How do doctors diagnose multiple sclerosis. What are the key symptoms of MS to watch for. Which diagnostic tools are used to confirm MS. How is multiple sclerosis treated after diagnosis. What should patients expect during the MS diagnostic process.

Understanding Multiple Sclerosis: Symptoms and Diagnostic Challenges

Multiple sclerosis (MS) is a complex neurological condition that presents significant diagnostic challenges for medical professionals. The absence of a definitive single test for MS, coupled with symptoms that mimic various other conditions, necessitates a comprehensive approach to diagnosis.

Neurologists specializing in MS play a crucial role in the diagnostic process. They evaluate patients’ symptoms and conduct a series of tests to determine whether MS or another condition is the underlying cause.

Key Symptoms That May Indicate MS

• Numbness or tingling in extremities, particularly hands and feet
• Unusual weakness in arms, legs, or fingers
• Slurred speech
• Difficulty walking or stumbling
• Visual disturbances, including double vision or loss of color perception
• Perception of flashing lights not visible to others
• Eye pain that worsens with movement
• Vision loss in one eye

When these symptoms persist for more than a few days, even if they resolve spontaneously, consulting a neurologist specializing in MS is advisable to expedite diagnosis and initiate appropriate treatment.

The Diagnostic Triad: Ruling Out Other Conditions, Identifying Brain Damage, and Temporal Progression

To establish a definitive MS diagnosis, medical professionals focus on three primary objectives:

1. Eliminating other potential causes of symptoms
2. Detecting damage in at least two distinct areas of the brain
3. Demonstrating that the damage occurred at different points in time

This approach ensures a thorough evaluation and minimizes the risk of misdiagnosis.

Diagnostic Tools and Techniques for Multiple Sclerosis

The diagnostic process for MS involves a combination of medical history assessment, physical examinations, and specialized tests. Each tool provides valuable information that contributes to the overall diagnostic picture.

Magnetic Resonance Imaging (MRI)

MRI scans are a cornerstone of MS diagnosis. They allow neurologists to visualize the brain and spinal cord, revealing telltale signs of MS-related damage such as inflammation and lesions. However, interpreting MRI results requires careful consideration of other factors, as similar brain changes can occur in older individuals or those with conditions like hypertension and diabetes.

Can MRI definitively rule out MS? While MRI is a powerful diagnostic tool, a normal scan does not automatically exclude MS. Some patients may have lesions in areas not visible on standard MRI scans, underscoring the importance of comprehensive evaluation.

Lumbar Puncture (Spinal Tap)

This procedure involves analyzing cerebrospinal fluid to detect elevated levels of proteins and other substances associated with MS. While lumbar punctures provide valuable diagnostic information, they are not considered definitive proof of MS on their own.

Evoked Potentials Tests

Evoked potentials measure the electrical activity in the brain in response to specific stimuli. These tests help confirm whether MS has affected areas of the brain responsible for vision, hearing, and sensation. The process typically involves placing electrodes on the scalp and presenting various stimuli to assess brain responses.

Blood Tests

While blood tests cannot diagnose MS directly, they play a crucial role in the diagnostic process. How do blood tests contribute to MS diagnosis? They help identify substances in the blood that may indicate MS and, more importantly, aid in ruling out conditions with similar presentations.

Comprehensive Eye Examination

Eye exams can reveal MS-related visual problems, providing additional diagnostic clues. Conditions that may be detected include:

• Optic neuritis: Inflammation of the optic nerve causing pain and visual disturbances
• Nystagmus: Involuntary eye movements potentially indicating nerve damage
• Diplopia: Double vision resulting from damage to nerve pathways controlling eye movements

The Emotional Impact of Multiple Sclerosis Diagnosis

Receiving an MS diagnosis can evoke a range of emotions, from relief after a long period of uncertainty to shock and concern about the future. How can patients cope with the emotional aftermath of an MS diagnosis? Engaging in open communication with healthcare providers, friends, family, and support groups is essential. Mental health professionals can also provide valuable support during this challenging time.

Tailoring Treatment Approaches for Multiple Sclerosis

Following diagnosis, the focus shifts to developing an effective treatment plan. MS affects individuals differently, necessitating personalized approaches to management. What factors influence MS treatment decisions? Healthcare teams consider various elements, including the specific type of MS, symptom severity, disease progression, and individual patient preferences.

Common Treatment Modalities for Multiple Sclerosis

• Disease-modifying therapies (DMTs) to reduce relapse frequency and slow progression
• Symptomatic treatments targeting specific MS-related issues
• Rehabilitation programs to improve physical function and quality of life
• Lifestyle modifications, including diet and exercise recommendations
• Complementary therapies to support overall well-being

The evolving landscape of MS treatment offers increasingly sophisticated options for managing the condition and improving patient outcomes.

Navigating Life with Multiple Sclerosis: Strategies for Adaptation and Resilience

Living with MS requires ongoing adaptation and resilience. How can individuals with MS maintain a high quality of life? Developing effective coping strategies, staying informed about the latest research and treatment options, and actively participating in disease management are crucial steps.

Key Aspects of MS Management

1. Adhering to prescribed treatment regimens
2. Regular follow-up appointments with healthcare providers
3. Monitoring and reporting new or changing symptoms
4. Engaging in appropriate physical activity and exercise
5. Maintaining a balanced, nutritious diet
6. Managing stress through relaxation techniques and mindfulness practices
7. Seeking support from MS communities and advocacy groups

By adopting a proactive approach to MS management, individuals can optimize their health outcomes and maintain a fulfilling lifestyle.

Advances in Multiple Sclerosis Research: Promising Developments and Future Directions

The field of MS research is dynamic, with ongoing investigations into novel therapeutic approaches and improved diagnostic techniques. What are some of the most promising areas of MS research? Current focuses include:

• Neuroprotective and remyelination strategies
• Personalized medicine approaches based on genetic and biomarker profiles
• Advanced imaging techniques for earlier and more accurate diagnosis
• Stem cell therapies for regenerative treatment
• Innovative drug delivery systems for enhanced efficacy and reduced side effects

These research endeavors hold the potential to revolutionize MS diagnosis, treatment, and long-term management, offering hope for improved outcomes and quality of life for individuals affected by the condition.

The Role of Support Networks in Multiple Sclerosis Care

Support networks play a vital role in the comprehensive care of individuals with MS. How do support systems contribute to MS management? They provide emotional sustenance, practical assistance, and valuable information sharing among those with shared experiences.

Key Components of Effective MS Support Networks

• Family and friends offering emotional and practical support
• MS support groups facilitating peer connections and information exchange
• Online communities providing accessible resources and virtual support
• Professional counseling services addressing psychological aspects of living with MS
• Patient advocacy organizations championing MS awareness and research funding

Engaging with these support networks can significantly enhance the overall well-being and quality of life for individuals navigating the challenges of MS.

As our understanding of multiple sclerosis continues to evolve, so too do the approaches to diagnosis, treatment, and ongoing management. By staying informed about the latest developments and working closely with healthcare providers, individuals with MS can optimize their care and maintain a positive outlook on life. The journey with MS may present challenges, but with the right support, information, and treatment strategies, many people with the condition lead fulfilling and productive lives.

How Doctors Test for MS

It can be a challenge for doctors to diagnose multiple sclerosis (MS). There’s no single test that can prove you have it. And many conditions have symptoms that seem like those of MS.

A neurologist — a doctor who specializes in treating the disease — should be able to help. They’ll ask how you’re feeling and help you figure out if your symptoms mean you have MS or another problem.

What Do Doctors Look For?

MS can take some time and a number of tests to diagnose. It starts when you or your doctor notices certain signs or symptoms that could be MS. These might include:

• Numbness or tingling in the skin (typically, hands or feet)
• Unusual weakness in arms, legs, or fingers
• Slurred speech
• Stumbling or trouble walking
• Double vision or loss of color
• Flashing lights that others can’t see
• Eye pain that gets worse with movement
• Vision loss in one eye

When you first notice these symptoms, especially if they are serious, your doctor might need to rule out other causes like stroke, tumor, or pressure on the spinal cord. If the symptoms last more than a couple of days, even if they go away on their own, it may be time to see a neurologist who specializes in MS to speed up diagnosis and start treatment.

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If your doctors suspect MS, they will look for further symptoms and signs that suggest MS. To make a final MS diagnosis, they will use several tools to try and do three things:

• Rule out any other conditions that could cause your symptoms
• Find damage to at least two spots on your brain
• Prove the damage happened at different points in time

What Are the Tools for Diagnosis?

The doctor will start by asking you about your medical history and your symptoms. They’ll also do a few tests to see if your brain and spinal cord are working as they should. These include:

MRI: This imaging test lets the doctor take a closer look at your brain. They can see changes caused by multiple sclerosis, like signs of inflammation in the deep parts of your brain or spinal cord.

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But older people or those with high blood pressure and diabetes also can have the same kinds of spots on a brain MRI. So the doctor will consider other info, including your symptoms, along with the scan results or the enhancement of lesions before they make a diagnosis.

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Also, an MRI result that says things are normal doesn’t rule out MS. You could be one of a small number of people who have lesions in places the scan can’t show.

Learn more about using MRI to diagnose MS.

Lumbar puncture: This test, which you may also hear called a spinal tap, checks the fluid that runs through your spinal column. Doctors use it to look for high levels of proteins and other substances that are signs of the disease. It can help diagnose MS, but it, too, isn’t absolute proof.

Know what to expect with a spinal tap to diagnose MS.

Evoked potentials: These electrical nerve tests can help doctors confirm if MS has affected the parts of your brain that help you see, hear, and feel. The doctor will place wires on your scalp to test your brain’s response as you watch a pattern on a video screen, hear a series of clicks, or get electrical pulses on your arm or leg.

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Find out how evoked potential tests help reach an MS diagnosis.

Blood tests: They can’t diagnose MS, but the doctor will use them to look for substances in your blood that point to it. Most importantly, they can help your doctor rule out conditions that look like MS.

Get more information about other types of demyelinating disorders that look like MS.

Eye exam: An eye exam could reveal problems that MS sometimes causes. Your doctor will test how well you can see detail far away, your field of vision, eye muscle strength, and pressure inside the eyeball, among other things. Possible MS-related conditions might include:

• Optic neuritis: Damage to the optic nerve that often causes pain as well as blind spots surrounded by areas of normal vision
• Nystagmus: Eyes move rhythmically back and forth or up and down without conscious effort. May be due to nerve damage, especially in the brainstem or cerebellum.
• Diplopia: Double vision that happens due to damage to the nerve pathways that control the eyes. It can be an early symptom of MS.

After a Diagnosis

It may take a long time to figure out that you have MS. If you’ve been waiting years or months, the news might be a relief. Or it could be a huge shock. Either way, you’ll have concerns about what the disease means for your life and your family. That’s completely understandable.

Talk with others — your friends, your doctor, a support group, or a counselor — about your feelings. Your health care team can help you decide the best ways to treat your disease and live with it day to day. MS affects everyone differently, so what works for one person with the condition may not be what’s best for you.

Multiple sclerosis – Diagnosis – NHS

Tests for MS

Diagnosing MS is complicated because no single test can positively diagnose it. Other possible causes of your symptoms may need to be ruled out first.

It may also not be possible to confirm a diagnosis if you have had only 1 attack of MS-like symptoms.

A diagnosis can only be made with confidence once there’s evidence of at least 2 separate attacks, although this may include signs of attacks on an MRI scan that you may not realise you have had.

Some of the tests you may need to confirm MS are discussed below.

Neurological examination

Your neurologist will look for abnormalities, changes or weakness in your vision, eye movements, hand or leg strength, balance and co-ordination, speech and reflexes.

These may show whether your nerves are damaged in a way that might suggest MS. 

MRI scan

An MRI scan is a painless scan that uses strong magnetic fields and radio waves to produce detailed images of the inside of the body.

It can show whether there’s any damage or scarring of the myelin sheath (the layer surrounding your nerves) in your brain and spinal cord. Finding this can help confirm a diagnosis in most people with MS.

A standard MRI scanner is like a large tube or tunnel. The machine is noisy and some people feel claustrophobic while the scan is done. Tell your neurologist if you’re worried about this.

Newer scanners are more open and work quicker than those used in the past, and most people have scans without any problems. 

Evoked potential test

There are several types of evoked potential test. The most common type assesses how well the eyes work.

Light patterns are shown to the eyes while your brainwaves are monitored using small, sticky patches called electrodes placed on your head.

It’s a painless test and can show whether it takes your brain longer than normal to receive messages.

Lumbar puncture

A lumbar puncture is a procedure to remove a sample of your spinal fluid by inserting a needle into the lower back.

Spinal fluid is the fluid that surrounds your brain and spinal cord, and changes in the fluid can suggest problems with the nervous system.

The procedure is done under local anaesthetic, which means you’ll be awake, but the area the needle goes in will be numbed.

The sample is then tested for immune cells and antibodies, which is a sign that your immune system has been fighting a disease in your brain and spinal cord.

Lumbar punctures are very safe, but are often uncomfortable and can cause a headache that occasionally lasts for up to a few days.

A lumbar puncture will often be performed to provide extra information if your symptoms or scans are unusual.

Blood tests

Blood tests are usually performed to rule out other causes of your symptoms, such as vitamin deficiencies or a very rare, but potentially very similar, condition called neuromyelitis optica.

If You Think You Have Symptoms of Multiple Sclerosis, Here’s What to Consider

Multiple sclerosis symptoms can be both visible, like changes in speech or difficulty with coordination, and invisible, such as fatigue or a dysfunctional bladder.

Many of the typical MS symptoms are also seen in other disorders ranging from Lyme disease and stroke to neuromyelitis optica, a disorder of the optic nerves and spinal cord. It’s one of several reasons that it’s challenging to diagnose the disease.

“We call multiple sclerosis the great mimicker,” said Dr. Suleiman Kojan, director of the Neuro-Immunology Program at Beaumont Hospital, Royal Oak, who specializes in MS diagnosis and care.

The other reason it’s hard to diagnose MS: There’s no single test that can definitively identify it. The medical criteria for how to diagnose MS has been revised several times over the years.

As such, specialists must weigh evidence from several tests and other sources. They include:

• a detailed medical history
• a full neurological examination
• MRI scans of the brain, spine or both to look for MS plaques
• a spinal tap to look for signs of inflammation and certain immune proteins that are often present in people with MS
• blood tests to rule out other disorders

Recent studies found nearly 15 percent of MS patients were misdiagnosed.

“The message we try to get to our patients is, ‘Don’t just take that MRI report and build all the anxiety and all the different things related to this diagnosis without seeing a specialist,’” Dr. Kojan said.

When to seek a doctor

If a doctor says you have multiple sclerosis, consider seeing a MS specialist, or neurologist, for a second opinion.

People should consider the diagnosis of MS if they have one or more of these symptoms:

• vision loss in one or both eyes
• acute paralysis in the legs or along one side of the body
• acute numbness and tingling in a limb
• imbalance
• double vision

Confirming the diagnosis is an important step for a disease that depends on a strong long-term relationship between a patient, family members and a medical team to monitor and manage the disease.

How is MS diagnosed | Multiple Sclerosis Society UK

MS Symptoms & Diagnosis—multiplesclerosis.com

MS Symptoms and Diagnosis

Diagnosing MS is complex and requires a complete review of your medical history, and may include a physical exam and various tests.¹

Medical History

A medical history, including symptoms, will provide your doctor with important information when diagnosing MS. Your doctor may also ask about past treatments, ongoing medical conditions, and a history of family health issues.¹

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Symptoms

Symptoms of MS are caused by the disruption in nerve signaling from the central nervous system (CNS) to other parts of the body as a result of damage to the myelin (the protective coating around nerve cells) and the nerve cells. The frequency and duration of symptoms vary and may include:

• Fatigue
• Tingling, pain or numbness
• Problems with balance and walking
• Changes in vision
• Depression/emotional changes
• Impaired thinking/understanding
• Poor muscle coordination
• Sexual problems
• Slurred speech and stuttering
• Bladder and bowel problems

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Physical Examination

A physical examination may reveal MS signs including¹:

• Irregular eye movement
• Changes in the way you talk
• Lack of coordination
• Sensory disturbances
• Changes in your reflexes
• Weakness/spasticity in your arms or legs

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MRI

¹

A common test in MS diagnosis is the magnetic resonance imaging test (MRI). An MRI can detect the distinctive lesions or scars in the central nervous system (brain, spine and optic nerve) that give multiple sclerosis its name.

After reviewing your medical history, doing a physical exam, and performing an MRI, healthcare teams sometimes have enough information to make a diagnosis of MS. In some cases you may need additional tests to make a confirming diagnosis (spinal tap, blood tests, etc.)

Learn more about Treatment Options. Or check out Living with MS.

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References:

1. National Multiple Sclerosis Society. Diagnosis. New York, NY: National Multiple Sclerosis Society; 2006. Multiple Sclerosis Basic Facts Series (brochure).

Multiple Sclerosis Diagnosis and Treatment | Brain Institute

At the OHSU Multiple Sclerosis Center, we use the latest advances to treat MS and related conditions.

You’ll find:

• Internationally recognized MS experts working as a team.
• Neurologists who meet weekly to discuss challenging cases and to apply the latest research breakthroughs.
• Experts who can give you a quick and precise diagnosis.
• Care tailored to your specific needs.
• Researchers forging paths to better understanding and treatments.
• A full range of treatment options, including wellness and complementary therapies.

Team-based care

Our providers work together. They understand the full range of treatment options, so they can tailor a care plan to your exact needs.

Your care team may include specialists such as:

• Neurologists
• Nurses and nurse practitioners
• Radiologists (imaging specialists)
• Infusion experts (hematologists-oncologists)
• Physical, occupational and speech therapists
• Psychologists
• Pain specialists (experts in managing pain)
• Pharmacists
• Urologists

Diagnosing multiple sclerosis

There is no single test for multiple sclerosis. Experts diagnose MS by assessing your symptoms, taking detailed scans and ruling out other conditions.

For an MS diagnosis, your doctor must:

• Rule out other conditions.
• Find damage in at least two areas of the brain or spinal cord.
• Find signs that the damage occurred at different times.

Why an early, accurate diagnoses is important

Our providers have the expertise to identify or rule out MS. This is important because, without treatment, your brain and nerves are at risk of permanent damage even in early stages.

In addition, MS is complex. Providers with less experience sometimes misdiagnose it. When that happens, patients don’t get proper care or end up with expensive treatments they don’t need.

Tests for MS

If you show signs of MS, your doctor will review your medical history and do a neurologic exam to measure your:

• Muscle strength
• Reflexes
• Nerve function
• Other physical and mental processes

Other tests may include:

MRI: A magnetic resonance imaging scan of your brain or spinal cord can show areas called lesions. Lesions, which can be signs of MS, are areas where the myelin surrounding your nerve fibers is damaged.

Spinal tap (lumbar puncture): Your doctor uses a thin needle to withdraw some of the fluid (cerebrospinal fluid) that surrounds your brain and spinal cord. High levels of certain substances in the fluid can be a sign of MS.

Evoked potential study: This test can show possible nerve damage. It measures the time it takes for nerves to respond to stimulation.

Blood tests: We may do tests to check for other conditions that could be causing your symptoms.

Multiple sclerosis treatment

Medications can help slow or change the progress of MS. Medications and other treatments can also manage relapses and ease symptoms.

Disease-modifying treatments

Disease-modifying medications can help lessen damage and delay disability in early stages of MS. More than a dozen medications can slow or modify relapsing forms of MS. One medication, ocrelizumab (Ocrevus), treats relapsing forms and primary-progressive MS.

These treatments can:

• Reduce the number and severity of relapses
• Reduce the number of brain lesions
• Slow disabling effects of the disease

They come in three forms:

• Pills
• Self-injectable medications (shots you give yourself)
• Infusions (IV drips)

Treatment for relapses

Relapses happen when MS causes inflammation in the central nervous system. An attack is considered a relapse when it lasts at least 24 hours and occurs at least 30 days after a previous attack.

Relapses can last for a few days to a few months. Mild relapses usually need no treatment. For severe relapses, a medication called a corticosteroid can reduce inflammation and shorten the relapse.

High-dose corticosteroids such as methylprednisolone are usually given by IV. You may take a corticosteroid such as prednisone by mouth after that. The lower-dose pills help you taper off the medication.

Managing MS symptoms

Your team may suggest medications for MS symptoms. Common types include:

• Muscle relaxants or sedatives for tremors, stiffness and spasms.
• Bladder relaxants for incontinence or overactive bladder.
• Stool softeners or fiber supplements for bowel issues.
• Stimulants or antiviral medications to ease fatigue.
• Antidepressants for depression.

Complementary therapies

The OHSU Multiple Sclerosis Center is an international leader in research on complementary therapies for MS. Therapies such as acupuncture, tai chi and diet can be used alongside medical treatments.

• Oral cannabis extract: Cannabis in pill form can lessen muscle stiffness and pain.
• Oromucosal cannabinoid spray: This form of cannabis comes as a mouth spray. It can reduce muscle pain caused by stiffness (spasticity) and reduce symptoms such as frequent urination.
• Acupuncture, tai chi and yoga: These techniques can lower stress and increase your energy, flexibility and balance.
• Vitamin D: Some studies have found that vitamin D supplements can lessen how often you have symptoms and make them less severe.
• Nutrition: A healthy diet low in fats and high in whole grains seems to lower disability and ease symptoms.
• Exercise: Routine exercise may improve your strength and mood. It can also help with fatigue, and improve bladder and bowel function. Stretching exercises may help with stiffness and improve mobility.
• Relaxation exercises: Deep breathing, meditation and visualization techniques can reduce stress.

Rehabilitation

Rehabilitation therapy helps patients with multiple sclerosis strengthen muscles and improve coordination. These, in turn, can help you manage symptoms.

Your care team will work with physical therapists, occupational therapists and other experts at OHSU’s state-of-the-art rehabilitation center. Our therapists, with expertise in neurologic disorders such as MS, can help you maintain function.

• Physical therapy: A therapist can help you with exercises to manage fatigue. Your therapist can also address strength or balance concerns.
• Occupational therapy: We can help you continue to use computers and other technology. We can help you learn to use assistive devices such as canes, braces, walkers and wheelchairs. We can also help you improve your coordination, and your finger and hand strength.
• Speech-language pathology: Our therapists can help with speech issues, memory and attention, along with accommodations for work or school.
• Electrical stimulation devices: We use the latest technology to stimulate weakened muscles. Devices include the FES bike, which uses low-level electrical signals to help people pedal a stationary bike. We also have Bioness, a wearable device the delivers low-level electrical stimulation to help MS patients with foot drop (trouble lifting the front of the foot).
• Body-weight-supported treadmill training: We provide robot-assisted walking therapy for patients who can’t use their legs. This training uses a device called a Lokomat to simulate a typical gait, to strengthen muscles and to improve circulation.

Managing pain

Many people with MS have chronic pain. OHSU’s Comprehensive Pain Center is one of the largest pain centers in the region. It provides expert treatment for patients with short-term and long-term pain.

Our team can also help you address the physical, mental and behavioral issues that can result from ongoing pain.

Early Signs of Multiple Sclerosis

Multiple sclerosis is the ultimate chameleon.

This chronic, inflammatory autoimmune disease affects the central nervous system, resulting in damaged nerves and scar tissue formation, so it can resemble a multitude of other illnesses. This also makes it incredibly hard to detect. And the fact that no two people with MS experience the same symptoms only adds to its unpredictability.

Here’s what makes it so tricky: Your brain and spinal cord are full of nerves that send electrical signals rapidly to all areas of your body, which allow you to walk, talk, see, swallow and much more. These nerves are coated in a sheath called myelin that helps transmit the signals.

With MS, the myelin gets destroyed because your immune system mistakenly tells your body to attack it, causing scarring — or sclerosis — and signal interruption. As a result, those with MS experience a variety of different symptoms depending on which signals get interrupted.

“Because MS can develop anywhere within the central nervous system and encompasses the optic nerves, the brain and the spine, a lot of different types of critical attacks can occur, so that leads to diagnostic complexity,” says Thomas Shoemaker, MD, a neurologist and MS expert at the Rush Multiple Sclerosis Center.

Although there’s currently no cure for MS, there are a number of promising treatments. Being aware of the early symptoms can help you get a diagnosis and start treatment earlier, which can help you better manage the disease. We asked Shoemaker to explain which initial signs to look for, as well as the risk factors associated with the disease.

Here’s where MS (typically) starts

Although a number of MS symptoms can appear early on, two stand out as occurring more often than others:

• Optic neuritis, or inflammation of the optic nerve, is usually the most common, Shoemaker says. You may experience eye pain, blurred vision and headache. It often occurs on one side and can eventually lead to partial or total vision loss.
• Spinal cord inflammation, or what’s called partial transverse myelitis, is the second most common symptom Shoemaker typically sees. “You may experience numbness, tingling, weakness in the arms and legs, bladder dysfunction and/or difficulty walking,” he explains.

Other early signs of MS include the following:

• Bowel problems range from constipation due to reduced physical activity causing a reduction of food moving through the intestinal tract to diarrhea and incontinence related to neurological dysfunction.
• Depression
• Difficulty thinking
• Fatigue
• Pain, which may be acute or chronic, caused by the nerves that carry sensation “short circuiting.” Types of pain can include band-like pain around the chest, or MS hug, caused by spastic nerves along with other types of painful sensations in the neck, arms, legs and feet. 
• Sexual problems. These may include changes in sexual function such as arousal and orgasm since arousal starts in the central nervous system and nerve pathways become damaged. MS may also create psychological factors such as mood changes and lower self-esteem that can affect sexual desire as well.

Detecting MS earlier and starting MS therapies earlier tend to improve the chances of having a good long-term outcome.

MS can also look like this

Another potential harbinger of MS is clinically isolated syndrome, or CIS, but this condition is complicated.

“CIS is kind of within the spectrum of MS. In fact, sometimes CIS is just the initial presentation of MS. And people with CIS often will go on to develop multiple sclerosis, but not always,” Shoemaker explains.

CIS is basically the first brush with MS, where neurological symptoms occur that often last 24 hours. The episode may result in one symptom or multiple, depending on scarring that occurs in one place or several places. The most common CIS symptoms include the following:

• Optic neuritis
• Numbness
• Slurred speech
• Tingling
• Weakness in legs

If you’re experiencing these symptoms, it’s important to see a doctor as soon as possible. If testing doesn’t reveal a high risk for MS, CIS could signal another serious condition that needs prompt attention, including the following:

• Autoimmune conditions that cause blood vessel inflammation
• Exposure to toxic materials
• Serious vitamin B12 deficiency
• Viral infection

Proper testing shows the bigger picture

Even if you have symptoms associated with MS, you may not have MS. You’ll need to confirm the diagnosis. 

“No single MS test exists, so the diagnosis can be delayed, incorrect or even missed altogether,” Shoemaker says. “An MS diagnosis really requires the synthesis of lots of different types of information by experts who know what to look for and how to put the pieces together.”

That’s why he recommends seeing a neurologist, who can ensure that the appropriate testing is done to get a complete and accurate picture.

This usually includes having an MRI of the brain and spine, which can reveal changes in the central nervous system that indicate MS.

“You need to have an experienced radiologist or experienced clinician, or both, to interpret the MRIs,” Shoemaker explains. “And the images can’t be viewed in isolation. They need to be put in the context of the clinical picture of the patient in front of you. So while the MRI may be somewhat able to predict MS, if the clinical history or the clinical exam is not really supportive of that, then it’s kind of inappropriate to make a diagnosis.”

Lesions are, however, a strong predictor of the disease. According to a 2014 report in Neurology, the risk for developing MS is generally 60 to 80 percent when lesions show up in an MRI. If none are found on the scan, then the risk lowers to 20 percent.

In addition to an MRI, additional procedures may also be required to help confirm a diagnosis, such as a spinal tap, also called a lumbar puncture, to test cerebrospinal fluid. When MS is present, the fluid often has a higher concentration of a certain type of immune proteins.

Shoemaker adds that in certain instances, more in-depth vision testing is needed.

“There’s a procedure called an optical coherence tomography, which can sometimes demonstrate prior optic nerve injury, and similarly, there’s a test called visual evoked potential, and that can also help dilate the optic nerve to see if there’s prior injury as well, which may indicate MS.”

Your doctor may also order blood tests if similar conditions to MS are also being considered.

Time and timing differentiate two types of MS

There are two main types of MS:

• Relapsing-remitting MS is exactly what it sounds like: New neurological symptoms develop caused by inflammatory attacks on myelin, called a relapse, followed by periods of recovery where the symptoms may improve, remain but not worsen, or go away. This period is called remission.

Relapsing-remitting MS is the most common form of the disease. According to the National Multiple Sclerosis Society, approximately 85 percent of people with MS are first diagnosed with relapsing-remitting MS. Most diagnosed with this type of MS are generally in their 20s and 30s.

• Primary-progressive MS occurs when there’s no improvement in symptoms from the onset of disease. “There may be subtle improvements, but overall, the trajectory is continued worsening over a period of at least a year,” Shoemaker explains.

This form of MS can be more difficult to diagnose since people with the primary-progressive type tend to have less brain scarring, more spinal cord scarring and less inflammation than those with relapsing-remitting MS. They also have more difficulty with mobility and everyday activities, and onset usually occurs in the 40s or 50s.

Whereas 80 to 85 percent of cases of MS are relapsing, primary progressive MS is about 15 percent of the cases at diagnosis, and a 50-50 split between men and women.

Know the risk factors

MS affects more than 2.3 million people globally. Though MS is not contagious or even directly inherited, some factors may increase the risk for this disease, including the following:

• Age. Most people diagnosed with MS, are between the ages of 20 and 50 years old, although MS can develop at any age.
• Ethnic background. Those of Northern European descent are at the greatest risk of developing MS, while Native Americans and those from African or Asian descent have the lowest risk.
• Gender. Although both men and women are affected by MS, women are at increased risk. In fact, according to the National Multiple Sclerosis Society, four times as many women have relapsing MS as men. “It tends to be a disease of women of reproductive age, so those from ages 18 to 50 receive the bulk of new diagnoses, with a median age of diagnosis being around 30 to 32,” Shoemaker says. 
• Genetics. Although MS is not inherited, the genetic risk for the disease may be, reports the National Multiple Sclerosis Society. The risk of developing MS is about 1 in 750 to 1,000 people in the general population. It increases, however, when a first-degree relative, such as parents, siblings and children, have the disease. And the risk is greater, nearly one in four, for identical twins.
• Geography. Areas farther away from the equator have more cases of MS. With less sun exposure, research indicates that people tend to have lower levels of vitamin D, which supports the immune function and protects against diseases like MS.

Shoemaker also cites other specific factors, either alone or in combination that may contribute to the disease, which include the following:

• Certain gene variations
• Exposure to the Epstein-Barr virus
• Low vitamin D or sun exposure
• Obesity during adolescence

Earlier diagnosis means better outcomes

Knowing what signs and symptoms to look for early has tremendous benefits.

“From some of the longer duration studies, detecting MS earlier and starting MS therapies earlier tend to improve the chances of having a good long-term outcome. Patients started on MS therapies earlier in their disease tend to have a lower likelihood of reaching certain disability milestones, like needing a cane or walker,” Shoemaker says.  

Although receiving an official MS diagnosis can be overwhelming, Shoemaker ensures that his patients understand how treatment can help. With nearly 15 Food and Drug Administration-approved therapies available, and new ones constantly being developed that are increasingly effective, management of MS continues to improve.

“We are at a point where we’re happy with how good we are at controlling the inflammatory aspect of the disease,” Shoemaker says. “Now we’re working on trying to improve patients’ overall quality of life so they can lead healthy, productive lives — as if they don’t even have MS.”

Multiple Sclerosis | Clinic “Oberig”

ADVANTAGES OF TREATMENT OF MULTIPLE SCLEROSIS IN THE UNIVERSAL CLINIC “OBERIG”

• Diagnosis and therapy of multiple sclerosis is based on modern criteria and protocols, which are fully implemented in the Universal Clinic “Oberig”
• Our medical center has the necessary equipment for MRI of the brain and spinal cord, study of the evoked potentials of the brain, laboratory diagnostics.

Multiple sclerosis refers to demyelinating diseases of the nervous system.Multiple sclerosis can occur in the form of mild or, conversely, severe symptoms such as paralysis, loss of vision, impaired coordination.

The cause of multiple sclerosis remains unknown. In the mechanisms of the development of the disease, the main role is played by the destruction of the myelin sheath of the nerves by the own immune system. Connective tissue (sclerosis) forms at the site of injury. As a result, the transmission of electrical impulses along the nerve is disrupted.

More than 2.3 million people worldwide suffer from multiple sclerosis.The diagnosis is usually made between the ages of 20 and 50. Two thirds of the patients are women. Multiple sclerosis is more common among the population of countries with cool climates.

Scientific research shows that genetic factors make some people more susceptible to disease. However, there was no evidence that multiple sclerosis is directly inherited.

FORMS OF MULTIPLE SCLEROSIS

Multiple sclerosis is an unpredictable disease. Symptoms vary greatly from patient to patient.Moreover, they can be different for the same person at different times.

There are four variants of the course of multiple sclerosis. At the time of diagnosis, most people have relapsing-remitting multiple sclerosis. They have periods of exacerbation and the appearance of new symptoms interspersed with periods of remission, which can last for months or even years. Other patients have progressive forms of the disease with constant worsening of symptoms.

The most severe course is primary progressive multiple sclerosis, when the disease progresses from the very beginning.Secondary progressive multiple sclerosis develops after a relapsing-remitting form. The most rare is progressive with exacerbations of multiple sclerosis, in which there are obvious exacerbations against the background of slow progression.

Since the disease affects patients in different ways, it is difficult to make assumptions about the timing of the onset of disability. According to statistics, 2 out of 3 people with multiple sclerosis retain the ability to walk for the rest of their lives, although many of them will need a cane or other device for this.The rest will need a wheelchair for mobility.

Studies have shown that people with multiple sclerosis live an average of seven years less due to complications of the disease or other medical problems. Caring for your overall health helps prevent diseases, including myocardial infarction and stroke, which contribute to shortening life expectancy.

SYMPTOMS AND SIGNS OF MULTIPLE SCLEROSIS

The manifestations of the disease depend on which nerves are damaged and how much.The first signs of multiple sclerosis may include impaired sensitivity, speech, and vision.

In the future, people complain of muscle weakness, imbalance and coordination of movements, painful muscle tension (spasticity), tremors (tremors). Some patients experience temporary or permanent paralysis. Disorders of the functions of the pelvic organs are often observed.

Many people with multiple sclerosis experience chronic fatigue. The disease can cause forgetfulness, difficulty concentrating, as well as mood swings, depression.The symptoms of multiple sclerosis can occur in any combination. They can be mild, moderate, or strong.

DIAGNOSTICS OF MULTIPLE SCLEROSIS

In most patients with relapsing-remitting multiple sclerosis, the diagnosis is fairly straightforward. It is based on characteristic symptoms and is confirmed by MRI of the brain and spinal cord.

Diagnosis of multiple sclerosis is difficult in patients with unusual or progressive symptoms.In this case, more research is needed.

Magnetic resonance imaging of the brain and spinal cord reveals foci of demyelination – the so-called plaques. The method is constantly being improved. One of the latest achievements is the use of a special contrast to assess the activity of the pathological process.

No laboratory tests specific to multiple sclerosis exist yet. The study of cerebrospinal fluid with the determination of a complex of immunological and infectious markers is considered quite informative.

The method of studying the evoked potentials of the brain is used to assess the speed of conduction of nerve signals under the influence of external stimuli – auditory, visual and somatosensory.

TREATMENT OF MULTIPLE SCLEROSIS

Multiple sclerosis is a chronic, progressive, but not fatal disease. Modern medicine has ways to control multiple sclerosis. In the world, scientific research is being carried out, which gives hope that in the future new methods of combating this disease will appear.

Corticosteroids are used to treat exacerbations of multiple sclerosis. At the end of the twentieth century, new drugs were developed, which are called “drugs that change the course of the disease (MDD)”, “drugs for modifying therapy”. They reduce the activity of relapsing-remitting multiple sclerosis and significantly improve the patient’s quality of life.

The rest of the treatments are focused on individual symptoms of multiple sclerosis. Medications are prescribed to control depression, muscle cramps, pain, sexual dysfunction, urinary and bowel disorders.Physical therapy is also indicated for patients to support the necessary motor skills.

If you suspect multiple sclerosis, contact the Oberig Universal Clinic. Experienced neurologists work in our medical center; modern equipment is used for diagnostics. Call by phone:

(044) 521 30 03

Diagnosis of multiple sclerosis on MRI

Multiple sclerosis is a chronic, progressive pathology of the nervous system that most often affects young people.This disease is very insidious, since its early signs are easily confused with symptoms of other diseases, which makes diagnosis very difficult. It is very important to make the correct diagnosis in a timely manner, this allows you to slow down the development of the disease, maintain working capacity for a long time and avoid dangerous complications. Today, the most informative method for diagnosing multiple sclerosis is magnetic resonance imaging.

Diagnostic benefits

The method of magnetic resonance imaging is very popular among doctors and patients.This is due to the following advantages:

• In just a couple of hours, the patient will be able to undergo a diagnosis, receive images along with a transcript, and go to the attending physician to make a diagnosis and prescribe treatment.
• The process of magnetic resonance imaging does not cause discomfort.
• Magnetic fields are harmless to the human body, unlike X-rays. Therefore, the number of MRI sessions is not limited.
• It is usually not necessary to specially prepare for the study, and the list of contraindications to it is small.

Indications for research

It is very important to detect multiple sclerosis in the early stages of the disease, so doctors perform an MRI scan for potential patients. Diagnostics using magnetic resonance imaging can be prescribed in the following cases:

• Complaints of the patient about deterioration of vision, most often in one eye. Loss of vision, blurred vision, and a foreign body sensation in the eye may also occur.
• Periodic dizziness.
• Unsteadiness of gait and impaired coordination of movements.
• Impaired sensitivity of the extremities: intermittent numbness, goose bumps, tingling sensations may occur.
• Muscle weakness.
• Possible malfunction of the pelvic organs. Most often this is manifested by sexual impotence (in men), as well as a violation of urination.
• Sleep disturbance.
• Feeling of anxiety, sudden fears.

Multiple sclerosis can present with other symptoms as well. The need for research is determined by the doctor.

Possible contraindications

Doctors may recommend a different type of diagnosis for multiple sclerosis if the patient has contraindications to MRI.

In what cases is research not allowed?

• If the body contains structures containing metal: pacemakers, wires, pins, implants, etc.p.
• If the patient has involuntary movements. For diagnosis, it is necessary to maintain a stationary state, otherwise the study may be insufficiently informative.
• With pronounced claustrophobia. Since the diagnosis of multiple sclerosis is carried out in a confined space, in the presence of claustrophobia, it is better to give preference to a different type of research.

Contrast testing is prohibited for pregnant women (throughout the entire period of pregnancy), with lactation, as well as with serious kidney disease.It is also required to conduct a test in advance to exclude an allergic reaction to the contrast agents used.

How to prepare for the procedure

Doctors say that urgently magnetic resonance imaging can be performed without prior preparation. If the MRI is scheduled for a specific day, try to follow a few guidelines:

• If an MRI scan with contrast is planned, you must come to the clinic on an empty stomach. The last meal should be no later than 5-6 hours before the MRI.
• Diagnostics can take up to 40 minutes, so it is better to go to the toilet in advance so as not to experience discomfort during the examination.
• If you are worried about the test, consult your doctor – he may prescribe you mild sedatives.
• It is forbidden to carry any metal objects into the tomograph capsule. Therefore, before the diagnosis, you need to take off all jewelry, hairpins, glasses and change into clothes without metal fittings.

How MRI is done in multiple sclerosis

For maximum information content and high quality of images, it is recommended to carry out diagnostics only in closed-type tomographs. Tell your doctor that an MRI is done to diagnose multiple sclerosis – this will help the doctor choose the right exam regimen. Before starting the diagnosis, you need to familiarize yourself with the simple rules:

• Do not be afraid of the noise that you hear when examining. If you are worried about loud noises, take earplugs with you.
• The patient must remain motionless during the MRI scan. Even small movements can lead to a decrease in the information content of pictures.
• Be sure to consult with your doctor before making an MRI appointment. This type of research is absolutely safe only if there are no contraindications to the procedure.
• Despite the closed space, inside the device there are very comfortable conditions: ventilation, light, speakerphone, panic button (pressing it will stop the study).

The diagnostic procedure is as follows:

• The patient changes into a change of clothing that does not have metal inserts. You also need to take off your shoes.
• The examinee lies down on a pull-out table. To reduce the likelihood of accidental movements, the limbs and head can be fixed with soft straps.
• An injection with a contrast agent is injected into a vein if a study with contrast enhancement is prescribed (if necessary, this is done not before the study, but in the process, if the study without contrast enhancement revealed the presence of foci characteristic of the disease).
• The procedure takes about 40 minutes.

MRI with contrast

For suspected early stage multiple sclerosis, magnetic resonance imaging is most often performed with additional contrast enhancement. This makes it possible to recognize even the smallest pathological changes characteristic of this disease.

The contrast agent is injected intravenously a few minutes before the procedure and is quickly distributed throughout the tissues and blood vessels, creating the effect of highlighting pathological foci in the images.

The advantage of contrast diagnostics also lies in the fact that it is completely harmless to the body. In just a day, the contrast is washed out of the body in a natural way, without accumulating in the tissues.

Interpretation of results

After the diagnosis is completed and the images are obtained, the doctor will have to decipher the images. This usually takes less than an hour.

How is Multiple Syndrome Recognized on Images? With multiple sclerosis, the images show a typical distribution of foci in the white matter of the brain. In addition, this diagnosis is characterized by damage to the corpus callosum, arcuate fibers, temporal lobes, brain stem, cerebellum and spinal cord. Such a distribution of foci is uncharacteristic for other pathological processes, therefore, difficulties in making a diagnosis usually do not arise. In angiopathy, lesions of the brainstem are possible, but they are usually symmetrical and located centrally, while the lesions in multiple sclerosis are localized in the periphery.

Upon completion of the magnetic resonance imaging, the patient is given photographs and a transcript of the results in paper or digital form.Contact your doctor for diagnosis and treatment. Timely detection of multiple sclerosis prolongs the period of active life and performance.

The first signs of multiple sclerosis that are worth knowing not only for people aged

Multiple sclerosis is a fairly young disease, as it is diagnosed in most cases in people between the ages of 20 and 50. It is most common in women between the ages of 20 and 40, and it is because of this predisposition to it at such a young age that it will be better if it is found in the early stages.

5 Fun Facts prepared for you 9 most common symptoms of multiple sclerosis, if you find them, it’s better to play it safe and consult a doctor.

What is multiple sclerosis

This ailment affects the spinal cord and brain and is chronic in nature, it is currently not possible to cure it. The disease occurs as a result of the appearance of inflammatory foci in the myelin sheath, which protects the nerve fibers of the spine and brain.

The disease is quite common – from 30 to 70 cases for every 100 thousand people of the population. Multiple sclerosis is not a fatal disease, but as it continues to progress, the patient’s quality of life deteriorates.

Vision problems

Vision problems are one of the most common symptoms of MS (multiple sclerosis). Its violation can arise quite suddenly, and it manifests itself as follows:

• one eye sees well, the other poorly;
• turbidity, “flies” in front of the eyes, interfering spot;
• color distortion;
• It constantly seems that something has got into the eye;
• vague contours.

You may not immediately notice this symptom and pay attention to it, because modern life is impossible without phones and computers, which can cause eye fatigue from constant contact with screens. But the real reason may be different.

Discomfort in the limbs

This is expressed as follows:

• goose bumps;
• burning;
• skin tightening;
• tingling sensation.

Such sensations can occur even in a very small area of ​​the body: finger, wrist, cheek, thigh.You should pay attention to this, since a person can simply refer to the fact that he served or lay down a leg, an arm, and so on. Of course, this is not always a sign of multiple sclerosis, but if these things start to happen regularly, you should not leave them unattended.

Problems with urination

This is another symptom that occurs in 80% of people with this diagnosis. If you are drinking the same amount of fluids as before, but suddenly go to the toilet less or more often, this may be more serious than you think.

It is worth considering this issue carefully if you have the following problems:

• frequent urination;
• urinary retention;
• inability to urinate completely;
• sudden urges.

Disorder of coordination

Also some of the earliest signs of multiple sclerosis are sudden dizziness, loss of balance, strange sensations while walking. Therefore, if you often encounter such troubles, you should consult a doctor.

Coordination problems are a fairly common symptom that can indicate a variety of disorders, from pressure problems to inner ear problems, so you shouldn’t take it lightly.

Emotional disorders

Sudden mood swings, depressive thoughts, fits of laughter or tears that appear for no reason can also be one of the signs of multiple sclerosis.This is due to the fact that the disease damages the nerve fibers in the brain, which directly affects the emotional background of a person. If you ignore these manifestations, then depression can go far, and it will be even more difficult to get out of this state.

Problems speaking and swallowing

The following problems may occur:

• Slurred or quiet speech;
• speech slowdown;
• voice changes (wheezing, harsh voice).

Difficulty swallowing may also appear: food and liquid may partially enter the trachea (windpipe), instead of going through the esophagus into the stomach as expected.

Tremor

Most people with early signs of MS experience this symptom. Trembling of the limbs causes a lot of inconvenience and makes a person’s life very difficult, because it becomes difficult to do even such simple things as holding a spoon, buttoning clothes, dialing a phone number. Tremor appears due to damage to complex nerve pathways that are responsible for coordinating movements.

Strange sensations

Your fingertips lose sensitivity, go numb, and it can be difficult to tell if hot or cold water is pouring out of the tap.This is a serious symptom, see your doctor as soon as possible.

“Electrical Discharges”

Many people with MS experience discomfort in different parts of the body. They are somewhat similar to an electric shock. They can occur when you turn your head and be given in absolutely any area – in the arms, legs, shoulders, back and other places.

Factors that increase the likelihood of multiple sclerosis

• Sex.The most vulnerable are women.

• Heredity. If one of your parents or siblings has had multiple sclerosis, you are at risk of developing the disease as well.

• Infectious diseases. For example, the Epstein-Barr virus.

• Nationality. People of northern European descent are at greatest risk. People of Asian, Indian and African descent have the lowest risk of MS.

• Climatic conditions.The disease is most common in temperate countries, including Canada, the northern United States, New Zealand, southeastern Australia, and Europe.

• Autoimmune diseases. The person is most likely to develop MS if they have thyroid disease, type 1 diabetes, or inflammatory bowel disease.

• Smoking. Cigarette smoke increases the likelihood of developing this disease.

Just because you experience any of these symptoms does not mean you have multiple sclerosis.But if there are several signs and on a regular basis, then this is a reason to see a doctor.

Multiple sclerosis

Multiple sclerosis

Multiple sclerosis is a disease in which the human immune system destroys a special membrane of the processes of nerve cells. This disrupts the conduction of nerve impulses in the brain and spinal cord, in connection with which the arms and legs weaken, vision deteriorates, dizziness appears, etc.

The disease is 2 times more likely to develop in women than in men. The first signs of the disease appear between the ages of 20 and 40. The symptoms of multiple sclerosis gradually worsen, leading to profound disability. At the same time, periods of improvement and deterioration of the patient’s condition alternate. Sometimes multiple sclerosis is difficult to diagnose, especially in the early stages. Treatment is aimed at reducing the severity of the manifestations of the disease. There are no treatments to achieve complete recovery.

Synonyms Russian

Multiple sclerosis.

English synonyms

Multiple sclerosis, disseminated sclerosis, encephalomyelitis disseminate.

Symptoms

• Decreased visual acuity, double vision. Sometimes there is pain when moving the eyes.
• Decreased muscle strength. May occur in one arm or leg, then spread to the opposite side.
• Numbness, tingling in the trunk, arms, legs.
• Impaired coordination, balance, dizziness.
• Incontinence or retention of urine, stool.
• Trembling in hands or feet.
• General fatigue, weakness.
• Decrease in memory, attention.

General disease information

Multiple sclerosis is one of the causes of profound disability in young and middle-aged people. It occurs as a result of the destruction of the nerve cell sheath called myelin.Myelin helps to isolate nerve fibers. If its structure is damaged, the transmission of nerve impulses in the brain and spinal cord is blocked or significantly impaired, causing manifestations of the disease. The destruction of this shell occurs when the cells of the body’s immune system act on it. There are theories according to which the disease develops mainly in people with defects in the functioning of the immune system. When the human body is exposed to certain infections, the immune cells not only begin to destroy the causative agent of this infection, but also have a damaging effect on their own nerve cells, destroying their membrane.Multiple foci of multiple sclerosis are formed in the brain and spinal cord. Such parts of the brain cannot function normally, which leads to the disease.

During the course of the disease, there are episodes of significant improvement in the condition, the so-called remission. Symptoms of the disease diminish or disappear altogether, and this allows patients to return to their normal life for a while. There are also exacerbations of multiple sclerosis, when the manifestations of the disease can significantly increase.

One of the factors that negatively affect the condition of patients is an increase in body temperature. In multiple sclerosis, even a hot bath can cause an increase in weakness in an arm or leg. This is due to the fact that the conduction of nerve impulses along the damaged processes of nerve cells deteriorates with increasing temperature.

The disease progresses over time.

Among the factors causing multiple sclerosis are:

• genetic factors – the predisposition to the disease is inherited;
• infections of the brain and spinal cord.

Scientists have found that multiple sclerosis is more common in countries with a temperate and cold climate, in countries with a hot climate, the incidence is lower.

Who is at risk?

• Persons whose close relatives suffer from multiple sclerosis.
• Women.
• Persons aged 20 to 40 years.
• Patients with infectious diseases.
• Living in countries with temperate and cold climates.

Diagnostics

Diagnosis of multiple sclerosis is based on identifying the characteristic manifestations of the disease and excluding diseases with similar symptoms. Magnetic resonance imaging of the brain and spinal cord plays an important role in this process, which makes it possible to obtain images of the internal structures of the body. In multiple sclerosis, a CT scan of the brain reveals multiple foci of damage to the medulla (although they can be caused by other diseases).

To clarify the diagnosis, laboratory tests are performed.

• Diagnosis of multiple sclerosis (isoelectric focusing of oligoclonal IgG in cerebrospinal fluid and serum). Liquor washes the brain and spinal cord. In multiple sclerosis, oligoclonal immunoglobulin G is detected in it, which indicates the effect of the immune system on the brain. Immunoglobulins arise in response to exposure to infections. Accordingly, the detection of this type of immunoglobulin in the blood serum indicates the action of the immune system against its own cells.

• Complete blood count (without leukocyte count and ESR). An increase in the number of leukocytes in the blood, the erythrocyte sedimentation rate indicates an inflammatory process (multiple sclerosis can develop when the body is exposed to infections).
• Analysis of cerebrospinal fluid for protein, glucose – changes in these indicators are observed in diseases of the brain and spinal cord.

Additional studies

• The method of evoked potentials is based on the study of electrical reactions of the brain and spinal cord in response to irritation of the muscles of the arms, legs, trunk, eyes, hearing organs.This allows you to measure the speed of propagation of nerve impulses, to assess the safety of the transmission of signals along the nerve endings.

Treatment

Treatment of multiple sclerosis consists in reducing the severity of existing symptoms, achieving a stable state of patients in the periods between exacerbations of the disease.

There are no methods to achieve a complete cure.

Adrenal hormone preparations (corticosteroids) are used.They help to reduce inflammation in the lesions of the brain and spinal cord. Also, various drugs are used that reduce the activity of the human immune system – this slows down the destruction of the sheath of nerve endings.

In addition, there are many medications available to treat the individual symptoms of multiple sclerosis.

Prevention

There is no prophylaxis for multiple sclerosis. With an already onset disease, it is necessary to prevent an exacerbation of the disease.For this, overvoltage, stress, hot baths should be avoided, since an increase in body temperature leads to an increase in symptoms. In some cases, drug prevention of exacerbations of the disease is used.

Recommended analyzes

• Diagnostics of multiple sclerosis (isoelectric focusing of oligoclonal IgG in cerebrospinal fluid and serum)
• General blood test
• Total protein in cerebrospinal fluid
• Glucose in cerebrospinal fluid

Multiple sclerosis MRI, diagnosis and how to determine the level of the disease

To begin with, it is worth noting that multiple sclerosis is a serious disease that requires constant attention and control, and not just distraction and forgetfulness, as many believe.In this disease, external symptoms are accompanied by damage to the myelin sheath, which covers the nerve fibers of the brain (brain, spinal). It is with the help of MRI that multiple sclerosis can be diagnosed in a timely manner and taken measures for treatment in time. The current possibilities of medicine can significantly reduce the severity of the disease and the number of exacerbations, but this requires high-quality diagnostics.

The inhabitants of our latitudes should be especially attentive to their health, since this disease and its prevalence, according to experts, largely depends on the place of residence of the person.The “higher” the degree of latitude, the greater the likelihood of multiple sclerosis. Most of all “chances” of getting this disease in people living on the 30th parallel and higher to the north. Thus, all citizens of Ukraine fall into the high-risk zone. And, by the way, residents of European countries suffer from multiple sclerosis more often than those living in various Asian countries. Residents of equatorial Africa, Malaysia, Ecuador and Colombia are practically not at risk of getting sick.

How to diagnose multiple sclerosis on MRI?

MRI in case of multiple sclerosis or suspicion of this disease is performed several times in order to make an accurate diagnosis, to reveal the extent of damage to nerve fibers, and also to monitor the effectiveness of the therapeutic measures taken.Such an examination usually involves a contrast agent containing gadolinium (gadodiamide, magnevist, gadovist, omniscan, etc.). In this case, the contrast is administered intravenously.

Let us clarify that MRI diagnostics establishes multiple sclerosis in the same way as other diagnoses: by interpreting the data obtained by exposure to a magnetic field on hydrogen atoms in the human body. Since the myelin layer is a fatty layer, it is water-repellent.Where this layer is damaged, no water-repellent effect is observed. As a result, the concentration of water in the damaged areas is higher than it should be normal.

How an MRI is done:

• Introduce contrast (special substance).
• Place the patient in the tomograph.
• Place the body parts to be examined under the ring scanner.
• Read and visualize the readings.

Therefore, when patients ask the question whether multiple sclerosis is visible on an MRI, a very specific answer can be given.The affected areas are displayed as a bright white spot or a darkened area. The imaging option depends on the type of MRI that will be selected for you individually.

Where to get an MRI scan for multiple sclerosis in Kiev?

If you or your relatives have multiple sclerosis, an MRI scan can be done in our Center “SDS” / “Successful Diagnostic Systems”. The research is carried out in any of the branches of Kiev or in Drohobych.

How a doctor diagnoses multiple sclerosis

Thermal sensitivity (or Uethoff phenomenon) – Patients with multiple sclerosis may not feel very well taking a bath, hot shower, sauna, solarium or exposure to direct sunlight.This is due to the properties of the sheath of nerve fibers: when heated, the myelin sheath changes its chemical-physical properties. If the membrane has already been damaged due to the attack of antibodies, then when heated, this can again be felt, even if the processes of restoration and regeneration of this place were effective.

The following symptoms are not major, but are more common in patients with multiple sclerosis.

• For example, a very important symptom is pathological fatigue .More than 50% of patients complain about it.
• Visual impairment or optic neuritis – it is important to understand that this is not any visual impairment, but an acute one.
• Lermitt’s symptom – the sensation of an electric current running along the spine.
• Also common complaints of a certain type of divergent strabismus, which is called internuclear ophthalmoplegia .

The following two signs are less common in multiple sclerosis.

• Progressive course of the disease.
• The onset of the disease before the age of 10 and after 50 years.

There are also symptoms that arise when not the nerve fiber is damaged, but the body of nerve cells itself, which is not the primary target. These symptoms include the following.

• Damage to the cerebral cortex with impaired speech, writing, counting, music perception, faces.
• Convulsions. This refers to epilepsy – seizures that also involve the cerebral cortex.
• Rapid decline in intelligence associated with processing and involvement of the cerebral cortex rather than nerve conductors.
• Development of a neurological deficit either instantly or within a few minutes.

When a person talks to a doctor about their complaints, an experienced neurologist knows that with multiple sclerosis absolutely any complaints can occur, there are a great many of them, it is not for nothing that MS is often called “a disease with a thousand faces.” This is one of the difficulties in making a diagnosis.The doctor should focus on two points: absent-mindedness of symptoms in space and absent-mindedness in time.

Let’s make a reservation right away that this has nothing to do with absent-mindedness in its everyday understanding (inattention, clumsiness, forgetfulness), but is equivalent to the word “prevalence” – both in space and in time. What does it mean?

The doctor sees the prevalence in space when a person talks about the symptoms caused by damage to various structures. So, the patient can tell that a few years ago he had a decrease in vision, after that there was weakness in the legs, unsteadiness when walking, hearing impairment, etc.It can also be seen when performing MRI of the brain or spinal cord – the presence of lesions will be noted.

The prevalence in time the doctor finds out by asking a person about the manifestations of the disease earlier. Also, the prevalence over time can be seen by comparing the results of several MRIs performed at different times – they show the appearance of new changes in the structure of the central nervous system. If there were no MRI studies before, then it is possible to inject a contrast agent at the time of the MRI, then those structural changes that were before and those that are present now will be visible – some of the foci will accumulate contrast, and some will not.By the way, MRI with contrast needs to be done only once – to confirm the diagnosis, since this is the point of contrast.

MRI of the brain is an effective method for early diagnosis of multiple sclerosis in Moscow Ramsey Diagnostics

Multiple sclerosis is a poorly studied chronic disease that in some cases leads to the loss of a person’s full working capacity. A disease with a thousand faces, as doctors call it. Recently, active young people are increasingly becoming victims of the disease.

The main difficulty of this disease is that it is difficult to diagnose. Patients live for many months or even years with symptoms of the disease until they are correctly diagnosed. In the early stages, neither laboratory examinations nor examinations can accurately determine the patient’s condition. In the later stages, changes occur that can be seen in the course of various studies.

If you suspect that you have multiple sclerosis, someone in your family has suffered from this disease, you have noticed any symptoms of the disease, immediately consult a doctor who, using modern diagnostic tools, such as MRI of the brain with contrast , will be able to correctly diagnose the disease.

Definition

Multiple sclerosis is an autoimmune disease. The nerve fibers of the spinal cord and brain are protected by a myelin sheath. In the case of multiple sclerosis, cells of the immune system attack and destroy myelin, leaving deep scars – sclerotic tissue. These changes lead to a break in the conduction of nerve signals. The symptoms of multiple sclerosis are different for every person. Symptoms change as the disease progresses, making diagnosis more difficult.

Fast fatigability

According to the National Multiple Sclerosis Association, fatigue occurs in 80% of patients with this diagnosis.Certain difficulties may arise in performing daily types of load. Given that fatigue is the most common and noticeable symptom, this information helps to identify multiple sclerosis. However, fatigue and fatigue are a consequence of many diseases. Fatigue and fatigue in the case of multiple sclerosis most often occurs in the morning, even after a good night’s sleep. This condition is accompanied by hot flashes and increased sweating. The patient feels much worse than in the case of “normal” fatigue.

Problems with coordination and balance

If you have multiple sclerosis, you may have difficulty walking straight. This is due to balance and coordination of movements. Given that nerve impulses do not fully reach the muscles, muscle weakness or, conversely, their tension, spasms and numbness may be felt. All these symptoms lead to difficulties with gait and coordination of movements. This is another classic symptom of multiple sclerosis. It is important to observe under what conditions you have a loss of balance and coordination.Loss of balance is a consequence of disturbances in the nervous system.

Vertigo

If you have multiple sclerosis during the day, you may experience dizziness and even loss of balance. In some cases, it may feel like the room you are in is spinning. Dizziness is also a common and fairly common symptom in multiple sclerosis. And at the same time, dizziness, like weakness, is a consequence of many other diseases.

Muscle spasticity

The term “spasticity” refers to a condition of muscle tension and muscle spasms that leads to a disorder of muscle control.Spasms are both mild, reminiscent of involuntary muscle tension, and quite painful. At such moments, the patient gets hot and sweats. Most often, these cramps occur in the legs.

These are just a few of the early symptoms of multiple sclerosis. It is worth clarifying that most of these symptoms are characteristic of other diseases as well. Only a doctor can determine if they are symptoms of multiple sclerosis.