Atrium Health Multiple Sclerosis & Autoimmune Neurology Center

Multiple sclerosis (MS) is a long-term autoimmune disease that attacks the central nervous system, including the brain, spinal cord and nerves.

These attacks damage the tissue that protects the nerves, making it hard for your brain to communicate with the rest of your body. This leads to symptoms that can be mild, moderate or debilitating.

Our team has experience diagnosing and treating all types of MS, including:

• Relapsing-remitting: This is the most common form of MS. There are clear relapses (or flare-ups) of symptoms and periods of recovery between each relapse.
• Primary-progressive: Symptoms steadily progress without clear relapses or periods of recovery.
• Secondary progressive: This starts as relapsing-remitting MS. Then, over time, symptoms worsen and relapses may last longer.
• Progressive-relapsing: There is steady worsening of symptoms over time with regular flare-ups that may not be followed by periods of recovery.

Experts still don’t know exactly what causes MS, but it appears that genetics and environmental factors play a role. MS is not directly inherited, but having a close family member with MS is a risk factor for the disease. MS is also more common in women.

The signs and symptoms of MS can vary a lot from person to person, and they can change as the disease progresses.

Some symptoms of MS include:

• Problems with vision, like blurry vision, double vision or vision loss
• Speech issues
• Weakness
• Numbness or tingling
• Fatigue
• Walking and coordination problems
• Dizziness
• Significant confusion
• Bladder and bowel dysfunction

Your MS care will be led by a neurologist, a doctor who specializes in conditions that affect the nervous system. At Atrium Health Multiple Sclerosis & Autoimmune Neurology Center, we have neurologists whose knowledge and expertise earned recognition as Partners in MS Care by the National MS Society.

Your neurologist will work closely with your primary care doctor and other experts to address all your needs. Your care team may include:

• MS nurses
• Neuropsychologists
• Psychologists
• Physical therapists
• Occupational therapists
• Speech/language pathologists
• Social workers
• Radiologists
• Researchers
• Urologists
• Urogynecologists
• Other specialists who can treat your specific symptoms

Relapsing MS is the most common form of MS. During relapses – also called exacerbations, flares or attacks – inflammation in the brain and spine causes new symptoms to appear or old symptoms to worsen. A relapse can last anywhere from 24 hours to weeks or months.

Relapses are followed by remissions, or times when you feel better, and your symptoms partly or completely go away. Attacks are different from person to person and can be mild or severe.

A pseudo-exacerbation is when you have new or worsening symptoms that aren’t related to new inflammation. The symptoms appear very similar to an MS relapse, but they’re triggered by other factors.

Some causes of pseudo-exacerbations are illness, fever, heat exposure and emotional and physical stress. Once these other causes are treated or avoided, the pseudo-exacerbation goes away.

One of the most common triggers of pseudo-exacerbations is urinary tract infections (UTIs). You may also experience worsening of symptoms when your body temperature rises, like when you have a fever, during exercise or when it is hot outside.

Contact your MS care team about any new or worsening symptoms lasting longer than 24 hours.

We’ll talk with you to determine what your next steps should be. The more information you can share, the better. Some questions we’ll ask are:

• Is the symptom new or old?
• Has the symptom lasted more than 24 hours?
• Do you have a fever or any signs of infection?
• Have you been overheated, experienced increased stress or overexerted yourself?
• Have you had any changes to your MS treatment plan?
• Have you had any health changes that are being treated by another doctor?

Most MS symptoms don’t require emergency care. But if you’re experiencing life-threatening symptoms, call 911 or go to the Emergency Department.

Our MS doctors do everything they can to prevent relapses with disease-modifying therapies. Still, relapses can happen.

Most relapses go away on their own, without treatment. But if you experience MS relapses that make it difficult to function, support is available.

The most common treatment for MS relapse is corticosteroids, which can be taken by mouth or given through an IV. These steroids decrease inflammation in the brain and spinal cord. We also offer other acute treatment options, like intravenous immunoglobulin (IVIG) and plasma exchange (also known as plasmapheresis).

Your care team will explain the available options and help you decide what’s best for your unique needs.

Your appointments are always tailored to your unique needs. If you have questions about a specific appointment, contact your doctor’s office.

It might also be helpful to know some of our clinic policies and recommendations below.

• Appointments required: We’re not able to see walk-ins. To schedule an appointment, please call us at 704-446-1900. We’ll do our best to get you in soon, but we can’t guarantee same-day appointments at this time.
• Canceling and rescheduling appointments: If you aren’t able to keep your appointment, please call 704-446-1900 to cancel and reschedule.
• Follow-up appointments: To avoid delays in care, we encourage you to schedule your follow-up appointments on your way out of the office after a visit. Your provider will give you clear instructions for when you need to come back in.

• Plan your visit: When planning your visit to our clinic, think about whether you need help with transportation, childcare, household duties or work accommodations. Let your care team know if you have concerns or need support.
• Prepare FMLA forms: If you have to miss work due to your condition, it may be helpful to complete paperwork for intermittent leave (taking blocks of time away from work) under the Family Medical Leave Act (FMLA). We can assist you with this. See the answer to the next question to find out how to get these forms completed.
• Gather personal information: If there are any changes to your personal information, please let your doctor’s office know before or during your appointment. This includes your contact and insurance information, the name and contact information of anyone else we can speak to on your behalf, and the name and location of all other healthcare providers.
• Bring your MRIs and medications: When you come to your appointment, please bring any MRIs (original or copies) and a list of any medications you’re taking (including prescriptions, over-the-counter drugs, vitamins and supplements).
• Check in on time: We ask that you arrive 10 to 15 minutes prior to your scheduled appointment to allow time for check-in.

Most refills are handled during your regular appointments. If you need a refill before or after your appointment, you can call our office at 704-446-1900 or send a message to your care team through MyAtriumHealth.

Some medicines require labs before you can refill them. If this is the case for any of your medications, our team will contact you to let you know.

We’re happy to help you with medical forms. You can:

• Bring the form with you to an appointment
• Fax it to our office at 704-446-1289
• Mail it to our office at 1225 Harding Place, Suite 4200, Charlotte, NC 28204
• Attach it to a message to your care team on MyAtriumHealth

Please provide detailed information about where we should send it once it’s complete and if there’s a deadline. Once we have your form, it typically takes 10 to 15 days for us to complete it.