop at one steroids course, or did they administer a second longer one? Some people that don't respond to steroids do respond to acthar gel. Have they tried plasmapheresis? I'm not sure if either treatment is available across the pond, but could be worth looking into.


        Improvements, however small, are a good sign and hopefully the start of even a bigger recovery. I had a wicked flare in 2012 that devastated my body, but years later I have finally recovered most of my function.


        Please keep us informed on what's going on. I definitely would be pushing the physicians to keep searching for a more definitive answer.

        Praying for you guys.

        Comment


          #5
          That sounds like a nightmare.

          My first MS flare, back when I didn’t know what was happening, was a slightly numb, tingly foot. Next was fatigue, next was a numb hand, by which time I’d guessed what it was likely to be, and then a good dose of double vision.

          Then I got diagnosed.
          Since then, 20 years ago, not much has been as bad as those “what is this?” times, because I know what is causing the trouble.

          Best wishes to you both.

          Comment


            #6
            Thank you for your replies!

            Neither of us has been faced with MS before - no family members, friends or even acquaintances have had it, so everything about this situation is new to us. It helps to hear other people's stories and see that maybe we are not as alone as we thought.

            His consultant has reached out to experts at a nearby hospital who have helped with his treatment and they are confident that they have stopped his current 'attack', and will continue with monthly Cyclophosphamide infusions for another 6-12 months. He has remained on steroids since his admission, but other than this there has been no mention yet of a future treatment plan.

            Angela - I can't imagine what you went through, going through all of this having just given birth. I dread to think how I would be feeling if I had a newborn baby added to the mix! I am glad things have turned around for you and hope it continues.

            Marco - He underwent 5 sessions of Plasmapheresis whilst in the High Dependency Unit and we did see small improvements, particularly with his breathing, however it was decided that this would not be aggressive enough to stop the attack in the long run and he was consequently started on Rituximab. Again, this wasn't enough to stop it so he was switched onto Cyclophosphamide.

            He is now on the Neuro-Rehabilitation ward and has been for almost 2 months. We have seen continuous improvements in his arms and he can now pick up a beaker to drink, and can now eat picky items such as sandwiches and crisps unassisted. We have also seen small movements in the feet and legs so are hopeful this will continue.

            The worst part at the moment is the unknown. Without a definitive diagnosis it is difficult for us to accept what is happening and understand why. Hopefully we will eventually get answers.

            Beth

            Comment


              #7
              I wonder if he has Marburg MS which is a rare and extremely aggressive MS.

              Comment


                #8
                There was a young man in Canada who had an initial case sort of like this and he was given stem cell treatment that brought him back. I think he was a med student. Try googling stem cell Canada multiple sclerosis Dr. Mark Freedman.

                Comment

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