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Multiple Sclerosis (MS) (cont.)

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What are MS symptoms and signs?

Multiple sclerosis symptoms are dependent on the area of demyelination. Symptoms and signs of MS include:

  • Visual changes, including loss of vision if the optic nerve has been affected
  • A sensation or feeling of numbness, tingling, or weakness, and the weakness may be mild or severe enough to cause paralysis of one side of the body
  • Vertigo
  • In some cases, individuals may develop incontinence or even an inability to empty their bladder.
  • As MS progresses, some affected individuals are left with muscle spasticity, or an involuntary painful contraction of certain muscles.

What are the different types of MS?

There are four types of MS which are described.

1. Relapsing-remitting multiple sclerosis (RRMS)

Relapsing-remitting multiple sclerosis (RRMS) is the most common form of MS.

People with this form of MS develop symptoms which respond to treatment and then resolve. The development of symptoms is often referred to as an exacerbation of the disease. Episodes of remission may last for weeks to years.

2. Secondary-progressive multiple sclerosis (SPMS)

Secondary-progressive multiple sclerosis (SPMS) is diagnosed when the problems caused by an exacerbation don't fully resolve during a remission. This often occurs in patients who were initially diagnosed with RRMS. Over time, patients are identified with progressive debility.

3. Primary-progressive multiple sclerosis (PPMS)

Primary-progressive multiple sclerosis (PPMS) progresses over time, without episodes of remission or improvement of symptoms.

4. Progressive-relapsing multiple sclerosis (PRMS)

Progressive-relapsing multiple sclerosis (PRMS) is identified when patients experience escalating symptoms over time, as well as intermittent episodes of remission.

How do doctors diagnose multiple sclerosis?

As in all conditions, the history of the patient is important. Many patients with MS have experienced various symptoms which were ignored or attributed to other events or illnesses. Even if no prior symptoms are recalled by a patient, the remaining medical history is needed to exclude other conditions which might mimic MS.

Once the history is obtained, a complete physical examination is required. Physicians look for signs of injury to the central nervous system (either the brain or spinal cord); findings on the examination can help a doctor determine which area of the central nervous system (CNS) is involved.

Imaging studies help to confirm a diagnosis of multiple sclerosis. The most common test done is a magnetic resonance image, or MRI. CT scans, while helpful in finding some brain injuries, are unable to reveal the changes associated with MS with as much detail as an MRI. MRIs can be used to image the brain and the spinal cord.

A spinal tap, or lumbar puncture, is done to collect a small amount of cerebrospinal fluid. Testing can be done on this fluid to confirm the presence of protein, inflammatory markers, and other substances. With the routine use of MRI, performing a spinal tap is not considered mandatory, unless there are questionable findings on the MRI or other questions to answer.

Evoked potential testing (visual evoked potentials, brainstem auditory evoked potentials, and somatosensory evoked potentials) can show slowed response times in the optic nerve, the auditory nerve, the spinal cord, or the brainstem. While helpful, these tests are not specific for changes seen in MS.

When MS is suspected, blood work and testing to exclude other conditions, such as Lyme disease, vasculitis, lupus, human immunodeficiency virus (HIV), and processes which lead to multiple strokes, are often done as well.

Medically Reviewed by a Doctor on 5/15/2015

Source: MedicineNet.com
http://www.medicinenet.com/multiple_sclerosis_ms/article.htm

Multiple Sclerosis

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