An MRI scan can detect MS activity early on , sometimes before an individual experiences any worsening symptoms.
MRI is considered the best test to help diagnose MS. However, 5% of people with MS do not have abnormalities detected on MRI; thus, a "negative" scan does not completely rule out MS. In addition, some common changes of aging may look like MS on a MRI.
In general, MS lesions are hyperintense or bright on T2 or FLAIR sequences. Hypointense lesions are dark or black. In general, old MS lesions are hypointense or dark on T1 sequences (“black holes”). Isointense lesions are gray, the color of surrounding brain tissue.
Although MRI is a very useful diagnostic tool, a normal MRI of the brain does not rule out the possibility of MS. About 5 percent of people who are confirmed to have MS do not initially have brain lesions evidenced by MRI.
People with multiple sclerosis (MS) tend to have their first symptoms between the ages of 20 and 40. Usually the symptoms get better, but then they come back. Some come and go, while others linger. No two people have exactly the same symptoms.
Those symptoms include loss of vision in an eye, loss of power in an arm or leg or a rising sense of numbness in the legs. Other common symptoms associated with MS include spasms, fatigue, depression, incontinence issues, sexual dysfunction, and walking difficulties.
Numbness of the face, body, or extremities (arms and legs) is often the first symptom experienced by those eventually diagnosed as having MS.
There are also multiple infectious entities that mimic MS including; progressive multi-focal leukoencephalopathy (PML), Toxoplasmosis, Tuberculosis, Herpes Simplex Virus, Cytomegalovirus, Varicella zoster virus, Epstein Barr virus, Cryptococcus and Human immunodeficiency virus.
MS activity appears on an MRI scan as either bright or dark spots. Typical MS lesions tend to be oval or frame shaped. MS lesions can appear in both the brain's white and gray matter. Healthcare professionals may use a chemical contrast dye called gadolinium to improve the brightness of MRI scan images.
Signs and Symptoms
Characteristic lesions are located in the periventricular and juxtacortical regions, in addition to the brainstem, cerebellum, spinal cord, and optic nerve.
Most symptoms develop abruptly, within hours or days. These attacks or relapses of MS typically reach their peak within a few days at most and then resolve slowly over the next several days or weeks so that a typical relapse will be symptomatic for about eight weeks from onset to recovery. Resolution is often complete.
MRI has greater than 90% sensitivity in the diagnosis of MS; however, other white matter diseases can sometimes have a similar appearance on medical imaging.
If you have MS and it's early in the disease course, you might not have tested positive in all the MS tests. In fact, you might not have tested positive in any of the tests.
Personalized, advanced MS treatments can slow disease progression, especially when the condition is detected early.
In addition, just 13% of patients with normal examination results ultimately were diagnosed with MS or possible MS. Thus, atypical history and normal neurological examination results were highly predictive of not diagnosing MS.
There are three main investigations that, because of their high specificity and sensitivity, are valuable in the diagnosis of MS: magnetic resonance imaging (MRI), evoked potentials; and cerebrospinal fluid (CSF) examination for the presence of oligoclonal bands (OCBs).
While there is no definitive blood test for MS, blood tests can rule out other conditions that cause symptoms similar to those of MS, including lupus erythematosis, Sjogren's, vitamin and mineral deficiencies, some infections, and rare hereditary diseases.
Multiple sclerosis is caused by your immune system mistakenly attacking the brain and nerves. It's not clear why this happens but it may be a combination of genetic and environmental factors.
Between 1 and 2 in every 10 people with the condition start their MS with a gradual worsening of symptoms. In primary progressive MS, symptoms gradually worsen and accumulate over several years, and there are no periods of remission, though people often have periods where their condition appears to stabilise.
Early signs and symptoms of MS
tingling and numbness. pains and spasms. weakness or fatigue. balance problems or dizziness.
Clinically isolated syndrome describes a person's first episode of neurological symptoms caused by damaged myelin in the CNS. CIS is often referred to as the first stage of MS, even though it doesn't meet the MS criterion for dissemination in time (MS damage that occurs on different dates).
Tests for multiple sclerosis. Diagnosing MS is complicated because no single test can positively diagnose it. Other possible causes of your symptoms may need to be ruled out first. It may also not be possible to confirm a diagnosis if you have had only 1 attack of MS-like symptoms.
Over 25,600 people in Australia are living with multiple sclerosis, including 3,700 Queenslanders, and it affects each person differently. On average more than 10 Australians are diagnosed with MS every week.