A Neurologist Ponders Multiple Sclerosis: Questions That Keep Me Up at Night

Here, Armistead Williams, III, MD, of the International Multiple Sclerosis Management Practice and the Multiple Sclerosis Research Center of New York speaks directly to neurologists about the hard questions that need to be addressed about this complex illness. Dr. Williams notes that great progress has been made in the diagnosis and management of MS over the past 2 decades, and he underscores the importance of scrupulous proactive care.

Dr. Williams finds inspiration in a 2004 article by Atul Gawande, MD, in The New Yorker magazine and commends it to your attention as a source of ideas about providing the best possible care of your patients with complex neurologic problems.

Some of the hard questions:

• What is primary progressive MS? Is it an entity distinct from MS? How is it optimally managed?

• Can scrupulous care of patients with relapsing remitting MS truly prevent secondary progressive MS?

• What will stem cells do to help us treat patients with MS?

• Biomarkers for MS: how close are we?

• What is the pathology of MS at the cortical level?