b'Medicine & ResearchMS relapse is associated with an approximatelyand MS-associated human leucocyte antigen 30 percent risk of new permanent disability.genes. They conducted a population-based Now, your insurance carrier will let you trycase-control study. Evaluations were made drug B as drug A failed to produce a positivebased on questionnaires completed by 93 effect in your treatment. You also have a newpercent of the cases and 73 percent of the permanent symptom because of the insurancecontrol participants, and blood samples from carriers restrictions. This scenario plays out73 percent of the cases and 49 percent of the all too frequently around the country daily.controls. Analysis of this data revealed that Another barrier placed by insurancesuffering head trauma at any point was linked carriers on MS healthcare providers and theto a 30 percent increased risk of later developing MS community is through site of serviceMS.Researchersconsideredthatperhaps restrictions on infused medications. Thesepeople who have elevated neurolament light restrictions limit where a patient can receivechain levels may experience more accidents, theirinfusedMStherapy.Onegoalofsuch as falls resulting in head trauma, and are comprehensive MS centers is to put as muchtherefore at higher risk of both head trauma MS care and expertise as possible in oneand MS. However, it could be that head trauma setting. This leads to better communicationresultsinthereleaseofCNScomponents betweenproviders,betterconvenienceforinto the CSF and causes further neurological patients, and a level of care that is focused ondamage. This research suggests that those MS, not a myriad of health conditions. Whenwho are genetically predisposed to MS may insurance carriers mandate that patients get theirbe more susceptible to head trauma and that infusions at sites outside of a comprehensivetrauma may trigger immune responses in MS center, all those advantages are erased forcertain individuals. The ndings were published the sake of cost savings to the carrier.in the Journal of Neurology, Neurosurgery Finally, insurance carriers can disrupt MSand Psychiatry. therapy through the use of white baggingThrower- MS is felt to be the result of a and brown bagging. White bagging requirescomplex interaction between genetic and that a patients infused medication be shippedenvironmental risk factors. Much of the from a specialty pharmacy to the MS infusionresearch on environmental factors has focused center rather than the center supplying theon Epstein Barr virus, childhood obesity, and low medicine directly. With brown bagging, thevitamin D levels. How about physical trauma, drugisshippedtothepatient,whothenespeciallyheadtrauma? Apositionpaper brings it in for their infusion. Both practicesfrom the American Academy of Neurology in create potential delays in care when shipments1999 stated there was no strong evidence to dont arrive on time. There are also safetysupport a link between physical trauma and concerns because of potential inappropriateMS onset or MS exacerbations. Fortunately, storage, temperature control, and mishandlingasnewevidenceemerged,thatposition of these MS medications.paper has been retired. Study nds head trauma, MS risk linkHead trauma does appear to be associated Swedish researchers in this study investigatedwith a higher risk for developing MS, with more possible interactions between head traumaepisodes of trauma resulting in a higher risk. msfocusmagazine.org 46'