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David J. Birnbach, MD
St Luke's—Roosevelt Hospital New York

Angela Bader, MD; Gerard W. Ostheimer, MD
Brigham and Women's Hospital Harvard Medical School Boston

JAMA. 1988;260(19):2838.

	Since this article does not have an abstract, we have provided the first 150 words of the full text PDF and any section headings.

To The Editor.—

We would like to respond to the article by Nelson et al¹ entitled "Risk of Multiple Sclerosis Exacerbation During Pregnancy and Breast-feeding" in the June 17, 1988, issue of JAMA.

An area of major concern to obstetric anesthesiologists is the potential for exacerbation of the symptoms of multiple sclerosis after delivery. Although a correlation between the use of regional anesthesia (epidural and spinal) for labor and delivery has been suggested, no study thus far has demonstrated conclusively the role that regional anesthesia may play in an exacerbation of the disease.

In reviewing the records of all parturients with multiple sclerosis who received regional anesthesia for labor from 1982 through 1987, data at the Brigham and Women's Hospital, Boston, suggest that the choice of anesthetic may indeed affect the course of the disease.² This remains a controversial area in the practice of anesthesiology, and, unfortunately, there . . . [Full Text PDF of this Article]

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