This presentation was part of the 2023 Holistic Health and Wellness Forum for MS held on May 17 in Southfield, Michigan.

Robert Pace, MD is a neurologist at Memorial Healthcare, Institute for Neuroscience. Have you recently been diagnosed with MS? Dr. Pace provides an overview of the disease for the understanding of new patients and their families.

Download Dr. Pace’s slides in the virtual Exhibit Hall.

Watch the full presentation

What is Multiple Sclerosis?

We all have an office tower in our spinal cord and brain and one office squeezes the left hand, one is the feeling on the right thumb and one recognizes the color blue for example, says Dr. Pace. In MS the office building is prone to fire (lesions). Your brain will move the job to another area when there’s not a fire. Ninety percent of the time you don’t have a symptom, your brain simply moves the job to another part of the brain. Sometimes over weeks or years symptoms can improve or it improves half way or never improves.

Some people have MS and you’d never know it. Others have horrific problems really quickly and luck is unfortunately a big factor in it. The biggest factor is how often the fires are happening. Having a fire every few years is different than having a fire every few months. MS impacts individual very differently. Lots of people have fires without symptoms for a long time and don’t know they have the disease.

If a building has fires year after year you can get damage to the structure of the building. This is when MS switches from relapsing to progressive MS. It’s not accurate to say there are all these different types of MS. MS simply changes over time.

Treatment and symptom management of MS

The first treatments for MS are fire suppression and stop new fires. The first disease modifying therapies (DMTs) came out in the ’90s and are most effective the earlier you use them. MRIs are the most effective test and gives us a picture that tells us about the fires that have happened. You can get a sense of frequency of fires and what type of treatments we’d move someone towards. However MRIs don’t tell the whole picture.

Not every symptom will present all the time, but if you’ve had a symptom before you’re more likely to have it again. If you get the flu/Covid, have more stress at work, or are not sleeping well your symptoms can come back. Symptoms are like a boulder at the bottom of a lake where the water level is going up and down. Sometimes you can see it, other times it’s covered in water. Even when it’s not visible it’s still there.

New damage is not caused by heat but heat drags the level of the lake down and your symptoms may temporarily get worse. Do things for your body to keep the level of the lake high like exercising, eating a healthy diet, practicing stress management and preventing other diseases and illnesses.

It’s important to keep an eye on your health and know what’s going on. Go see your neurologist, get your MRIs and blood tests even if you’ve decided not to take disease modifying therapies (which some people choose not to take for a variety of reasons.)

Equally and possibly more important that DMTs are:

  • Stop smoking
  • Practice yoga
  • Follow a healthy diet

Dr. Robert Pace is a board certified and fellowship trained neurologist, specializing in Multiple Scleroris, at the Memorial Healthcare Institute for Neuroscience. Dr. Pace completed his medical degree at The Ohio State University College of Medicine & Public Health in 2008. He trained in neurology with a further fellowship in Multiple Sclerosis and Neuroimmunology at the University of Michigan, where he stayed as an Assistant Professor before joining Memorial Healthcare.

Dr. Pace is an active member of the American Medical Association and American Academy of Neurology and is a Diplomate of the American Board of Psychiatry and Neurology. He also serves as Associate Editor for MedLink Neurology, the leading information resource for clinical neurology, and is a guest author for AwareNow™ magazine.

Dr. Pace cares for and has expertise in a variety of neurologic conditions. He is passionate about demyelinating disorders of the central nervous system and is committed to providing his patients with compassionate personalized care and to advancing our understanding of Multiple Sclerosis through research and innovation. He has experience using a variety of immunomodulating and suppressing agents and lectures nationally regarding treatment options for Multiple Sclerosis.

In collaboration with the Memorial Healthcare Institute for Neuroscience Multiple Sclerosis team, Dr. Pace participates in numerous clinical trials for Multiple Sclerosis, including being one of the first centers in the nation to research and monitor the biomarker Neurofilament light chain in a real-world setting.

Dr. Pace and his partner, Dr. Jeanie Cote, have launched “Grey Matters,” a Multiple Sclerosis-focused podcast which share informative content for patients, caregivers, and healthcare providers alike. Grey Matters is dedicated to discussing the latest adavancements, research, and personal stories related to Mutliple Scleorisis and can be found at

Episode 2 of Grey Matters is out now! Take a listen as our neurologists share stories and discuss topics related to all things neurology! We invite you to check them out on one of the platforms below!