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Q&A-18: an equivocal new lesion
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Q&A-18: an equivocal new lesion

Facial twitching; could this be MS? Thyroid cancer; can I restart natalizumab? An equivocal new lesion on ocrelizumab; should I switch? Measles and rubella seronegative; should I have a booster?

Questions

Q1: My daughter has just had her 28th birthday and complains of intermittent twitching above her right eye. I was diagnosed 21 years ago and have had eye twitching in the past. Could this be the initial manifestation of MS in my daughter? What should I do? 

Q2: I have MS and have been on natalizumab for close to 1 year. I have recently been diagnosed with thyroid cancer and have had surgery in which the left side of my thyroid was removed. Which MS treatments are compatible with cancer? Will I be able to restart natalizumab? 

Q3: I am 59 years of age and have been on ocrelizumab for four years. My latest MRI shows an equivocal new lesion. I think my MS is stable, with a possibility of some age-related slowing down. What is an equivocal lesion? Should I escalate my treatment? 

Q4: I am due to start ofatumumab in the next few weeks, but my neurologist checked my MMR (mumps, measles and rubella) status, and I only have antibodies to mumps. I have been told to get an MMR booster. Would you recommend this? 

Think measles! - Birmingham and Solihull Mental Health NHS Foundation Trust

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Answers

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