Dr. Aida Abaz Quka
Neurology
The following is an actual conversation between an iCliniq user and a doctor that has been reviewed and published as a Premium Q&A.
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Patient's Query
Hi doctor,
I am a patient with a history of MS. I have had several bouts of optic neuritis, and I do not take steroids due to their awful side effects. However, I was recently admitted to a hospital for two weeks as I had lost feeling in my legs, accompanied by spasticity and walking issues. I was under a five-day course of 1000 mg IV Solu-Medrol and the treatment was completed seven months ago. But for the past four days, I began to have symptoms of optic neuritis again, including pain during movement of my right eye and shaky vision in the right eye. This is my sixth bout of optic neuritis and the second bout in my right eye.
As the side effects of the steroids are very harsh, and I am getting past them from my last treatment. I am wondering if I should get treated with steroids or not. A neurologist has confirmed this bout of ON is due to an afferent defect in the right eye. Also, I am currently taking 3 mg long-lasting Hydromorphone. So my question is whether I should get treated with the given steroid dosage and whether it can prevent vision loss if I treat it at the early stages.
Please help.
Hi,
Welcome to icliniq.com.
I went through your query and understood your concern.
I would not recommend taking another treatment with Solu-Medrol (Methylprednisolone), considering the short period of time since your last IV (intravenous) therapy. For this reason, I suggest you start with oral steroids (Prednisone, a glucocorticoid) as a possible treatment option. It is also important to check aquaporin-4 antibody titer for possible neuromyelitis optica, which is a different disorder compared to MS (Multiple sclerosis) and with other treatment options. Plasmapheresis would be another treatment option for steroids. If the aquaporin-4 antibody result is negative, I suggest you to discuss with your doctor regarding starting a disease-modifying therapy (I would suggest taking Ocrelizumab, an immunosuppressive agent), considering the high frequency of your relapses.
Kindly consult a specialist, talk with them, and take the medications with their consent.
I hope you will find this information helpful.
Take care.
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Neurology
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