Multiple Sclerosis

Multiple Sclerosis (MS) affects more than 70,000 people in Canada. It is recognized as the most common cause of neurological disability in young adults in North America.

Multiple Sclerosis

MS typically begins in the second or third decade of life but can be diagnosed as early as age 10 and as late as in the 60s. It is a chronic, inflammatory, demyelinating, and neurodegenerative disease of the central nervous system (CNS), believed to result from a genetic predisposition combined with an environmental trigger. The disease course is heterogeneous, with 85% of patients starting with a relapsing-remitting course, which, after 15 to 20 years evolves into a secondary progressive course. The remaining 15% of patients will have a chronic, primary progressive course from the onset.

Common presenting symptoms include visual loss, sensory loss in one or both lower extremities, weakness of a limb or loss of balance, walking difficulties.

Clinical Evaluation

At CNO, we have a bilingual, multidisciplinary team consisting of neurologists, physiotherapists, medical assistants, specialized nurses and office administrators. Our team is experienced in the diagnosis, treatment and follow-up of patients with MS. Investigations and monitoring evaluations often include MRI, evoked potentials, blood tests and cerebrospinal fluid (CSF) analysis which can all be done at or arranged through the clinic. Initial consultations are available by referral from a physician.

Treatments

The treatment armamentarium used in MS has grown exponentially over the past few decades and continues to grow. To support physicians, CNO developed a repository of up-to-date information on the various MS treatments.

Many treatments in MS are administered intravenously. These can be received at CNO’s infusion clinic, administered by specialized MS nurses under the supervision of experienced neurologists.

While treatments in MS have changed the clinical evolution of the disease, they are not a cure. Much remains to be accomplished to fully understand the mechanisms of the disease, how to stop the progression of neurological disability and enable repair within the central nervous system (CNS).

CNO continues to be active in the field of clinical research in MS. Clinical trials at CNO are seen as a viable treatment option for patients whose disease does not respond optimally to currently available treatments.

rTMS in MS

Repetitive transcranial magnetic stimulation (rTMS) is a form of non-invasive neuromodulation. It is a method by which we can modulate how neuronal networks communicate within and across neuronal networks. It consists of inducing brief, repetitive, focal, small electrical currents in the brain using an electromagnet. It is commonly used to treat medication resistant depression. While it is still regarded as experimental, our experience with rTMS has convinced us that it can help alleviate a number of MS related symptoms such as weakness, spasticity, pain and neurogenic bladder. We are currently involved in clinical trials looking at rTMS in patients with MS.

Rehabilitation

Exercise is important for patients with multiple sclerosis (MS) to optimize mobility, support recovery from relapses, reduce pain and spasticity, and improve balance. However, exercise is often not a realistic option for individuals with MS without the help of experts and access to specialized equipment.

Through its partnership with Clinique NeuroGym, CNO offers patients with MS the opportunity to access physiotherapy services within the clinic. Clinique NeuroGym specializes in motor-enabling rehabilitation for individuals with a range of neurological conditions, including MS.

Together, CNO and Clinique Neurogym have conducted research projects in the field of MS rehabilitation and continue to collaborate to improve clinical outcomes of patients with MS.

Multiple Sclerosis