March is Multiple Sclerosis Awareness Month, and here’s the first thing you need to know: Diagnosing multiple sclerosis (MS) isn’t easy. Because there’s no single test and a multitude of symptoms, MS often goes undiagnosed, sometimes several times, before identifying it as the root cause. Unfortunately, the inverse is true as well in that many people are misdiagnosed with MS who actually do NOT have the disease.
A proper diagnosis may require some perseverance between you and your doctor and tracking of symptoms, observations about episodes, diagnoses that have been ruled out by various physicians and bloodwork and/or MRI’s over time. Most neurologists will be able to make the diagnosis of MS, but for those with unusual symptoms or progressive disease, you may require a more specialized evaluation. The key is to not give up until you get the answers you deserve.
What is multiple sclerosis?
MS is a long-term condition that affects the nervous system. Researchers believe it’s an autoimmune disorder, where the body mistakenly attacks itself. Everyone experiences different symptoms and some are more severe than others. Common signs include blurred vision, weakness in the arms and legs, fatigue, speech problems, dizziness and hearing loss. The exact cause of MS is unknown, but factors like genetics, infections and even some environmental determinants are all suspects.
Multiple sclerosis is more common in areas further from the equator and affects twice as many women as men. It’s characterized by destruction of the protective covering of nerve cells – the myelin sheath – and lesions on the brain and spinal cord. Sensory disturbances (like tingling, numbness and pain) in the limbs are common; there may also be muscle control issues like trembling, weakness or paralysis and vision problems.
The most well-known type of MS is relapsing-remitting MS, where periods with symptoms alternate with periods of remission. After 10 years or so it usually progresses into secondary progressive MS with no remissions and steadily worsening symptoms. A smaller percentage (10 to 20 percent) of people have primary progressive MS from the start which just keeps getting worse over time.
How is multiple sclerosis diagnosed?
Multiple Sclerosis (MS) can be hard to diagnose as there is no single test that confirms this disease. However, health professionals usually rely on a combination of examinations and tests.
To start, they will ask you questions about your history and symptoms, to gain a greater understanding of the condition. Next, they will carry out tests of your sensory and motor abilities, such as reflexes, eye movement, and other neurological functions. Blood tests will follow, which may check for antibodies linked to MS or other autoimmune disorders. Imaging tests such as MRI scans and evoked potentials (EP) are often requested to help identify lesions caused by MS. If the doctor is still unsure about a diagnosis, a lumbar puncture may be recommended which looks for changes in the cerebrospinal fluid.
In order to meet the criteria for MS, two attacks of symptoms at least one month apart must have occurred and there must be damage in more than one area on an MRI scan of the brain that has been intensified with contrast. All these tests can help determine an accurate diagnosis and ensure that appropriate treatment is given quickly.
What are the treatment options for multiple sclerosis?
Treatment for MS includes steroid medication to reduce inflammation and slow the progression of the disorder, as well as plasma exchange for those who don’t respond to steroids. There are also over 20 medications available to help prevent MS attacks and damage from new lesions on the brain, as well as disease-modifying drugs to reduce the number of flare-ups, plus medications to manage issues like fatigue, pain, and depression.
Rehab activities could include building muscle strength and endurance with exercise, adjusting the home environment for safety and mobility, relearning thinking skills, and learning about tools to assist with getting around. Physical therapy, occupational therapy, and speech therapy are useful options as well. It also could be helpful to reach out for mental health support if you are feeling overwhelmed or need someone to talk to.
Keep in mind that there’s ongoing research into new treatments and medications that could provide better solutions for MS, so you can always check in with your doctor to see what advancements have been made.
Overall, the best thing you can do is to research your options, be persistent as you know your body the best and come prepared to talk to your doctor to find out what options are best for you. Check out the MS Society website for a listing of resources near you, and then check out how Kith + Kin can help.