This concern greatly impacts clinical decision making. These decisions, like neurology consultations for pre-operative clearance, can delay important surgeries, potentially unnecessarily.
Lindsey De Lott, M.D., assistant professor of neurology and first author of the manuscript, says she hopes this research gives physicians and patients the confidence in moving forward in the procedural decision making process.
“The idea that patients with MS might be at an increased risk of relapse following surgery isn’t necessarily the case, so we need to be careful delaying important surgeries,” says De Lott.
De Lott and senior author Tiffany Braley, M.D., M.S., associate professor of neurology and multiple sclerosis specialist, hypothesized that In the absence of post-operative complications, anesthesia exposure or surgery would not trigger functional decline or symptom recurrence.
Braley says the “vast majority” of her patients do well after surgery without evidence of relapse. So where do these concerns come from?
“In the rare instance when we have encountered a person with MS who developed neurological symptoms after surgery, the symptoms could usually be explained by a fever or infection,” says Braley, “yet, the limited research previously done on this topic did not take these factors into account.”
Limitations
Given these factors, patients who had surgical procedures that required minimal or no sedation, procedures expected to alter post-operative neurologic examinations, and procedures associated with immunosuppressive therapy use that may affect MS relapse rate (e.g. organ transplants) were excluded from the study.