Multiple Sclerosis (MS) (cont.)
Danette C. Taylor, DO, MS, FACN
Dr. Taylor has a passion for treating patients as individuals. In practice since 1994, she has a wide range of experience in treating patients with many types of movement disorders and dementias. In addition to patient care, she is actively involved in the training of residents and medical students, and has been both primary and secondary investigator in numerous research studies through the years. She is a Clinical Assistant Professor at Michigan State University's College of Osteopathic Medicine (Department of Neurology and Ophthalmology). She graduated with a BS degree from Alma College, and an MS (biomechanics) from Michigan State University. She received her medical degree from Michigan State University College of Osteopathic Medicine. Her internship and residency were completed at Botsford General Hospital. Additionally, she completed a fellowship in movement disorders with Dr. Peter LeWitt. She has been named a fellow of the American College of Neuropsychiatrists. She is board-certified in neurology by the American Osteopathic Board of Neurology and Psychiatry. She has authored several articles and lectured extensively; she continues to write questions for two national medical boards. Dr. Taylor is a member of the Medical and Scientific Advisory Council (MSAC) of the Alzheimer's Association of Michigan, and is a reviewer for the journal Clinical Neuropharmacology.
Charles Patrick Davis, MD, PhD
Dr. Charles "Pat" Davis, MD, PhD, is a board certified Emergency Medicine doctor who currently practices as a consultant and staff member for hospitals. He has a PhD in Microbiology (UT at Austin), and the MD (Univ. Texas Medical Branch, Galveston). He is a Clinical Professor (retired) in the Division of Emergency Medicine, UT Health Science Center at San Antonio, and has been the Chief of Emergency Medicine at UT Medical Branch and at UTHSCSA with over 250 publications.
In this Article
- Multiple sclerosis (MS) facts
- What is the definition of multiple sclerosis (MS)?
- What is multiple sclerosis (MS)?
- What causes multiple sclerosis?
- What are the risk factors for developing multiple sclerosis?
- What are MS symptoms and signs?
- What are the different types of MS?
- How do doctors diagnose multiple sclerosis?
- What are multiple sclerosis treatment options?
- MS medications
- What is the treatment for MS symptoms?
- What is the prognosis and life expectancy for multiple sclerosis?
- Is it possible to prevent multiple sclerosis?
- What research is being done on MS?
- Multiple Sclerosis (MS) FAQs
- Find a local Neurologist in your town
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
- 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.
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