Brains and Mysteries

Is it possible for a physician to mistake Lyme disease for multiple sclerosis, since white lesions show on the MRI film for both diseases?
Most experts will exclude neuroborreliosis (Lyme disease) when they are evaluating patients for possible multiple sclerosis. There are widely available laboratory tests that help make this distinction. By and large, the symptoms of neuroborreliosis affect the peripheral nervous system, mainly the nerves, whereas the symptoms of multiple sclerosis exclusively affect the central nervous system. For example, Bell's palsy (facial weakness) affecting both sides of the face, often occurs in Lyme disease, but very rarely in authentic multiple sclerosis. Sometimes, the MRI of the brain shows some small white lesions in patients with a history of Lyme disease, but there is no good evidence that these are similar to the kinds of lesions seen in MS. Of course, a rare person might have both MS and Lyme disease, but this would be relatively rare and there are no data suggesting a causative relationship.

Is Lewy body disease hereditary? Why doesn't it get much publicity?
Lewy body disease is the second most common cause of Parkinsonism after Parkinson disease. It is relatively rare but is seen regularly by specialists in Parkinson-like diseases. It is usually not hereditary, but, as is the case with many human diseases, likely the result of a genetic predisposition combining with environmental factors to trigger the clinical onset of the disease. There is no direct treatment for Lewy body disease, but the symptoms may sometimes be helped with medications that are used for conventional Parkinson's disease and various psychiatric disorders.

I have primary progressive multiple sclerosis. Balance is my main problem. Are there any medications to treat this?
Primary progressive multiple sclerosis should be managed by an MS expert. There are two interlocking problems; one is inflammation in the nervous system and the other is loss of nervous tissue (neurodegeneration). The inflammation problem is the one that is treatable, but it may require a fairly aggressive regimen of drug therapy in people with primary progressive MS, so it is generally believed that such patients should be managed in an experienced MS center. At the moment, we have no evidence that any other form of therapy (e.g., physical therapy) is beneficial is slowing the progression of this type of MS.

I was diagnosed with multiple sclerosis a few months ago. Since I have several symptoms that are bothersome, I would like to know if there are any improved medications for fatigue and spasticity (stiffness).
Fatigue in MS is a common and sometimes debilitating problem. Amantadine is one of the best-proved treatments for the fatigue of MS, but some newer drugs, such as modafanil (which is used to treat sleepiness) may sometimes help, as well. Stiffness is usually due to spasticity, which can often be treated with pills, such as baclofen or tizanadine, or sometimes with local injections of botulinum toxin.

I had a right lobectomy surgery in 1990, which has been successful in controlling my seizures. However, I have daily headaches and some severe "brain pain"--deeper than a migraine or headache. My concern is scar tissue. Do you ever recommend gamma knife or some other procedure to break up the post-op scar-tissue problems?
Head pain this far post-operatively is probably not due to scar tissue in the brain. Also, the brain itself is not pain sensitive, so breaking up scar tissue there would probably not treat the head pain. It is more likely that these are more conventional headaches, like migraine headaches. If so, there are many treatments that could help. A neurologist who specializes in headache could be of great help.

I am 63 years old and was diagnosed with multiple sclerosis in 2000. I have been reading about a possible DNA serum vaccine, among other potential treatments. Since I am on my own, I would want to aggressively treat my disease in order to better be able to remain independent.
There are many new therapies that are being tested as a possible treatment for multiple sclerosis, but a vaccine is not yet one of them. The best approach is to become associated with one of the major MS clinics around the country, where you can have an expert advise you about the new therapies and chances to enroll in legitimate clinical trials.