Diagnosing MS
Multiple Sclerosis may appear at first , as a series of vague symptoms that weaken over time, many of these signs can be attributed to other medical conditions (diseases). Therefore there can pass a certain period of time before the diagnostic suggests MS. On the other hand, a clearer diagnosis of MS can be made in case of typical symptoms (eg optic neuritis) and by an exact timeline of the crises. The neurologist needs evidence that indicate the involvement of at least two parts of the central nervous system that has visible effects in two different times. Multiple sclerosis is ultimately a clinical diagnosis and there are no specific tests for this disease just as no other test is 100% exact. For MS diagnose are needed a series of tests and medical procedures that include the following:
The personal medical past
The doctor will require a record of past personal medical information about signs including past symptoms, as well as on your current health status. The type of symptoms, appearance and their pattern may suggest Multiple Sclerosis, but it takes the entire series of examinations and tests to confirm the diagnosis.
Neurological examination
The neurologist will examine the presence of anomalies along the nerve pathways. The most common neurological signs include changes in eye movements, limb coordination, weakness, balance problems, the senses, speech and the reflexes. However examination can not provide a clear conclusion on the causes of these defects, therefore it is necessary to eliminate diseases that have similar symptoms to MS.
Auditory and visual evoked potential test
When demyelination occurs (scarring) the nerve impulses are transmitted more slowly. Evoked potential measures the time required for the brain to receive and interpret messages (speed transmission nerves). This is done by placing electrodes on the head to monitor brain waves produced in response to visual and auditory stimuli. Normally the brain reacts almost instantly to these types of stimuli, but in the case of demyeliation of central nervous system there might be a delay. This test is not invasive or painful and does not require hospitalization.
Magnetic resonance (NMR)
MRI scanning is a recently used test in diagnosing and produces high resolution images of the brain and the spine, highlighting the areas affected by sclerosis (lesions or plates). Although this is the only test that allows visualization of MS lesions, this test can not be considered decisive because the scan does not allow highlighting of all lesions and because there are other diseases that can cause such anomalies. MRI shows most clearly in size, number and distribution of lesions and, along with evidence of their medical history and the neurological examination which very important in the diagnosis of MS. MRI is an important tool in evaluating clinical trials that allow measurement of disease activity in the brain and the spine.
Lumbar puncture
This test consists of taking the cerebro-spinal fluid (fluid that circulates around the brain and spine) to detect an antibody. Antibodies can appear due to MS, but also because of other neurological diseases. The fluid is taken by inserting a needle in the back and extract a small amount of liquid. The patient is locally anesthetic for the numbness of the skin, therefore, although a little uncomfortable, this test is not usually painful. After sampling the fluid the patient must stay lying for several hours or even spend a night in hospital. Some patients may require a recovery period. This test can indicate the presence of MS but it is definitely individually.
Diagnosing MS is not always clearly defined. Initial symptoms can be vague or transient and misleading to both patients and doctor. Invisible or subjective symptoms are sometimes hard to be communicated to the doctors and health professionals making patients sometimes mistakenly considered to be neurotic or hypochondria. After a flare in which you asked for advice from a physician, he can not tell you about MS. This is normal because the doctor wants to observe at least two such events in an interval of one months and that is Metin over 24 hours.
Your bond with your family doctor and neurologist is essential. MS may have moments of acute crisis or who require special medical attention, but is a disease that is a part of everyday life. Time of diagnosis is very difficult both for the person with MS and for his family and caregivers to be informed in detail about the diagnosis, prognosis, treatment, adjustment of lifestyle and considerations on living with MS. For people with MS , the family doctor and local MS Society [SSMR local] are the sources of information and important care. Diagnosing MS is a shock and often tends to stereotypes about wheelchairs and other disabilities. However it is very important to know that many people with MS and their caregivers agreed to the fact that life can still live fully, without omitting limitations imposed by the disease. Therefore, in many cases abandonment of the workplace, the education or social life is unnecessary. Many people with MS still lead productive lives, fulfilled and relatively normal.
