It can take a few years to make an accurate diagnosis of progressive MS because the condition usually worsens slowly.
The process of diagnosis can take months, in some cases years, and is often referred to as 'limboland'. In this factsheet we look at the early symptoms of MS and hope to answer some of the common questions that you might have at this time.
MS is diagnosed by your neurologist. They will use a specific checklist to diagnose MS, known as the McDonald criteria. They'll carry out a number of tests to run through the criteria, which could include blood tests and MRI.
Multiple sclerosis symptoms typically won't send you to the emergency department, but there may be instances when you need care quickly. Symptoms related to multiple sclerosis (MS) are rarely life threatening, but they can be painful and frightening — and may lead you to consider a trip to the hospital.
In most people with relapsing-remitting MS , the diagnosis is straightforward and based on a pattern of symptoms consistent with the disease and confirmed by brain imaging scans, such as an MRI. Diagnosing MS can be more difficult in people with unusual symptoms or progressive disease.
An MRI scan can detect MS activity early on , sometimes before an individual experiences any worsening symptoms.
Sjogren's syndrome is an autoimmune disease that can mimic some of the symptoms of MS such as fatigue and joint pain.
These include fibromyalgia and vitamin B12 deficiency, muscular dystrophy (MD), amyotrophic lateral sclerosis (ALS or Lou Gehrig's disease), migraine, hypo-thyroidism, hypertension, Beçhets, Arnold-Chiari deformity, and mitochondrial disorders, although your neurologist can usually rule them out quite easily.
It's most commonly diagnosed in people in their 20s, 30s and 40s although it can develop at any age. It's about 2 to 3 times more common in women than men. MS is one of the most common causes of disability in younger adults.
Some conditions that doctors may commonly misdiagnose as MS include migraine, RIS, spondylopathy, and neuropathy. To accurately diagnose MS, doctors must rule out conditions with similar symptoms and look for signs and symptoms specific to MS. As such, the process of diagnosing MS may be lengthy and complex.
Neurological examination
Your neurologist will look for abnormalities, changes or weakness in your vision, eye movements, hand or leg strength, balance and co-ordination, speech and reflexes. These may show whether your nerves are damaged in a way that might suggest MS.
What Does MS Feels Like? A lack of feeling or a pins-and-needles sensation can be the first sign of nerve damage from MS. It usually happens in your face, arms, or legs, and on one side of your body. It tends to go away on its own.
Here's where MS (typically) starts
Although a number of MS symptoms can appear early on, two stand out as occurring more often than others: Optic neuritis, or inflammation of the optic nerve, is usually the most common, Shoemaker says. You may experience eye pain, blurred vision and headache.
Many members of the MS community suggested that patients try to stay present as much as possible. Ways to avoid worrying include staying busy with work, watching movies, gardening, and spending time (even virtually) with friends, children or grandchildren. “Do not get ahead of yourself!” “Stay in the moment.
How long can MS go undiagnosed? MS is usually diagnosed between the ages of 20 and 50, but it can go undetected for years. In fact, a 2021 study suggested that many people with MS experience disease symptoms several years before being officially diagnosed with the disease.
Blood Tests: Currently, there are no definitive blood tests for diagnosing MS, but they can be used to rule out other conditions that may mimic MS symptoms, including Lyme disease, collagen-vascular diseases, rare hereditary disorders and acquired immune deficiency syndrome (AIDS).
One of the more obvious first signs of MS is a problem with vision, known as optic neuritis. This is often because it's a more concrete symptom as opposed to vaguer neurological symptoms like numbness and tingling.
In the general population, the risk of developing MS is about 1 in 750-1000. What are other risk factors for MS? Evidence shows that low vitamin D levels, smoking and obesity all play important roles in the development of MS.
MS can be present even with a normal MRI and spinal fluid test although it's uncommon to have a completely normal MRI. Sometimes the MRI of the brain may be normal, but the MRI of the spinal cord may be abnormal and consistent with MS, so this also needs to be considered.
While it is true that almost all people with MS will have evidence of brain lesions on MRI, not all people with brain lesions have MS.
Now, a study led by Stanford Medicine researchers has proved that the Epstein-Barr virus, a common type of herpes virus, triggers multiple sclerosis by priming the immune system to attack the body's own nervous system.
But despite some similarities, “for the most part, there is no mistaking symptoms of MS with fibromyalgia,” says Philip Cohen, MD, a rheumatologist, professor of medicine and professor of microbiology and immunology at the Lewis Katz School of Medicine at Temple University in Philadelphia.
Nail problems are common, and they are not usually serious. If a person has multiple sclerosis (MS), nail problems can cause pain or discomfort. While nail issues are not directly related to the disease, determining the cause may help prevent a person with MS from experiencing further discomfort.