American actress Christina Applegate, who is often remembered for her role as Kelly Bundy on the hit TV show Married With Children that aired from the late 80s to late 90s, said this week that she was wrongly diagnosed with multiple sclerosis.
asserted
she → remember → sclerosis
Ms. Applegate first announced in 2021 that she had been diagnosed with the disorder that causes the immune system to attack the cells in the central nervous system.
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system → announce → system
On Tuesday, The Globe and Mail spoke with Dr. Mark Freedman, an internationally recognized neurologist who serves as director of the Multiple Sclerosis Research Unit at the Ottawa Hospital, to learn more about the disease and how common it is to be misdiagnosed.
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it → speak → disease
MS is considered an autoimmune disease.
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MS → consider → ?
Every organ of the body has an autoimmune disease associated with it.
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organ → have → it
In MS, the autoimmune target is the insulation of the wires of the central nervous system, called myelin.
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target → call → system
Anywhere you have the central nervous system, myelin is open to attack from the immune system.
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myelin → have → system
It includes what some people don’t realize: the optic nerve.
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people → include → nerve
The optic nerve is an extension of the brain and it’s coated with myelin, similar to the way the rest of the brain and spinal cord are.
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rest → coat → brain
Your brain controls everything, right?
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brain → control → everything
So depending on where the attack occurs, you could have a multitude of different symptoms, or you could have no symptoms at all.
uncertain
you → depend → symptoms
How is MS diagnosed?
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MS → diagnose → ?
We actually just published a brand-new series of criteria about a year ago.
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We → publish → criteria
This was an international effort at trying to really line up the clues for MS.
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This → try → MS
Every rendition of our diagnostic criteria had two things in mind.
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rendition → have → mind
Number one: make sure that if you put the label of MS, it really is MS.
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it → make → MS
The second is to try to diagnose the disease earlier, so there’s an opportunity for treatments.
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second → try → treatments
The earlier you introduce an effective treatment, the better the long-term outcome.
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you → introduce → treatment
How common is it for patients to be misdiagnosed with MS?
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patients → misdiagnose → MS
In Canada, I would say it’s very uncommon.
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it → say → Canada
Most of the neurologists in our country are highly trained in usually large academic centres.
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Most → train → centres
We always train fellows.
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We → train → fellows
That’s not the case in other countries, such as the U.S.
The disease has become so complex, not only in terms of the diagnosis but also in the therapies that we apply.
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we → become → that
Why is it key for patients to be able to receive the correct diagnosis?
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patients → receive → diagnosis
Psychologically, would you really want to be labelled with a disease you don’t have?
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you → want → disease
I would err on the side of “This could be MS, but I’m not convinced of it, and I need to do more tests or I need more time.”
uncertain
I → err → time
The drugs that we’re using today are actually quite complex and very expensive.
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we → use → that
Do I want to commit a patient to a therapy they don’t need and could be potentially harmful to them?
uncertain
they → want → them
I don’t want to do that.
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I → want → that
Our Hippocratic Oath when we became doctors is to first do no harm.
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we → become → harm
The data varies a little bit, but most of the time we say that if you have a first-degree relative – mother, father, sister, brother – with MS, your chances are 30 to 50 times the population risk.
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chances → vary → MS
What are you thinking about as you look to the future and how to best support patients?
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you → think → patients
There’s so much that we need to know.
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we → ’ → that
Years ago, we pioneered the use of autologous stem cell treatment for MS in Ottawa.
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we → pioneer → Ottawa
We are still the leading centre in Canada that does these treatments for people who have very aggressive forms of the disease.
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who → lead → disease
In those individuals, we’ve been able to stop it cold and they’ve done very well.
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they → stop → it
It’s quite an extreme procedure to completely remove an immune system and replace it with patients’ own stem cells.
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It → ’ → cells
We still do one or two a month from all over Canada.
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We → do → Canada
Even if we stop all inflammation in patients, some patients still continue to progressively get worse.
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patients → stop → patients
That is a different type of inflammation that is not currently targeted by the therapies we have, but there are some new ones on the horizon.
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we → target → horizon
…and 1 more, not listed.
The Aporia
