The John L. Trotter Multiple Sclerosis Center has been caring for patients with multiple sclerosis and similar disorders for more than three decades. Our approach combines compassionate treatment, patient education, advanced technology and cutting-edge research to better understand the disease process.
Some of the diseases treated at the John L. Trotter Multiple Sclerosis Center include:
Multiple Sclerosis (MS)
Visit our multiple sclerosis page for more information.
Optic Neuritis (ON)
Optic neuritis often occurs together with multiple sclerosis, but also may occur as a separate disease. This condition affects the optic nerve which carries visual information from the eye to the brain. In ON, the optic nerve becomes inflamed, disrupting the flow of visual information along the nerve. Some loss of vision is to be expected at least temporarily, though in some cases eyesight returns to normal, even without treatment.
Transverse myelitis is a neurological disorder caused by inflammation of the spinal cord. The inflammation can damage or destroy myelin, which protects and improves conduction of nervous system signals via nerve cell fibers.
Although some patients recover from transverse myelitis with minor or no residual problems, others may have permanent impairments that affect performance of ordinary tasks of daily living. Most patients will have only one episode of transverse myelitis; a small percentage may have a recurrence. Transverse myelitis occurs in adults and children, in both genders and in all races. An estimated 1,400 new cases of transverse myelitis are diagnosed each year in the United States.
Transverse myelitis may occur as an isolated disorder, or during multiple sclerosis, neuromyelitis optica (see below) or as part of another disease.
Neuromyelitis Optica (Devic’s Disease)
Neuromyelitis optica (NMO), also called Devic’s disease or Devic’s syndrome, is a condition in which a person’s optic (eye) nerves and spinal cord are injured by the immune system. This condition resembles multiple sclerosis in several ways. It is chronic, and frequently involves relapses and remissions. The syndrome involves attacks of optic neuritis, often in both eyes. NMO also involves transverse myelitis, which may occur at the same time as the optic neuritis or separately. There is no cure for Devic’s disease, but treatments to slow the disease and to relieve symptoms are available. Recovery can be difficult and may result in permanent loss of eyesight and muscle control. Due to recent breakthroughs in the understanding and diagnosis of NMO, it is currently an area of intense investigation.
This is an inflammatory syndrome of unknown cause that may mimic other diseases, such as systemic lupus erythematosus or multiple sclerosis. Inflammation of blood vessels in the brain (or, more rarely, the spinal cord) leads to a wide range of neurological problems, many of them severe. The disease may be relapsing and remitting in clinical course. People with CNS vasculitis may develop disabling symptoms such as pain, confusion, paralysis, fatigue, impaired cognition, speech problems, seizures and a host of other neurological problems. The signs and symptoms of CNS vasculitis can be similar to those of multiple strokes due to other causes, infections, CNS tumors and multiple sclerosis.
CADASIL (cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy) is the most common form of hereditary stroke disorder. It is caused by a gene mutation. One common manifestation of CADASIL is multiple strokes in patients between 40 and 50 years old who don’t have the typical risk factors for stroke. It is frequently also accompanied by migraine headaches.
Referrals are accepted from primary care physicians, other neurologists, attending physicians, and patients themselves for treatment and for second opinions. The center has one of the fastest appointment times in neurology. Patients are seen after receipt and review of medical records, depending on the availability of specific clinicians.
For a referral to a Washington University neurologist or neurosurgeon at Barnes-Jewish Hospital, call