Dr. Brian Sweeney, Consultant Neurologist Cork Universtiy Hospital, was the opening speaker. He bemoaned the fact that even if 12 more neurologists were appointed by the HSE the ratio would only be 1:100,000 and that would still be shy of what is needed. He spoke on the incidences of MS with Europe standing at 108:100,000 while North America has the unenviable figure of 140:100,000. I’m glad I’m European. He spoke of the signs and symptoms but sadly we were all too aware of those even though we all present differently. Thankfully don’t all have all the signs and all the symptoms. The average age at diagnosis is 30, more women than men have MS, there is an hereditary factor, albeit a small one; 97% of people with MS have no family history.
I have previously blogged on the need for PR training for those giving diagnoses and Dr Sweeney told us how the use of medical jargon is being discouraged in medical student training. Not quite PR training but it is a start. While commenting on the available treatments he said that MS is a marathon not a sprint and treatments should be considered with the long term plan in mind and not to look for ‘instant gratification’. He warned of patients having too high an expectation of any drug but I think that we all know that the treatments currently available are not cures but hopefully are at least stabilisers. Steroids are a quick fix for relapses but carry their own set of risks.
Dr Sweeney said that the two aspects of MS that cause most concern to PWMS are walking and vision and with that in mind he said that Fampyra should be available without the needless worry of cost.
Dr Eric Downer, Dept of Anatomy & Neuroscience, UCC spoke on Cannabinoids – he started by noting that he was scientist and not a clinician who rarely meets patients. Cannabis has had bad press over the years with its recognition as a psychoactive drug. The components of cannabis are readily absorbed into the system and thus give instant gratification. There are between 80 & 100 active components in cannabis but only two are of real interest with THC being one. This psychoactive element of cannabis reaches a very high level in the body and stays active for a prolonged period of time after smoking but when ingested medically its peak is much lower and it remains in the system for a shorter period of time.
Cannabinoids have been used in the treatment of tumours but what has achieved most notice over the last number of years is its use in the alleviation of spasticity and tremors in MS.
Prof. Michael Hutchinson, Consultant Neurologist, SVUH Dublin - spoke on Vitamin D and its role in MS. On the matter of Vitamin D he told us that research is ongoing but much more is needed as there is no universally agreed intake level and its presence, or lack thereof, does not totally explain the prevalence of MS in certain areas.
He gave some very interesting facts regarding Vitamin D:
- Vitamin D deficiency may lead to increased susceptibility to MS.
- Immigration prior to the age of 15 causes the immigrant to acquire the MS risk of the recipient country and the converse is also true.
- The incidence of MS is higher in North East France than in South West France.
- A 22 year study of US armed forces concluded that Vitamin D protects against MS.
- MS activity tends to be seasonal. It tends to be active in the spring, after winter when our Vitamin D levels are depleted and very low activity in the autumn/early winter when our Vitamin D levels are raised after the summer sunshine
- Evidence points to the likelihood of MSers being born in the spring when Vitamin D levels are lower.
- High Vitamin D levels reduce the rate of brain atrophy in early MS.
- Vitamin D is naturally available through sunlight and fatty fish but both are insufficient Ireland. Professor Hutchinson recommended a daily supplement especially in the winter months but a discussion with your doctor should take place before starting any supplementation.
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