Q&A 157: heart rate variability and MS I would be interested to know of this kind of hardcore medical information is useful for people with MS and their families.

#MS_Selfie Q&A 157: heart rate variability and MS

I would be interested to know if this kind of hardcore medical information is useful for people with MS and their families. buff.ly/DOLaAp3

Q&A 156: Hypertensive crises The assumption that hypertensive crises are always due to MS-related autonomic dysfunction needs to be challenged.

#MS_Selfie Q&A 156: Hypertensive crises

The assumption that hypertensive crises are always due to MS-related autonomic dysfunction needs to be challenged. buff.ly/Pvj2XBJ

Diagnosing MS: can we do better? We are proposing a tiered approach to formulating MS diagnostic criteria designed to develop and validate new, biologically-based diagnostic criteria for MS, avoiding a tautology....

#MS_Selfie - Diagnosing, not diagnosing and undiagnosing MS: can we do better?

We are proposing a tiered approach to formulating MS diagnostic criteria designed to develop and validate new, biologically-based diagnostic criteria for MS, avoiding a tautology.... buff.ly/hbHlnNi

Q&A 154: Measles and anti-CD20 treatment WARNING: There is a case report of a young patient who contracted a fatal measles infection while on a rituximab-containing regimen despite being vaccinated as a child.

#MS_Selfie Q&A 154: Measles and anti-CD20 treatment - should you be worried?

WARNING: There is a case report of a young patient who contracted a fatal measles infection while on a rituximab-containing regimen despite being vaccinated as a child. => buff.ly/BFdW4ky

Brazil - celebrating cladribine A celebration to mark the first year of cladribine’s availability through the public healthcare system in Brazil to treat people with highly active relapsing MS.

#MS_Selfie Newsletter: Brazil - celebrating cladribine

A celebration to mark the first year of cladribine’s availability through the public healthcare system in Brazil to treat people with highly active relapsing MS. gavingiovannoni.substack.com/p/brazil-cel...

Q&A 153: late-onset MS - cladribine vs. anti-CD20 therapy If you had late onset MS, i.e. was diagnosed with MS in your fifties, would you prefer to be treated with cladribine or an anti-CD20 therapy?

#MS_Selfie Q&A 153: late-onset MS - cladribine vs. anti-CD20 therapy

If you had late-onset MS, i.e., were diagnosed with MS in your fifties, would you prefer to be treated with cladribine or an anti-CD20 therapy? Has this person with MS been gaslit? gavingiovannoni.substack.com/p/q-and-a-15...

Q&A 152: natalizumab and renal cancer As usual, there are no definitive answers to your questions, only an opinion. I hope this helps.

#MS_Selfie Newsletter Q&A 152: Natalizumab and renal cancer

As usual, there are no definitive answers to your questions, only an opinion. I hope this helps => buff.ly/Yk3XhW8

Research News - 5 February to 16 March 2026 It looks like there are big research themes that are shaping up in 2026 are being defined.

#MS_Selfie Research News - 5 February to 16 March 2026

It looks like major research themes are shaping up in 2026 and being defined. buff.ly/fOEqZMe

Q&A 151: undiagnosing MS after a negative CSF examination Has anyone else had their MS undiagnosed in the past and labelled as having a functional neurological disorder or another disease? How was this handled, and was it with care and compassion?

#MS_Selfie Q&A 151: undiagnosing MS after a negative CSF examination

Has anyone else had their MS undiagnosed in the past and labelled as having a functional neurological disorder or another disease? How was this handled, and was it with care and compassion? => buff.ly/S3GRf7A

Q&A: managing advanced MS I am at EDSS 8 and need to get my affairs in order. I cannot do anything really anymore, so is this the beginning of the final stages?

#MS_Selfie Podcast and Newsletter on managing advanced MS

Q: I am at EDSS 8 and need to get my affairs in order. I cannot do anything really anymore, so is this the beginning of the final stages? => buff.ly/0eYTwba

Q&A 149: are placebo-controlled trials in MS ethical? I would be interested in your opinion on this topic. It is not a black-and-white issue and I suspect many of you would disagree with me.

#MS_Selfie Q&A 149: Are placebo-controlled trials in MS ethical?

I would be interested in your opinion on this topic. It is not a black-and-white issue, and I suspect many of you would disagree with me. => buff.ly/9Xv3ajU

Q&A 118: The NHS will see you now Prof. G, will it be possible to arrange an appointment to see you on the NHS? If not, can I see you privately?

#MS_Selfie Podcast and Newsletter Q&A 118: The NHS will see you now

Prof. G, will it be possible to arrange an appointment to see you on the NHS? If not, can I see you privately? => buff.ly/iD5M0FO

Spring news - good news Fenebrutinib pulverizes teriflunomide in relapsing multiple sclerosis

#MS_Selfie Spring news - good news

Fenebrutinib pulverises teriflunomide in relapsing multiple sclerosis gavingiovannoni.substack.com/p/spring-new...

Q&A 147- Will the BTK inhibitors get to market? I suspect this question is from a business or market analyst. It is not necessarily the kind of question my patients would ask.

#MS_Selfie Q&A 147- Will the BTK inhibitors get to market?

I suspect this question is from a business or market analyst. It is not necessarily the kind of question my patients would ask. buff.ly/CWmfPZc

Q&A 146: Brain training or cognitive rehabilitation or prehabilitation Do you use computerised cognitive training (CCT), which platform do you use, how long you have been using it, and have you have noticed any benefits?

#MS_Selfie Q&A 146: Brain training, cognitive rehabilitation, or prehabilitation

Do you use computerised cognitive training (CCT)? Which platform do you use, how long have you been using it, and have you noticed any benefits? buff.ly/NencnKk

Pressure sores When I started working in neurology over 30 years ago, I recall always having at least one or two patients on the neurology ward with pressure ulcers. Thankfully, this is now uncommon...

#MS_Selfie Podcast and Newsletter on MS-related pressure sores

When I started working in neurology over 30 years ago, I recall always having at least one or two patients on the neurology ward with pressure ulcers. Thankfully, this is now uncommon... buff.ly/10xXLpS

Research News #2: EBV and MS None of these studies is definitive in its own right; they are simply pieces of a large black jigsaw puzzle (black box) that is currently filling one corner.

#MS_Selfie Research News #2: EBV and MS

None of these studies is definitive in its own right; they are simply pieces of a large black jigsaw puzzle (black box) that is currently filling one corner => buff.ly/RQXvEaZ

Q&A 145: MS and Obsessive Compulsive Disorder or OCD Comorbid OCD is commoner than you realise in people with MS. Do you want to know more about it?

#MS_Selfie Podcast and Newsletter - Q&A 145: MS and Obsessive Compulsive Disorder or OCD
Comorbid OCD is more common than you realise in people with MS. Do you want to know more about it? buff.ly/PNU24PQ

Understanding your liver function tests or LFTs How healthy is your liver? Do you know how to interpret your LFT blood results?

#MS_Selfie Newsletter - understanding your liver function tests or LFTs

How healthy is your liver? Do you know how to interpret your LFT blood results? => buff.ly/VPbNbZK

Q&A 144: drug-induced liver injury Correction, I was wrong. Transaminitis defined as a rise in ALT greater than 3x or greater than 10x the upper limit of normal, is actually lower with tolebrutinib compared to fenebrutinib.

#MS_Selfie Newsletter Q&A 144: drug-induced liver injury or DILI
Correction, I was wrong. Transaminitis, defined as a rise in ALT greater than 3x or greater than 10x the upper limit of normal, is actually lower with tolebrutinib compared to fenebrutinib. => buff.ly/pBTrZdP

Q&A 143 - ACTRIMS 2026: BTK inhibition in PPMS “MS at a Crossroads” - a new treatment for Primary Progressive Multiple Sclerosis

#MS_Selfie Q&A 143 - ACTRIMS 2026: BTK inhibition in PPMS

“MS at a Crossroads” - a new treatment for Primary Progressive Multiple Sclerosis => buff.ly/zsTJOAK

Research News #1 I am launching a new MS-Selfie feature called “Research News” in which I will review research papers that have caught my attention over the last week or so. January 28, 2026 – February 4, 2026

#MS_SELFIE RESEARCH - Research News #1

I am launching a new feature called “Research News” in which I review research papers that have caught my attention over the last week or so. January 28, 2026 – February 4, 2026. Let me know if this is something worthwhile persisting with => buff.ly/sWUPikB

What is an MS label? These MS labels have now become sticky and inform clinical practice. What label best describes your MS?

#MS_Selfie => What is an MS label?

These MS labels have now become sticky and inform clinical practice. What label best describes your MS? => gavingiovannoni.substack.com/p/what-is-an...

Q&A 142: Epsilon toxin and MS One hypothesis I have spent less time discussing is the so-called ‘dual-hit’ hypothesis, i.e. EBV sets the stage for another factor such as a toxin to trigger the onset of MS.

#MS_Selfie Q&A 142: Epsilon toxin and MS

One hypothesis I have spent less time discussing is the so-called ‘dual-hit’ hypothesis, i.e. EBV sets the stage for another factor, such as a toxin, to trigger the onset of MS. If you are interested, please read the newsletter => buff.ly/jJiENAv

Should I be worried about measles? Do you know your MMR status? If not, you may want to know particularly if you are about to start an immunosuppressive therapy.

#MS_Selfie Newsletter and Podcast - Should I be worried about measles?

Do you know your MMR status? If not, you may want to know particularly if you are about to start an immunosuppressive therapy. => buff.ly/5hAcg0C

Q&A 141: neutropaenia on ocrelizumab Have any of you developed low neutrophil counts on ocrelizumab or the other anti-CD20 therapies? Did it resolve and/or recur? How was it managed? Did your neurologist stop your treatment?

#MS_Selfie Q&A 141: neutropaenia on ocrelizumab

Have any of you developed low neutrophil counts on ocrelizumab or the other anti-CD20 therapies? Did it resolve and/or recur? How was it managed? Did your neurologist stop your treatment? => buff.ly/OxfIWi2

#MS_Selfie Newsletter - Tolebrutinib treatment algorithm version 2.0

The aim of the diagram is to demonstrate how complex things become when you start to divide non-relapsing SPMS into subgroups. What do you think? => gavingiovannoni.substack.com/p/tolebrutin...

Q&A 140 - therapeutic inertia In my opinion, this patient has been inadvertently mismanaged.....

#MS_Selfie Podcast and Newsletter - Q&A 140 - therapeutic inertia

In my opinion, this patient has been inadvertently mismanaged..... Do you agree? => buff.ly/d8CIVbw

Male and female-specific MS care pathways The evidence for a male-specific MS pathway is grounded in the need for aggressive management of MS, specific symptom control and managing culturally/socially sensitive issues. Do you agree?

#MS_Selfie podcast and newsletter - more on male and female-specific MS care pathways

The evidence for a male-specific MS pathway is grounded in the need for aggressive management of MS, specific symptom control and managing culturally/socially sensitive issues. Do you agree? => buff.ly/QV5oiun

Gender inequality in MS care MS services mainly cater for women. Do men need their own services?

#MS_Selfie Podcast and Newsletter in "Gender inequality in MS care"

MS services mainly cater for women. Do men need their own services?