Wednesday, 17 September 2014

MS Day Waterworks in MS


Dr Jalesh Panicker: Q&A

Why do you use tablets or certain type of tablets when people have cognitive problems?

Blood brain barrier separates brain from the rest of the body. These tablets can cross the blood brain barrier and they can go to different parts of the brain and proteins that are there. This is why these tablets can cause memory problems. Not everyone experiences this problem. However If there is an issue, then we will just use the tablets that do not cross the blood brain barrier such as trospium chloride.
Can you tell us if there is a role for sacral nerve stimulation (SNS) in MS patients?
To tell you about SNS, it’s a treatment involving stimulating one of the  sacral nerve roots with a device akin to a pacemaker, which is surgically implanted.  It has been shown to help with urinary urgency, frequency and incontinence, as well as with retention.  The evidence base for its use in MS is limited though.  Though it might be useful in the short term, it’s less clear whether it continues to work when bladder dysfunction worsens with MS progression.  This becomes relevant considering that it is an expensive device with costs approaching £8000. Moreover, the commonly used devices are not compatible with MRI, though newer MR-compatible devices are becoming available. 

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