Diagnosing Multiple Sclerosis

Multiple sclerosis (MS) is a chronic, inflammatory disease that affects the central nervous system. MS can cause a variety of symptoms, including changes in sensation, visual problems, muscle weakness, depression, difficulties with coordination and speech, severe fatigue and pain. Although many patients lead full and rewarding lives, MS can cause impaired mobility and disability in more severe cases requiring the need for a wheelchair.

Multiple sclerosis may take several different forms, with new symptoms occurring either in discrete attacks or slowly accruing over time. Between attacks, symptoms may resolve completely but permanent neurologic problems often persist. Although much is known about how MS causes damage, its exact cause remains unknown. MS currently does not have a cure, though several treatments are available which may slow the appearance of new symptoms. MS primarily affects adults, with an age of onset typically between 20 and 40 years, and is more common in women than in men.

Individuals with multiple sclerosis may experience a wide variety of symptoms. The initial attacks are often . They often do not prompt a health care visit and sometimes are only identified in retrospect once the diagnosis has been made based on further attacks. The most common initial symptoms reported are: changes in sensation in the arms, legs or face (33%), complete or partial vision loss (optic neuritis) (16%), weakness (13%), double vision (7%), unsteadiness when walking (5%), and balance problems (3%). Fifteen percent of individuals have multiple symptoms when they first seek medical attention. Most people find their initial MS symptoms occur over a period of hours to weeks. For some people the initial MS attack is preceded by infection, trauma or strenuous physical effort.

Other symptoms and physical findings common in multiple sclerosis are flickering eye movements, speech difficulties, tremor, clumsiness of the hands, abnormal muscle spasms, and bladder and bowel difficulties. Cognitive impairments are also common, such as difficulty performing multiple tasks at once, difficulty following detailed instructions, loss of short term memory, emotional instability, and fatigue. Emotional symptoms are common and can be the normal response to having a debilitating disease or the result of damage to the nerves that generate and control emotions. The most common condition, clinical depression, is a product of both causes. Feelings such as anger, anxiety, frustration, and hopelessness are also common and suicide is a very real threat. People with MS may also experience a range of acute and chronic pain syndromes.

The signs and symptoms of MS can be similar to other medical problems such as stroke, brain inflammation, infections, tumors and other autoimmune problems such as lupus. Additional testing may be needed to help distinguish MS from these other problems.

Read about multiple sclerosis treatment, prognosis, why multiple sclerosis occurs, how multiple sclerosis causes damage and history of multiple sclerosis.