Michelle Stern | Search PubMed

PubMed2005

Aging with multiple sclerosis.

The chronic and progressive nature of MS may be overwhelming to the patient and the family. It is vital for the clinician to develop a system of periodic evaluations and interventions that monitor the disease and address the effects on the patient's physical, psychologic, social, and vocational functioning. MS patients are susceptible to other diseases of aging, such as stroke, cancer, heart disease, and diabetes, and need to be evaluated and treated for these conditions. Obtaining appropriate routine medical care may become difficult in less mobile patients because many clinicians' offices are unable to accommodate handicapped patients. Careful coordination and referral to handicap-accessible centers may be required to ensure adequate treatment. Nearly half of MS patients die from complications of their disease. Other major causes of mortality are malignancy (16%), suicide (15%), and myocardial infarction (11%). Age-appropriate cancer screenings and cardiac evaluation are necessary. Depression is an important factor in geriatric MS patients despite the fact that most MS patients have an easier time adjusting to the aging process than the general population. There are many unanswered questions for the older MS population due to the paucity of research, but future studies may rectify this situation. Although there is no cure for MS, the clinician can play a key role in helping the patient and family adapt to the illness and improve their quality of life. Resources are available for the clinician, the patient, and family members.

Aging↗

PubMed2004

Symptomatic thoracic vertebral hemangioma: a case report and literature review.

Vertebral hemangiomas are relatively common, but those causing spinal cord compression are rare. A man in his early sixties with back pain that had not resolved with conservative treatment was seen in an outpatient physiatrist office. Subsequent workup with computed tomography scan showed a large hemangioma in the T5 vertebra extending to the posterior elements where his pain was located. Three weeks later, the patient had progressive weakness and numbness in his lower extremity. He subsequently underwent a T3-5 laminectomy, with a subtotal resection of the mass. He reported improvement in lower-extremity strength and sensation and completed a course of inpatient rehabilitation. Recognizing when to expect neurologic symptoms and the proper time to intervene can be very critical. From this case study and other similar instances, one can conclude that vertebral hemangiomas are not always benign and are capable of causing cord compression. Proper diagnosis and treatment may prevent the development of neurologic symptoms.

Back Pain↗