neuroimmunology

Northwestern Comprehensive Multiple Sclerosis Program

The Division of Neuroimmunology engages in clinical treatment and research of multiple sclerosis and related diseases through the Northwestern Comprehensive Multiple Sclerosis program established in 1987 by Dr’s Bruce Cohen in the Department of Neurology and Dr. James Sliwa in the Department of Physical Medicine and Rehabilitation.  The program was one of the first to provide a comprehensive multidisciplinary approach to the treatment of the multiple sclerosis patient combining medical, physical and rehabilitative strategies to optimize function and quality of life.  The National Multiple Sclerosis Society affiliated MS Specialty clinic at the Northwestern Medical Faculty Foundation Department of Neurology conduced by Dr Bruce Cohen and Dr. Joy Derwenskus provides diagnostic and treatment services to patients, and conduct clinical research studies on manifestations and treatments of the disease. 

The program has affiliated specialists in Neuro-ophthalmology, Neuro-psychology, Neuro-urology, Neuro-otology, Neuroradiology and Psychiatry who collaborate in the care of individual patients.  The affiliated MS clinic at the Rehabilitation Institute of Chicago directed by Dr. James Sliwa provides disease-focused physical and occupational therapeutics, orthotic design and application, and therapeutic exercise programs to optimize function and quality of life for the MS patient.

Within the Feinberg School of Medicine at Northwestern University, the division interacts with the Immunobiology Center directed by Dr. Stephen Miller, Professor of Microbiology and Immunology which includes neuro-immunologists and immunopathologists studying mechanisms of immune function and dysfunction in search of new knowledge which may lead to new potential therapeutic approaches and future clinical studies.

Staff

Bruce Cohen, MD
Dr. Cohen attended University of Illinois College of Medicine in Chicago.  He completed internal medicine and neurology residencies, joining the faculty at Northwestern University after his residency where he is now Professor of Neurology.  He is certified in Neurology by the American Academy of Psychiatry and Neurology, and in Internal Medicine by the American Board of Internal Medicine. He is director of the Northwestern Comprehensive MS program in the Department of Neurology.  Dr. Cohen is a fellow of the American Academy of Neurology,  the American College of Physicians, and the American Heart Association, and is an elected member of the American Neurological Association..  He is the incoming chair (2008-2009) of the Multiple Sclerosis section for the American Academy of Neurology, and the current chair of the clinical care committee of the National Multiple Sclerosis Society.

Joy Derwenskus, DO
Dr. Derwenskus attended medical school at the University of Osteopathic Medicine and Health Sciences in Des Moines, Iowa.  After internship at Evanston Hospital, she completed neurology residency at Case Western in Cleveland, Ohio.  She then did a two-year fellowship in MS at Mt. Sinai in New York where she was awarded the Serono Pfizer MS Clinical Fellowship through the National MS Society.  While at Mt. Sinai she earned a Master’s Degree in clinical research.  She has participated in numerous clinical trials in multiple sclerosis.  She joined the Northwestern Comprehensive MS program in 2005.  Dr Derwenskus is an Assistant Professor of Neurology at Northwestern University.

Melanie Dumlao, MSN, CNP, MSCN
Melanie is the nurse practitioner at the Northwestern Comprehensive MS program and has been with the program since 2000.  She completed her nursing degree at Loyola and subsequently went to the University of Illinois at Chicago where she earned her master’s degree.  Previously she was an ICU nurse at Evanston Hospital.  She is a certified MS nurse through the International Organization of Multiple Sclerosis Nurses (IOMSN). 

Cherrie Hartman, RN, BA
Cherrie is a neurology nurse clinician since joining the MS program in 2006.  She graduated from Ravenswood School of Nursing in 1997 and then obtained her Bachelor’s Degree at DePaul University.  Previously she worked in cardiology here at Northwestern.  She is in charge of enrollment, maintenance, and administration of Tysabri in the clinic.

Catherine O’Connell, RN, BSN, MSCN
Cathy is a neurology nurse clinician at the Northwestern Comprehensive MS program since 2005.  She graduated from the Loyola University School of Nursing.  Her prior nursing experiences include working in an adult day care center with patients with dementia, a headache clinic, and an internal medicine office.  She is an IOMSN certified MS nurse.

Patricia Casey, OTR/L, CCRC
Pat is the research coordinator for the Northwestern Comprehensive MS program.  She graduated from Colorado State University with a B.S. in occupational therapy and received a M.S. at the University of Illinois Health Sciences Center.  She has worked at NMFF in research since 1993 and has coordinated MS studies since 2002.       

General Information on Multiple Sclerosis

What is MS?
Multiple sclerosis is a disease of the central nervous system in which damage occurs both to  the myelin or fatty insulation on nerve cells and to the nerve cells and their fibers called axons.  When there is break down of myelin (demyelination), nerve conduction is impaired which results in symptoms.  The type of symptoms depends upon the location of the damage.  Disease can occur in the brain, spinal cord, or optic nerves causing a variety of impairments.  MS begins most commonly in young adults, often of  European decent.  Women with MS outnumber men by 2:1. The exact cause of MS remains unknown, although it is  considered to be an autoimmune disease because of immune reactions targeting myelin and the cells which make it..  It is commonly presumed  that there is an exposure to some environmental factor in an individual with a genetic predisposition.  This activates the immune system leading to demyelination.  There is a small inherited genetic risk of  the disease  in first-degree relatives of individuals with MS.      

Types of MS
There are several types of MS.  The most common is relapsing-remitting disease where individuals have attacks of new symptoms called exacerbations followed by improvement.  In natural history studies conducted before the availability of current treatments, approximately half of these individuals developed a pattern of gradually worsening impairments  called secondary progressive MS.  About 10% of patients present with progressive disease without clinical attacks and are considered to have primary progressive MS.

Signs and Symptoms of MS
The presentation of MS varies in all individuals depending on which part of the nervous system is involved.  The most common presenting symptoms are visual loss or numbness and tingling.  Other symptoms include weakness, gait imbalance, dizziness, bowel or bladder changes, mood disturbance, fatigue, and memory impairment.  If you are experiencing new symptoms, you should discuss these symptoms with your neurologist.

Diagnosis of MS
Despite the development of MRI, the diagnosis of MS can be challenging.  There is no single test that makes a diagnosis of MS.  The diagnosis is based on a combination of the history, neurological examination, imaging, and other supportive tests.  MRI is extremely sensitive to detect changes in the white matter regions of the central nervous system.  These changes over time in individuals with MS  have been incorporated into the diagnostic criteria.  There are supportive tests for MS including analysis of  inflammatory proteins in spinal fluid obtained by a spinal tap, and evoked potentials which measure the speed of nerve impulse conduction.  Conditions which may mimic findings in MS need to be ruled out and  there can be no other better explanation for the disease process in order to make a diagnosis of MS.    

Treatment of MS
Treatment of MS includes treatments designed to modify the immune responses against myelin in order to favorably alter the course of the disease, and treatments to suppress acute symptoms and treat persistent symptoms in order to optimize function and quality of life..  Acute attacks are often treated with steroids to enhance the speed of recovery of neurological function.  Individuals with a demyelinating process felt to be consistent with MS are often started on disease modifying therapy to reduce the likelihood of new attacks and neurological damage..  Currently, there are six FDA-approved treatments for MS.  All of these lessen the risk for subsequent disease activity.  Individuals should discuss the need for treatment with their neurologist.

Clinical Trials

The Northwestern Comprehensive MS program is active in clinical trials testing new treatments for MS and evaluating measures of neurological function in MS.  Current clinical research interests involve trials of new therapeutic approaches, studies of cognitive function in early MS patients, and studies of changes in brain and retinal nerve fiber density as markers of disease activity

If you are interested in clinical trials at Northwestern, please schedule an appointment for consultation.

Giving to the MS Center

Consider a gift to the Northwestern University Comprehensive MS program.  If interested, please contact Dr. Bruce Cohen at the Davee Department of Neurology, Feinberg School of Medicine, Northwestern University.

Contact Us

If you are interested in an evaluation at the Northwestern Comprehensive MS program, please call 312-695-7950 to schedule an appointment.