Diagnosing Multiple Sclerosis

To mark Multiple Sclerosis Awareness Month, we invited Guangbin Xia, MD, PPG – Neurology, to offer more information on how this disease presents and what’s involved with treatment.

Defining MS

Multiple Sclerosis (MS) affects the central nervous system, including the brain and spinal cord. An abnormal immune system response creates a disruption in the flow of information between the brain and the body. All messages come from the brain and down the spinal cord, so if there are lesions on these pathways, it can be a disruption to the body’s function.

Signs and symptoms

This unpredictable condition can present in several different ways. For many, it begins with a change in vision (optic neuritis), perhaps the patient’s sight becomes blurry or they feel pain in the eye.

According to the National Multiple Sclerosis Society, MS could be related to any of the following symptoms: 

  • Fatigue
  • Walking (gait) difficulties
  • Numbness or tingling
  • Spasticity (feelings of stiffness and involuntary muscle spasms)
  • Weakness
  • Vision problems
  • Dizziness and vertigo
  • Bladder problems
  • Sexual problems
  • Bowel problems
  • Pain
  • Cognitive changes
  • Emotional changes
  • Depression
  • Speech problems
  • Swallowing problems
  • Tremor
  • Seizures
  • Breathing problems
  • Itching
  • Headache
  • Hearing loss

Often called the great mimicker, MS can present with symptoms often associated with other conditions. A diagnosis of MS often occurs while looking for something else.

The presentation depends on the part of the brain being impacted. Symptoms are also known to surface and resolve on their own, only to resurface again. The symptoms can pile up and impact general morbidity.

Diagnosis

The protocol for diagnosing MS begins by observing the clinical presentation. If symptoms consistent with MS are present, the neurologist will do an exam to see how great the deficit is. This is followed by an MRI. If the MRI indicates MS, the neurologist will likely pursue a spinal tap to test the spinal fluid. All of this information is taken into consideration when making a diagnosis.

Treatment

Treatment can vary based on the type of MS the patient has. While there is no cure for the disease, there are effective options for slowing the progression of the disease, improving the symptoms or preventing relapse. A multidisciplinary approach is best, utilizing specialties like physical therapy, occupational therapy and neurology to develop plans specific to the patient. It’s important for those living with MS to realize that they can still have a great quality of life for years to come.

 

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