There are four broad types of multiple sclerosis (MS) that either can be independent of one another or represent a progression.
MS is a complex disease that often can be difficult to diagnose, as one patient’s symptoms vary greatly from another’s.
The experience and training of the board-certified and fellowship-trained MS specialists at the Norton Neuroscience Institute Hussung Family Multiple Sclerosis Center will help you come away with a precise diagnosis and customized treatment plan to address relapses, treat your disease and ease your symptoms.
Thorough diagnostic tools and expertise are some of the reasons the National Multiple Sclerosis Society has designated Norton Neuroscience Institute Hussung Family Multiple Sclerosis Center a Center for Comprehensive MS Care. Patients receive a comprehensive range of treatment options, rehabilitation, outpatient therapies, home treatment and the full range of educational and support services of Norton Neuroscience Institute Resource Centers.
There isn’t a test that can definitely point to a diagnosis of MS. Many times, the diagnosis process is lengthy and tedious as other causes of a patient’s symptoms are ruled out.
A thorough medical history and record of symptoms such as vision issues, numbness or tingling for a long period, can help.
A neurological exam from head to toe, assessing the whole body for any symptoms, is important, since MS is different from person to person.
Often, optic neuritis is one of the first signs of MS. Regular eye exams that assess the health of optic nerves are important.
An MRI scan is often very important to an MS diagnosis. An MRI of the brain, neck and chest can reveal lesions, or damage, to the myelin of nerves, which is their sheath or outer covering.
A lumbar puncture to draw spinal cord fluid can aid in diagnosis.
For some patients, the battery of tests shows a clear diagnosis. For others, diagnosis requires more effort to eliminate other causes.
Contact your physician if you experience neurological symptoms such as eye movement pain or numbness and tingling that lasts more than 24 hours. These symptoms can be caused by inflammation or damage to the myelin that covers nerve pathways.
Sometimes there is an indication of MS on an MRI scan, sometimes not. If the diagnosis is a condition known as clinically isolated syndrome, starting patients on medication soon can help improve their condition in the future. In some cases, the condition may warrant close monitoring without medication.
This is the most common form of MS and represents about 85% of patients. Life with relapsing remitting MS means going for periods of no symptoms, then encountering a relapse or exacerbation where symptoms last for more than 24 hours. Depending on where the lesion of damaged myelin is, symptoms can vary greatly.
Symptoms can last for days or months before going away in part if not completely. The level of symptoms after a relapse establishes a new baseline until the next exacerbation. Sometimes the new baseline is no symptoms; sometimes it’s something that lingers that wasn’t there before.
Relapses can be treated with medication, including steroids that can help shorten the duration of relapse symptoms.
This type of MS comes later in the disease’s progression. Rather than symptoms starting suddenly before going away, the change is more gradual with secondary-progressive MS. Patients may develop new lesions as seen on an MRI. Patients also may have more disabilities and other symptoms with no new lesions on an MRI.
Generally, secondary-progressive MS represents a transition from relapsing-remitting MS over time. Newly available medications for relapsing-remitting MS appear to delay if not prevent the transition to secondary-progressive MS.
About 10% to 15% of patients have this type of MS. Rather than the stair-step symptoms of relapsing remitting MS, primary progressive MS gradually progresses without remissions or relapses. These patients often will have trouble walking or will have another symptom that gets worse over time. It’s typically difficult for the patient to pinpoint a specific episode of worsening or improving symptoms.
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