How is Multiple Sclerosis (MS) Diagnosed?

Multiple Sclerosis (MS) affects more than 2.3 million people worldwide and is one of the most prevalent disabling neurological diseases amongst young people. Though it has been found in younger children as well as older adults, it is most common in patients between 20 and 40 years of age. It’s important to be accurate in the diagnosis, since it’s no longer just a diagnosis of exclusion.

I believe that the correct diagnosis combined with the aggressive treatment of both the disease and its symptoms, can help give you the maximum quality of life while living with MS.

What is MS?

Multiple sclerosis (MS) is a chronic disease of the central nervous system.  It involves the body’s immune system attacking our brain, spinal cord, and optic nerves.  That same immune system usually protects us from viruses and bacteria, but in MS, it attacks the insulating cells of the nervous system, and also damages nerve cells too.

A variant of MS has also been found in people of Asian and African American descent, called Devic’s disease, or Neuromyelitis Optica (NMO) .  This disease was lumped with MS for many years, but now we know it behaves differently from MS and requires different treatments.   Both diseases involve the immune system.

 Transmission of nerve signals is impaired in MS and NMO, and this causes many symptoms.

Identifying MS Symptoms

Part of the problem of identifying and diagnosing MS is that the symptoms are unpredictable and vary from person to person. Some of the more common symptoms of MS include:

1. Leg numbness or weakness
2. Arm numbness or weakness
3. Tingling sensation or pain in parts of your body
4. Blurred or double vision
5. Bladder problems or loss of bladder control
6. Problems walking
7. Emotional changes and depression

Getting an MS Diagnosis

For a long time MS has had a diagnosis by exclusion. Instead of taking a single diagnostic test, there were typically a series of tests done to try and rule out other potential causes of your symptoms.  These tests include MRIs, spinal taps, evoked potentials, and laboratory tests. Along with these tests, doctors will complete a neurologic examination as well as review your medical history.

The diagnosis of MS is now carried out with more certainty with new accepted diagnostic criteria such as the MacDonald 2010 criteria. But, even with these new criteria, there are still patients who are being diagnosed with MS, but actually have another disease that mimics MS. These other conditions that could be leading to an incorrect diagnosis of MS include various stress-related disorders, vitamin deficiency, brain infection, stroke, and inflammation of the blood vessels.

Because of the complexity of the disease, if you have MS or are experiencing MS symptoms, you should be seen by  neurologists and centers who specialize in Multiple Sclerosis.

What to do with an MS Diagnosis?

Once a solid diagnosis of MS has been made, the next step is to treat it. Though there is currently no known cure, there are a wide variety of treatment options for you, including symptomatic therapy to treat the symptoms of MS and disease-modifying therapies (DMTs) that affect the actual disease itself. Since MS is such an unpredictable disease and because symptoms can remain steady for months and then suddenly change overnight, close monitoring and proactive care is essential for optimizing your treatment.

In the video below, I explain the three simple principles I follow when it comes to diagnosing and treating MS.

1. Be picky about the diagnosis of Multiple Sclerosis
2. Follow MS patients actively to make sure the treatment is effective in each patient.
3. Even if a patient has MS, don’t blame every symptom on MS

Overall, it has been my philosophy and approach that an integrated approach to care, considering the whole patient, is necessary when it comes to taking care of MS patients.

If you are currently being treated for MS, be sure to take a proactive approach in your diagnosis and make sure your doctor is monitoring your progress closely.

Your doctor’s goal should be to help you have the best quality of life possible when living with MS, because you deserve it!