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Multiple Sclerosis (MS) and Autoimmune Neurological Disorders Clinic

(A part of the Basil and Farida El-Baz Center for Multiple Sclerosis and Devic’s Disease)

Services

The Multiple Sclerosis and Autoimmune Neurological Disorders Clinic manages a broad category of autoimmune neurological diseases, with specific emphasis on multiple sclerosis. Our approach focuses on ruling out the many conditions that can mimic multiple sclerosis first. Once a diagnosis is confirmed, our care team is trained to provide the full range of services our patients need, including routine screening for cognitive, vision, movement, walking and mental health integrity.

Providers

Mahmoud AbdelRazek, MD

Laurel Vuong, MD (Neuro-Ophthalmologist)

Our neurology specialists also work with experts in:

  • Ophthalmology
  • Psychiatry
  • Neuropsychology
  • Urology
  • Neuroimaging/Neuroradiology/Nuclear Medicine
  • Occupational therapy
  • Physical therapy
  • Speech therapy
  • Neurosurgery

What to expect during your first clinic visit

  • During your first visit to the clinic, our providers will have reviewed any of your records available to them through our electronic medical record system, or that which you have provided by mail or fax to our clinic.
  • Our providers will perform a full neurological examination.
  • They will go over your brain imaging with you, and give you their medical opinion regarding your diagnosis if you have not yet been diagnosed with a specific disease like MS.
  • They will discuss what your diagnosis means, answer your questions, address your concerns and point you to sources that will aid you further.
  • Additional testing will usually be requested.

How to prepare for your first clinic visit

  • We ask that you mail a copy or fax over any outside records, including doctors’ notes and brain imaging done.
  • We also ask that you provide us with CD’s of any brain MRI or head CT done outside the Mount Auburn healthcare system. You can check with our staff over the phone what healthcare records within the Boston area we already have access to.

Research Advisory Board; be a part of decision-making in research

Our hospital is an Harvard teaching hospital and clinical research is important to us at the Neurology clinic. We welcome our patients taking part in the process of choosing what research ideas should be implemented. This can be achieved by joining our Neurology Research Advisory Board. The goal of this board is to include opinions from the different stakeholders of health care in choosing research ideas. The advisory board includes doctors, patients, patients' family members, physical therapists, financial administrators and others. The board meets on a regular basis to discuss the ongoing and future clinical research projects. For more information or if you would like to participate, please contact us at NRAB@mah.harvard.edu.

About Multiple Sclerosis and Autoimmune Neurological Disorders

Autoimmunity refers to one’s own immune system attacking the body’s different tissues and organs, leading to short-term or long-term inflammation and reduced function of these organs.

Types of Autoimmune Neurological Disorders:

Multiple Sclerosis and other demyelinating diseases (like NMO)

Multiple sclerosis (MS) is by far the most common autoimmune neurological condition affecting the brain and spinal cord. MS is most common disease we treat in our clinic.

Multiple sclerosis is a chronic condition characterized by episodes of inflammation of the optic nerves, brain and spinal cord. These episodes, called flares or attacks, remit to a varying degree and recur again over a period of many years. Historically, these flares progressively led to accumulation of disability; but as treatment therapies have advanced dramatically, we are seeing less and less disability.

Neuromyelitis optica (NMO or Devic’s Disease) was originally considered a variant of MS, but we now know that it is a separate disease characterized by the presence of an antibody that attacks the optic nerves and spinal cord. Similar to MS, NMO is also known to cause recurring flares of inflammation, but unlike MS, the location of inflammation is usually in one of the optic nerves or the spinal cord and not the brain.

Neurological Manifestations of Rheumatologic Diseases

Conditions referred to as rheumatologic diseases include lupus, sarcoidosis, rheumatoid arthritis, IgG4-related disease, Sjogren’s syndrome, vasculitis, Behcet’s disease and others. These conditions are considered autoimmune disorders and typically affect organs other than the brain or spinal cords. Rarely, their inflammatory reaction also includes the brain, the spinal cord, their covering membranes (meninges) and the nerves of the arms and legs; this is referred to as their “Neurological Manifestations”. Treatment of such cases requires expertise in this rare field of conditions which our clinic offers. An understanding of these conditions is important as they can mimic multiple sclerosis but are treated very differently.

Autoimmune encephalitis and myelitis

Autoimmune diseases that can affect the brain and spinal cord are vast and diverse. MS is the most common of these, but other conditions include autoimmune encephalitis which results from an antibody attacking the brain or spinal cord. An understanding of these conditions is important as they can mimic multiple sclerosis but are treated very differently. The providers at our clinic are trained to diagnose and treat these diseases.

Monitoring

At our clinic, we monitor objectively for the signs of disease improvement or progression. We screen each patient on a routine basis with:

  • Symbol Digit Modality Test (for cognition or mental capacity)
  • 9-hole Peg Test (for hand coordination)
  • Timed 25-Foot Walk Test (for gait or walking)
  • Brain, Cervical Spine, Thoracic Spine MRI (for new MS lesions that don’t produce symptoms and only show on MRI)

Treatments

We provide all available services for treatment, this includes:

Pharmacological Treatment:

  • MS attack prevention: Called “Disease-modifying therapy”. This includes Injectable, Oral and Infusion therapies. The providers in our clinic work with our patients to choose and tailor these therapies to each specific individual, based on their risk profile and potential side effects.
  • MS attack relief: Mainly in the form of steroid therapy. Our goal is to avoid needing to use steroid therapy, but this is available in infusion and oral forms when our providers feel this is absolutely necessary.
  • Management of MS symptoms: This includes oral treatments and referrals to other specialists if needed for bladder, fatigue, itching, pain and other symptoms that may arise.

Non-pharmacological Treatment:

  • We encourage exercise as it promotes strength, improves mood and reduces MS-related fatigue.
  • We encourage a healthy diet of high-fiber and moderation in fat, carb and protein intake. There is not yet an “MS-specific” diet with rigorous evidence.

Mental Health:

  • Routine screening questionnaires for depression and other mental health issues that may arise in MS are part of our approach.
  • Our clinic is geared to ensure and promote strong mental health through drug therapy, counseling, and referral to one of the many mental health providers at Mount Auburn Hospital.

Additional Recourses

National Multiple Sclerosis Society

Autoimmune Encephalitis Alliance

Americas Committee for Treatment in Multiple Sclerosis

Contact Us

To schedule an appointment with the Multiple Sclerosis and Autoimmune Neurological Disorders Clinic, please call 617-868-0880.

Basil and Farida El-Baz Center for Multiple Sclerosis and Devic's Disease

Find an understanding and supportive atmosphere offered through others challenged by MS and other autoimmune conditions at our weekly clinic. To schedule an appointment, please call 617-868-0880.

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