Swedish News Blog

Power of reflection: Mirror therapy in MS

Angeli Mayadev, MD

Angeli Mayadev, MD
Physical Medicine & Rehabilitation, Swedish Multiple Sclerosis Center

The great wisdom traditions teach us that internal reflection is a useful means to grow.  Reflecting upon that. I thought that we could spend some time reviewing a technique of external reflection in rehabilitation known as mirror therapy. This was first described in 1995 by Ramachandran and his team who studied phantom limb pain.

Many concepts in multiple sclerosis (MS) rehabilitation come from stroke and pain rehabilitation fields.  There is evidence in these fields that supports the use of mirror therapy to help rehabilitation of the weaker side.  It also helps reduce neuropathic pain in patients who have phantom limb ( arm or leg) pain after an amputation.

There is very limited published research on the use of mirror therapy in MS.  We think that adding this type of therapy in the care of MS patients might be beneficial to reduce pain and weakness, and perhaps reduce "learned disuse" of the limb.

A brief summary of how to perform Mirror therapy is the following:

Lemtrada is FDA approved for people with relapsing MS

James D. Bowen, MD
On November 14, 2014, the U.S. Food and Drug Administration (FDA) approved Lemtrada (alemtuzumab) for the treatment of patients with relapsing forms of multiple sclerosis (MS) who have responded inadequately to two or more MS drugs.  Lemtrada is already approved in over 40 countries around the globe including the EU, Canada and Australia.

The FDA approval of Lemtrada is a significant milestone for people living with relapsing MS.  Lemtrada demonstrated superior efficacy over Rebif on annualized relapse rates in two pivotal randomized Phase III open-label rater-blinded studies in patients with relapsing remitting MS which were the basis for approval.  The clinical development program for Lemtrada involved nearly 1,500 patients including patients at the Swedish MS Center with more than ...

The difference between service dogs and therapy dogs

Mallory Higgins

Mallory Higgins
Education Coordinator and Marketing Specialist, Swedish MS Center

A service dog is an assistance dog that has been specially trained to help someone who has a disability. Service dogs work only with one owner/handler. They are trained for the person’s specific needs. For example, an owner/handler may have mobility limitations, hearing loss or deafness, visual impairment, or autism.

A service dog may be provided to the owner/handler at no cost. In some cases, the owner/handler may purchase the dog.

Some service dogs wear a vest, working harness or a bandana to signify that they are trained. However, the Americans with Disabilities Act does not require them to do so. The ADA covers public access for service dogs ...

Free Traveling Educational Workshop about Multiple Sclerosis in Bremerton

Mallory Higgins

Mallory Higgins
Education Coordinator and Marketing Specialist, Swedish MS Center

Experts from the Multiple Sclerosis Center at Swedish Neuroscience Institute and the National Multiple Sclerosis Society are bringing this traveling roadshow of Multiple Sclerosis (MS) education and information to Bremerton, Washington.


Where: Kitsap Conference Center Bremerton Harborside
100 Washington Avenue Bremerton, Washington  98337

When: Saturday, November 15, 2014, 10 a.m. – 2 p.m.
 
Workshop Topics
  • Comprehensive Care for MS 
  • Role of MRI in MS Diagnosis and Treatment                        
  • Exercise and MS
  • Cognition in MS                                              
  • Bladder and Bowel Issues in MS
Speakers: 

Free Pilates Class at the Multiple Sclerosis Center begins Nov. 14

Mallory Higgins

Mallory Higgins
Education Coordinator and Marketing Specialist, Swedish MS Center

Pilates is a system of gentle exercises that stretch, tone, and lengthen the muscles. This class is designed to improve posture, flexibility, balance, and core strength.
 
This class, beginning Friday Novemer 14, 2014, is appropriate for all mobility levels and those new to Pilates. Wheelchairs are welcome. Family members, caregivers, and friends are welcome to ...

Breastfeeding, Disease Modifying Therapies (DMTs), and Postpartum Relapse in Multiple Sclerosis

Peiqing Qian

Peiqing Qian
Neurologist, Swedish Multiple Sclerosis Center

Women with multiple sclerosis (MS) have higher risk of relapse during the postpartum period.  Can exclusive breastfeeding alone prevent relapses? How soon after delivery should disease modifying therapies (DMTs) be reintroduced? Are any DMTs safe to take while breastfeeding? 
 
While disease modifying therapies (DMTs) have been shown generally to reduce relapse rates, none of them are indicated for use during pregnancy and lactation. Therefore, the question of when to restart DMTs postpartum remains a difficult one for physicians counseling MS patients who wish to breastfeed their children.
 
Trying to predict the risk of relapse for any one individual is very difficult. The risk factors for postpartum attacks include ...

Rare infection occurs in patient on Tecfidera

James D. Bowen, MD
On Tuesday 10/21/14 Biogen announced that a patient treated with Tecfidera developed a rare infection, progressive multifocal leukoencephalopathy (PML). This patient was from Europe and had been treated with Tecfidera for 54 months. For approximately 3 ½ years, this person’s lymphocyte counts were very low, in the 200-500/mm3 range. After an illness lasting about 4 months this patient died from complications of the infection.
 
PML is an infection caused by the JC virus. About half of the population has the JC virus. Once a person has the JC virus, the immune system quickly brings it under control, but the virus remains hidden in the kidneys after that. From the kidney, the virus can periodically flare up and the immune system quickly brings it under control again. There are many other viruses that have this ability to periodically flare up, for example a virus that remains hidden in the nerves of the face can periodically flare up causing fever blisters, or chicken pox virus remains hidden in the nerves and can periodically flare to cause shingles. The JC virus is fairly easy for the immune system to control, and it generally does not cause medical problems. The one exception is PML.
 
PML occurs when the JC virus flares up in a person whose immune system is not normal. In this setting the virus can spread from the kidney to the brain where it causes widespread damage and usually death. This can happen with a number of immune system diseases, or with prolonged courses of chemotherapy. In recent years PML has occurred with other medications that block the immune system.
 
Tecfidera has been a very successful medication used to treat multiple sclerosis. However, it can cause a decrease in the white blood cells and lymphocytes in the blood. This decrease is usually about 30, which is a level that would not be concerning.  About...
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