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Thursday, May 03, 2007

Early is Already Late
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Do you keep a spare tire in the trunk of your car? You probably won't need it anytime soon, but it's good to know it's there in case one of the essential four tires goes flat. In the meantime that fifth tire is redundant.

Redundancy is also a good thing in medicine.

Redundancy is also a good thing in medicine.

The human nervous system, for example, has far more fibers (axons) than it really needs. Since damaged axons cannot repair themselves, there are other axons nearby to carry the load.

Well, that's it for the good news. Get ready for the worrisome part.

When a tire goes flat, you immediately know it. POW! Some wobbly steering and off to the highway shoulder you go.

When nerve fibers are damaged by a degenerative disorder you don't immediately know it. There may be no symptoms whatsoever because those neighboring, redundant fibers immediately take up the slack. Okay, but what happens when the progressive disorder damages the redundant fibers? Sadly, game over.

Clinical researchers who study multiple sclerosis now acknowledge that there is far more widespread nerve damage than the isolated plaques that appear on the brain MRI scans. Early is already late. With each subsequent attack (recurrence) more axons are destroyed.

Ophthalmologists are familiar with a similar destructive pattern that occurs in folks with glaucoma. By the time a glaucoma patient starts having visual field changes and decreased vision significant irreversible nerve damage has already occurred.

These findings are the basis for early, aggressive treatment for degenerative neurologic disorders. Whether it's MS, glaucoma, or other similar diagnoses, there is no time to waste. Far too many axons are already lost or compromised. Any delay will lead to further nerve damage and reduce the potential effectiveness of any medical treatment.

Yes, timing is everything.

Yes, timing is everything.

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Posted by: Dr. Lloyd at 12:51 PM

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