Multiple sclerosis and neuroinflammation

Multiple sclerosis (MS) is a disease of the central nervous system (the brain and the spinal cord) in which inflammation causes damage to nerve cells (neurons) and the myelin sheath which surrounds them. Initially there is good repair of the damage caused by inflammation, allowing for good clinical recovery. However, over time, such repair and clinical recovery tend to become incomplete and lead to various degrees of disability.

The MS service at NUH is based at QMC and was started in 1994 by Professor Lance Blumhardt and continued by Professor Cris Constantinescu at the University of Nottingham. Consultant neurologists also involved in the MS service include Dr Nikos Evangelou and Dr Bruno Gran, both academics, and Dr Chris Gilmore (NHS), who runs MS clinics every Tuesday (Constantinescu, Gran) and Friday (Evangelou, Gilmore). Dr Athanasios Papathanasiou also runs weekly MS clinics. Over 3,000 patients are regularly followed up in these clinics in which a multidisciplinary approach provides access to neurologists as well as MS specialist nurses and neurophysiotherapists.

In addition, disease modifying treatments (DMTs) are offered including Interferon-beta in all its available formulations, Glatiramer acetate, Natalizumab, Dimethyl fumarate, Teriflunomide, Fingolimod, and Alemtuzumab. Recently approved oral DMTs such as Fingolimod are expected to become available in the near future. DMTs are aimed at reducing the inflammation and the accumulation of neurological impairment over time.

Professor Constantinescu also runs a monthly neuroimmunology clinic, in which he sees patients with other diseases of the nervous system caused by a dysfunction of the immune system. These include CNS vasculitis, sarcoidosis, and Behcet's disease. He is also the Director of the MS Clinical Trial Unit of the University of Nottingham, which was founded in 1995.

Dr Xia Lin is a consultant in neurological rehabilitation at the Royal Derby Hospital, with special research and clinical interests in MS. She runs a MS clinic every Friday at QMC campus.

Neurology consultants are actively involved in MS research and internationally recognised for their studies, as detailed in their personal profiles and related websites.

The MS specialist nurses include Kate Hartley (lead), Razia Khan, Maxine Morgan, and Cheryl Loosemore. They give telephone advice to patients and ward advice to doctors, and take part in outpatient clinics. They also run MS nurse-led clinics and can be reached on 0115 875 4605.



NHS Nottingham University Hospitals
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