Multiple sclerosis (MS) is a chronic disease of the central nervous system that affects more than 2.3 million people worldwide. MS is usually diagnosed in patients between 20 and 40 years of age, more commonly in women than in men. However, a variant of MS found in people of Asian and African American descent has been discovered and studied over the last few years, and it requires different types of treatment from traditional MS.
Both diseases are thought to be caused by the immune system, which usually protects against bacteria and viruses, attacking the insulating cells and nerve cells of the central nervous system (brain and spinal cord.) Transmission of nerve signals is thus impaired and causes many symptoms. These symptoms are a little unpredictable, and may change from one person to another. However, common early symptoms include numbness and tingling, blurred or double vision, coordination problems, loss of balance, and trouble walking.
Partly due to the unpredictable nature of its symptoms, multiple sclerosis is also an extremely difficult disease to properly diagnose. Because there is no single diagnostic test that provides positive proof of MS, diagnosis is typically handled by a series of tests intended to rule out other potential causes of symptoms, along with a physical examination and an analysis of the patient’s medical history. Some of the tests used to help diagnose MS include MRIs, spinal taps, and evoked potentials, as well as laboratory tests to help exclude other diseases.
Accepted diagnostic criteria, called the MacDonald 2017 criteria, have enabled the diagnosis of MS to be carried out with more certainty (dissemination in time and space with MRI criteria). However, some people who are diagnosed with multiple sclerosis actually have another disease that mimics MS.
A number of different conditions can be incorrectly diagnosed as MS, including various stress-related disorders, vitamin deficiency, brain infection, stroke, and inflammation of the blood vessels. Because of the complexity of the disease, people who have MS, and need to have MS diagnoses, should be seen, if possible, by neurologists and centers specializing in MS.
Once a solid diagnosis of MS is made, the next step is to treat it. Though there is currently no known cure, patients who are diagnosed with multiple sclerosis have a wide variety of treatment options, including symptomatic therapy to treat the symptoms of MS, and disease-modifying therapies (DMTs) that affect the actual disease itself. At Rowe Neurology, we believe an integrated approach to care, considering the whole patient, should be the goal of everyone taking care of MS patients. Because MS is such an unpredictable disease, and because symptoms can remain steady for months and then suddenly change overnight, close monitoring and proactive care is essential for optimizing treatment.
These are the three simple principles that all MS doctors must follow:
- Be picky about the diagnosis of MS
- Follow MS patients actively to make sure the treatment is effective in each patient.
- Don’t blame everything on MS in any patient.
Here at Rowe Neurology, we believe an integrated approach, including correct diagnosis and aggressive treatment of both the disease itself as well as its symptoms, will give patients the maximum quality of life they can have while living with multiple sclerosis. We do this because our patients deserve it.