How is multiple sclerosis diagnosed. What are the main symptoms of MS. Which treatment options are available for multiple sclerosis. What are the different types of MS. How does cerebrospinal fluid analysis help diagnose MS. What role does MRI play in MS diagnosis. Can multiple sclerosis be cured.

The Fundamentals of Multiple Sclerosis: An Overview

Multiple sclerosis (MS) is a complex neurological condition that affects the central nervous system, primarily targeting the brain, spinal cord, and optic nerves. At its core, MS involves damage to the myelin sheath, the protective layer surrounding nerve fibers. This damage disrupts the transmission of signals between the brain and various parts of the body, leading to a wide array of symptoms.

The disease manifests differently in each individual, making it a challenging condition to diagnose and treat. Most people with MS experience periods of relapse, where symptoms worsen, followed by periods of remission, where symptoms may improve or stabilize.

Key Characteristics of Multiple Sclerosis

• Autoimmune nature: The body’s immune system mistakenly attacks its own tissues
• Demyelination: Damage to the myelin sheath surrounding nerve fibers
• Neurological symptoms: Affects various functions controlled by the central nervous system
• Unpredictable course: Symptoms and progression vary widely among individuals
• No known cure: Treatment focuses on managing symptoms and slowing disease progression

The Diagnostic Journey: Identifying Multiple Sclerosis

Diagnosing multiple sclerosis can be a complex process, as there is no single definitive test for the condition. Instead, healthcare professionals rely on a combination of methods to reach a diagnosis. This multifaceted approach helps rule out other conditions and provides a comprehensive picture of the patient’s neurological health.

Key Components of MS Diagnosis

1. Medical history evaluation
2. Neurological examination
3. Magnetic Resonance Imaging (MRI)
4. Cerebrospinal fluid analysis
5. Evoked potential tests
6. Blood tests to rule out other conditions

Can multiple sclerosis be diagnosed with a single test? No, MS diagnosis typically requires a combination of clinical evaluation, imaging studies, and laboratory tests. This comprehensive approach helps healthcare providers differentiate MS from other neurological conditions with similar symptoms.

Magnetic Resonance Imaging: A Window into MS

Magnetic Resonance Imaging (MRI) plays a crucial role in the diagnosis and monitoring of multiple sclerosis. This non-invasive imaging technique provides detailed pictures of the brain and spinal cord, allowing healthcare providers to visualize areas of demyelination and inflammation characteristic of MS.

MRI in MS Diagnosis and Management

• Detects lesions in the brain and spinal cord
• Helps track disease progression over time
• Guides treatment decisions
• Assists in differentiating MS from other neurological conditions

How often should MS patients undergo MRI scans? The frequency of MRI scans varies depending on the individual’s condition and treatment plan. Generally, patients may have scans annually or more frequently if there are new symptoms or changes in their condition. Your healthcare provider will determine the appropriate schedule based on your specific needs.

Cerebrospinal Fluid Analysis: Unraveling the Mystery of MS

Cerebrospinal fluid (CSF) analysis is another valuable tool in the diagnostic arsenal for multiple sclerosis. This clear, colorless liquid that surrounds the brain and spinal cord can provide important clues about the presence of MS and help rule out other conditions.

The Role of CSF in MS Diagnosis

In people with MS, the cerebrospinal fluid often contains specific markers that indicate inflammation and immune system activity within the central nervous system. These markers include:

• Oligoclonal bands: Specific proteins indicating an abnormal immune response
• Elevated protein levels: Suggesting inflammation or damage to the nervous system

Is CSF analysis alone sufficient to diagnose MS? While CSF analysis provides valuable information, it is not definitive on its own. About 5-10% of people with confirmed MS do not show abnormalities in their CSF. Therefore, healthcare providers consider CSF results alongside other diagnostic criteria to make an accurate diagnosis.

The Lumbar Puncture Procedure

To obtain a sample of cerebrospinal fluid, doctors perform a lumbar puncture, also known as a spinal tap. This procedure involves:

1. Positioning the patient on their side or in a seated, bent-forward position
2. Cleaning and numbing an area of the lower back
3. Inserting a needle between vertebrae to collect a small amount of CSF
4. Sending the sample for laboratory analysis

While the procedure may sound intimidating, it is generally safe and well-tolerated when performed by experienced healthcare professionals.

Recognizing the Symptoms: The Many Faces of MS

Multiple sclerosis can manifest in a wide variety of symptoms, reflecting the diverse areas of the central nervous system that may be affected. The nature and severity of symptoms can vary greatly from person to person and may change over time.

Common MS Symptoms

• Fatigue: Often described as overwhelming tiredness
• Vision problems: Including blurred or double vision
• Numbness or tingling: Particularly in the limbs
• Muscle weakness or spasms
• Balance and coordination issues
• Cognitive changes: Such as difficulty with memory or concentration
• Bladder and bowel dysfunction
• Pain: Including neuropathic pain

Do all people with MS experience the same symptoms? No, the symptoms of MS can vary widely between individuals. Some people may experience only a few symptoms, while others may have a broader range of issues. The unpredictable nature of MS means that symptoms can also fluctuate over time, with periods of worsening (relapses) and improvement (remissions).

Types of Multiple Sclerosis: Understanding the Course of the Disease

Multiple sclerosis is not a one-size-fits-all condition. There are several recognized types of MS, each with its own characteristics and patterns of progression. Understanding these types can help patients and healthcare providers better manage the disease and set appropriate expectations.

The Four Main Types of MS

1. Relapsing-Remitting MS (RRMS): The most common form, characterized by clearly defined attacks of new or worsening symptoms, followed by periods of partial or complete recovery.
2. Secondary Progressive MS (SPMS): Many people with RRMS eventually transition to SPMS, where there is a steady worsening of neurologic function over time, with or without relapses.
3. Primary Progressive MS (PPMS): Characterized by worsening neurologic function from the onset of symptoms, without early relapses or remissions.
4. Progressive Relapsing MS (PRMS): A rare form that is progressive from the start but also has clear acute relapses, with or without recovery.

Can the type of MS change over time? Yes, it’s possible for an individual’s MS to evolve from one type to another, particularly from RRMS to SPMS. This underscores the importance of ongoing monitoring and adjustment of treatment strategies throughout the course of the disease.

Treatment Approaches: Managing Multiple Sclerosis

While there is currently no cure for multiple sclerosis, a variety of treatment options are available to manage symptoms, reduce the frequency and severity of relapses, and slow the progression of the disease. Treatment strategies are typically tailored to the individual’s specific type of MS, symptoms, and overall health status.

Key Components of MS Treatment

• Disease-Modifying Therapies (DMTs): Medications that can reduce the frequency and severity of relapses and slow disease progression
• Symptom Management: Treatments targeting specific MS symptoms such as fatigue, pain, or spasticity
• Rehabilitation: Physical therapy, occupational therapy, and speech therapy to improve function and quality of life
• Lifestyle Modifications: Diet, exercise, and stress management strategies to support overall health
• Mental Health Support: Counseling and support groups to address the psychological impact of living with MS

How effective are current MS treatments? While treatments cannot reverse the damage already done by MS, they can be highly effective in reducing the frequency and severity of relapses, slowing disease progression, and managing symptoms. The effectiveness of treatment can vary between individuals, and finding the right combination of therapies often requires a process of trial and adjustment.

Emerging Therapies and Research

The field of MS research is dynamic, with ongoing studies exploring new treatment approaches and potential ways to repair myelin damage. Some areas of current research include:

• Stem cell therapies
• Neuroprotective agents
• Remyelination strategies
• Personalized medicine approaches

These ongoing research efforts offer hope for improved treatments and potentially a cure for MS in the future.

Living with MS: Strategies for Quality of Life

A diagnosis of multiple sclerosis doesn’t mean the end of a fulfilling life. Many people with MS lead active, productive lives by adopting strategies to manage their symptoms and maintain their overall health and well-being.

Key Strategies for Living Well with MS

1. Adherence to Treatment: Following prescribed treatment plans and communicating regularly with healthcare providers
2. Healthy Lifestyle: Maintaining a balanced diet, regular exercise, and adequate rest
3. Stress Management: Practicing relaxation techniques and mindfulness
4. Adaptive Technologies: Utilizing tools and devices to maintain independence and functionality
5. Support Networks: Connecting with family, friends, and support groups for emotional and practical assistance
6. Continued Education: Staying informed about MS and new developments in treatment

Can people with MS continue to work and participate in regular activities? Many individuals with MS are able to continue working and engaging in their usual activities, especially with proper treatment and management strategies. However, some may need to make adjustments or accommodations depending on their symptoms and disease progression. Open communication with employers and loved ones can help in navigating these challenges.

The Importance of a Support System

Living with MS can be challenging, both physically and emotionally. A strong support system can make a significant difference in coping with the disease and maintaining a positive outlook. This support can come from various sources:

• Family and friends
• Healthcare team
• MS support groups
• Mental health professionals
• Online communities

These support networks can provide emotional encouragement, practical assistance, and valuable information about living with MS.

The Future of MS: Advances in Research and Treatment

The field of multiple sclerosis research is continually evolving, with scientists and healthcare professionals working tirelessly to improve our understanding of the disease and develop more effective treatments. Recent years have seen significant advancements in various areas of MS research, offering hope for improved outcomes for people living with the condition.

Promising Areas of MS Research

• Biomarkers: Identifying specific biological indicators to improve diagnosis and predict disease progression
• Personalized Medicine: Tailoring treatments to individual genetic and environmental factors
• Neuroprotection and Repair: Developing therapies to protect neurons and promote myelin repair
• Advanced Imaging Techniques: Improving our ability to visualize and understand MS lesions
• Gut Microbiome: Exploring the relationship between gut bacteria and MS progression
• Lifestyle Factors: Investigating the impact of diet, exercise, and stress on MS outcomes

Are we close to finding a cure for MS? While a cure for MS remains elusive, significant progress has been made in understanding the disease and developing more effective treatments. Ongoing research offers hope for continued improvements in MS management and potentially a cure in the future. However, it’s important to approach such prospects with cautious optimism and continue focusing on current best practices for MS care.

The Role of Clinical Trials

Clinical trials play a crucial role in advancing MS research and treatment. These studies help researchers evaluate new therapies, treatment combinations, and management strategies. Participating in clinical trials can offer several benefits:

1. Access to cutting-edge treatments
2. Contribution to scientific knowledge
3. Close monitoring by healthcare professionals
4. Potential improvement in personal health outcomes

Individuals interested in participating in clinical trials should discuss this option with their healthcare provider to determine if it’s appropriate for their specific situation.

Navigating the Healthcare System with MS

Managing multiple sclerosis often involves interacting with various healthcare professionals and navigating complex healthcare systems. Understanding how to effectively work with your healthcare team and access available resources can greatly improve your MS management and overall quality of life.

Building Your MS Care Team

An effective MS care team typically includes a range of specialists working together to address different aspects of the condition:

• Neurologist: Specializes in diagnosing and treating MS
• MS Nurse: Provides education, support, and coordination of care
• Physical Therapist: Helps maintain mobility and strength
• Occupational Therapist: Assists with daily living activities and adaptations
• Speech Therapist: Addresses speech and swallowing issues
• Mental Health Professional: Supports emotional and psychological well-being
• Nutritionist: Advises on dietary considerations for MS

How often should someone with MS see their healthcare provider? The frequency of healthcare visits can vary depending on the individual’s condition, treatment plan, and any new or changing symptoms. Generally, people with MS may see their neurologist every 3-6 months, with more frequent visits during relapses or when adjusting treatments. Regular check-ups with other specialists may also be necessary based on specific symptoms and needs.

Accessing MS Resources and Support

Numerous organizations and resources are available to support individuals living with MS and their families. These can provide valuable information, assistance, and community connections:

1. National Multiple Sclerosis Society: Offers comprehensive information and support services
2. MS Navigator Program: Provides personalized information and support
3. Local MS Support Groups: Offer peer support and shared experiences
4. Online Forums and Communities: Provide platforms for connecting with others living with MS
5. Patient Assistance Programs: Help with accessing medications and treatments
6. Vocational Rehabilitation Services: Assist with employment-related issues

Utilizing these resources can help individuals with MS stay informed, connected, and empowered in managing their condition.

CSF and Lumbar Punctures | National Multiple Sclerosis Society

• CSF and Lumbar Punctures
• Magnetic Resonance Imaging (MRI) for Diagnosing Multiple Sclerosis

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What is cerebrospinal fluid (CSF)?

Cerebrospinal fluid (CSF) is a clear, colorless liquid that surrounds the brain and spinal cord. Its primary function is to cushion the brain within the skull and serve as a shock absorber for the central nervous system. But CSF also circulates nutrients and chemicals filtered from the blood and removes waste products from the brain. Changes to cells and atypical cells in the CSF can be evidence of damage or other issues in the central nervous system. CSF analysis is one of several tools for diagnosing MS, in addition to a medical examination, evaluation and MRI.   

Cerebrospinal fluid in people with multiple sclerosis

In MS, damage to myelin causes certain types of proteins to be released into the spinal fluid. When these proteins are identified in the spinal fluid but not in the blood, MS is thought to be one of the possible diagnoses.

How is a lumbar puncture done?

Spinal fluid is obtained through a lumbar puncture (also known as a spinal tap). Your doctor would perform it in their clinic. For this procedure, you lay on your side or bend forward while seated. The doctor cleans an area of your lower back and injects a numbing medicine. They then insert a needle and use a syringe to remove a small amount of spinal fluid, which they send for testing. 

High protein levels in spinal fluid: A potential indicator of multiple sclerosis

The CSF of people with MS usually contains:

• A specific group of proteins called oligoclonal bands
• Elevated CSF protein levels

These findings indicate an abnormal immune response within the central nervous system and may be suggestive of MS. Oligoclonal bands indicate inflammation of the central nervous system. In MS, inflammation does much of the damage that causes MS symptoms.

It is important to know that an abnormal immune response in the CSF is found in other diseases so the test is not specific for MS. In people with a confirmed diagnosis of MS, 5-10% do not show abnormalities in the CSF. Therefore, CSF analysis by itself cannot confirm or exclude an MS diagnosis. Your MS care provider will consider the results along with your medical history, a neurological examination, MRI and tests to rule out other conditions to make an accurate diagnosis.

Learn more about how MS is diagnosed.

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Multiple sclerosis (MS) – symptoms, treatment and types

Key facts

• Multiple sclerosis (MS) is an illness involving damage to the myelin layer that protects your nerves, preventing signals going from your brain to your body.
• Most people with MS have relapses of symptoms followed by periods of recovery (remission).
• MS can cause many different symptoms, including trouble with muscle control and vision, tiredness, pain and changes in thinking.
• An MRI scan of your brain can show areas of damage, but there is no single test to diagnose MS.
• Many treatments are available to reduce relapses and relieve symptoms of MS.

What is multiple sclerosis (MS)?

Multiple sclerosis (MS) is a chronic illness that affects your central nervous system. Your nerve cells are surrounded by a layer called myelin. Myelin protects your nerves and helps them send signals quickly from your brain to the rest of your body.

In MS, your immune system attacks the myelin layer and damages it. This causes your nerves to become exposed and scarred. As a result, your nerves can’t send signals around your body properly.

MS is 3 times more common in females and usually starts between age 20 to 40.

What are the different types of multiple sclerosis?

There are several common patterns of MS.

Relapsing-remitting MS (RRMS)

This is the most common form of MS.

New symptoms appear, or existing symptoms worsen over a period of days, weeks or even months. This is known as a relapse. It is followed by a partial or complete recovery, known as remission. In RRMS this pattern continues, with relapses followed by periods of remission.

Primary progressive MS (PPMS)

About 1 in every 10 people with MS are diagnosed with PPMS. In this type, symptoms become gradually worse from the start of the illness, with no separate attacks or periods of remission. There can be times when your symptoms are stable and don’t get worse or better.

Secondary progressive MS (SPMS)

This is a later stage that follows RRMS. In this form, after years of having RRMS, your symptoms become gradually worse, without remission.

Clinically isolated syndrome (CIS)

This is where you have one episode of MS symptoms and then recover. The episode lasts days or weeks.

Usually, you need at least 2 episodes of symptoms to be diagnosed with MS. Many people with CIS will eventually have more episodes and be diagnosed with MS.

What are the symptoms of multiple sclerosis?

Symptoms of MS depend on which part of your central nervous system is affected and how much damage has occurred.

MS can cause problems with controlling your body, such as:

• muscle cramps and stiffness
• weakness
• tremor (shaking)
• loss of coordination and balance
• trouble with talking and swallowing

Vision problems are very common. You might notice blurred or double vision, blind spots or changes in how colours look.

Other common symptoms include:

• tiredness
• vertigo
• unusual sensations — such as pins and needles, nerve pain and sensitivity to heat
• bladder and bowel problems — such as incontinence, diarrhoea and constipation
• problems with sexual function
• changes in memory, concentration or thinking
• depression and anxiety

The symptoms of MS vary widely from person to person. They can also come and go in any one person. MS is unpredictable.

CHECK YOUR SYMPTOMS — Use the Symptom Checker and find out if you need to seek medical help.

What causes multiple sclerosis?

The cause of MS is not known, but there are several factors that make you more likely to develop MS. These include:

• having a close relative with MS or another autoimmune illness
• low vitamin D levels
• living further away from the equator — possibly because this usually means you have a lower level of vitamin D
• previously having Epstein-Barr virus (glandular fever)
• smoking
• living with obesity

How is multiple sclerosis diagnosed?

Your doctor will refer you to a neurologist. They will examine you to check how different parts of your nervous system are working.

A combination of tests is used to diagnose MS. The best test is an MRI of your brain and spinal cord to detect areas of damage. You might also need to have blood tests, a lumbar puncture and tests to measure nerve activity.

It can be hard to reach a diagnosis because there is no single test for MS. You will be diagnosed with MS if there is evidence of damage in different parts of your central nervous system, at different times, with no explanation other than MS.

ASK YOUR DOCTOR — Preparing for an appointment? Use the Question Builder for general tips on what to ask your GP or specialist.

How is multiple sclerosis treated?

There is currently no cure for MS, but there are treatments that can help. The best medicine for you depends on the symptoms and type of MS you have. Talk to your neurologist about the right combination of treatments for you.

It’s especially important to talk to your neurologist if you are planning a pregnancy. They can talk to you about your chance of a relapse and make sure your treatment is safe for your baby.

Disease modifying therapies

Disease modifying therapies, or immunotherapies, are medicines that target your immune system. They make relapses less frequent and severe, with less damage to the myelin layer.

These medicines are usually used for people with relapsing-remitting MS. They can slow down or prevent RRMS developing into SPMS. However, they can have significant side effects.

Treatment for relapses

Steroid medicines reduce inflammation in your central nervous system. If you have a relapse of MS, they can make your symptoms less severe.

Symptom relief

There are medicines available that can ease many symptoms of MS, such as muscle stiffness, pain, bladder or bowel problems, tiredness, depression and anxiety.

Other treatments may include:

• regular exercise can improve a wide range of symptoms
• physiotherapy for muscle problems
• continence products
• counselling for depression or anxiety
• cognitive rehabilitation to improve your memory and thinking

Resources and support

If you have MS or care for someone with MS, visit MS Australia for information and support.

Sources:

Brain Foundation
(Multiple scelrosis),
Australian Journal of General Practice
(Multiple sclerosis: Diagnosis, disease-modifying therapy and prognosis),
Healthy WA
(Multiple sclerosis),
MS Australia
(What is multiple sclerosis (MS)?),
MS Australia
(Types of MS),
MS Australia
(MS symptom: Visual disturbances),
MS Australia
(MS symptoms),
MS Australia
(Unravelling the causes of MS),
MS Australia
(How is MS diagnosed?),
MS Australia
(Positive news for women with MS planning pregnancy),
MS Australia
(Treatments),
MS Australia
(Exercise and MS),
Australian Journal of General Practice
(Cognitive rehabilitation in multiple sclerosis)

Learn more here about the development and quality assurance of healthdirect content.

How a Doctor Diagnoses Multiple Sclerosis

Temperature Sensitivity (or Uthoff Phenomenon) – Patients with multiple sclerosis may not feel well when taking a bath, hot shower, sauna, tanning bed, or direct sunlight. This is due to the properties of the sheath of nerve fibers: when heated, the myelin sheath changes its chemical and physical properties. If the shell 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 have been effective.

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

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

The following two signs are less characteristic of 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 occur when there is damage not to the nerve fiber, but to the nerve cell body itself, which is not the primary target. These symptoms include the following.

• Damage to the cerebral cortex with impaired speech, writing, counting, perception of music, faces.
• Convulsions. This refers to epilepsy – convulsive seizures that also involve the cerebral cortex.
• Rapid decline in intelligence associated with the processing and involvement of the cerebral cortex, and not the nerve conductors.
• The development of a neurological deficit, either instantly or within minutes.

When a person tells a doctor about his complaints, an experienced neurologist knows that absolutely any complaints can occur in multiple sclerosis, 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 must be guided by two points: the dispersion of symptoms in space and the dispersion in time.

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

Prevalence in space the doctor sees when a person talks about 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. This can also be seen when performing an MRI of the brain or spinal cord – the presence of lesions will be noted.

Prevalence in time The doctor finds out by asking the person about the manifestations of the disease earlier. Also, the prevalence over time can be seen by comparing the results of several MRI performed at different times – they show the appearance of new changes in the structure of the CNS. If there were no MRI studies before, then a contrast agent can be injected 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 should be done only once – to confirm the diagnosis, since the meaning of the contrast is precisely in this.

BETALIFE – Diagnosis of multiple sclerosis. How is the diagnosis made?

Select status

Main Encyclopedia Diagnosis of multiple sclerosis. How is the diagnosis made?

Multiple sclerosis is diagnosed in several stages. For this, various instrumental and laboratory methods are used, as well as the collection of anamnesis.
Thanks to diagnostics, it is possible not only to identify the disease, but also to determine its degree and predict its development. And specific criteria make it possible to identify disability and its indicators.

To date, there are no specific symptoms, physical findings, or special laboratory tests that are direct evidence of multiple sclerosis. A number of diagnostic methods are used to rule out other causes of some neurological symptoms. For this, neurological examinations, the study of the medical history and examination of the patient, as well as various instrumental methods, including magnetic resonance imaging (MRI), the method of evoked potentials (EP), and analysis of cerebrospinal fluid are used [1, 2].

In order to make a diagnosis of multiple sclerosis, the doctor needs [1, 2]:

In most patients with the relapsing-remitting form, it is easier to diagnose the disease, since it is often caused by a certain set of symptoms and, as a rule, is confirmed by using MRI [3].

However, it takes some time to identify the progressive form of multiple sclerosis, because the symptoms can be very varied and unpredictable. For people with atypical symptoms of multiple sclerosis, diagnosis can be significantly more difficult. In these cases, it is necessary to examine the cerebrospinal fluid and use the EP method [3].

Approaches to the diagnosis of multiple sclerosis

Clinical manifestations [1] :

Paraclinical manifestations are determined using a number of diagnostic methods [1]: 900 04

• find signs of damage to the myelin sheath in various areas of the central nervous system (CNS), including the brain and spinal cord, peripheral nerves;
• establish that the duration of symptoms is greater than at least 1 month;
• exclude other possible diagnoses.
• clinical – on the basis of clinical manifestations, the nature of symptoms and the type of course of the disease;
• paraclinical – based on the data of instrumental and laboratory research methods.
1. Onset at a young age. Most often, multiple sclerosis develops between the ages of 20 and 50.
2. A history of retrobulbar neuritis (optic nerve inflammation), sensory disturbances, unsteadiness when walking, double vision, transient weakness of an arm or leg are common symptoms of multiple sclerosis. Vision problems are the most common symptom of multiple sclerosis. Inflammation damages the optic nerve and impairs vision. The patient may see objects as double or blurry. In some cases, partial loss of vision occurs.
3. The changeable nature of complaints and well-being during the day is also found in the early stages of the disease.
4. Alternation of exacerbation with remission within 1-2 years and more common picture in relapsing-remitting form of multiple sclerosis.
5. Neurological examination. The neurologist will look for abnormalities, changes or disturbances in vision, motor functions of the eyes, hands, feet, coordination. Study reflexes and speech deviations. These studies can show if your nerves are damaged and if it is related to multiple sclerosis.
6. Possible discrepancy between complaints and results of neurological examination.
7. Cognitive and emotional disorders. The presence of depression, anxiety and memory impairment.
1. The evoked potential method is used to record the electrical signals produced by the nervous system in response to a stimulus. To assess EP, various visual stimulations can be used, in which the subject observes a moving visual pattern and feels the effect of electrical stimuli (short electrical impulses that are sent along the nerves in the arms and legs). Sensors measure how fast impulses travel along nerve pathways.
2. Neuro-ophthalmological findings: fundus examination.
3. Magnetic resonance imaging (MRI) can reveal lesions in the brain and spinal cord. In order to identify lesions in the active phase, a special contrast material is injected into the blood.
4. Investigation of blood serum activity to detect antibodies to myelin. In addition, a blood test allows you to exclude the possibility of other diseases with similar symptoms.
5. A lumbar puncture is performed by drawing fluid from the spinal cord. This method can indicate the presence of antibodies, protein components of the blood that fight foreign agents. And in the case of multiple sclerosis, waging war against myelin.

McDonald criteria

Currently, the most common diagnosis of multiple sclerosis is established and specified on the basis of diagnostic criteria MacDonald . This technique was first published in 2001 by a research team led by Professor Ian McDonald. Based on various diagnostic methods, the McDonald criteria allow to establish the presence of lesions in the brain and spinal cord in space and time [4].

In most cases, MRI data are used to determine the MacDonald criteria, which allow an accurate diagnosis [4].

The presence of multiple sclerosis in this case will be indicated [4]: ​​

To detect multiple sclerosis, various methods will be required, including neurological examination, MRI scanning, evoked potentials, various laboratory tests. Early diagnosis in multiple sclerosis is very important. Since treatment can slow the progression of the disease, it is necessary to start therapy as early as possible.

Commentary by the leading specialist Totolyan Natalya Agafonovna

• Spread in space (damage in different parts of the central nervous system)
  • Clinically: the presence of two or more clinical lesions.
  • Paraclinically (by MRI): lesions in the spinal cord or brain.
• Spread over time (presence of damage that occurred in different time periods)
  • Clinically: repeated exacerbation (clinical manifestations lasting at least 24 hours, interval between clinical attacks at least 1 month).