Magnetic resonance imaging (MRI) is the gold standard imaging technique for the identification of demyelinating lesions which can be used to support a clinical diagnosis of MS, and MS can now be diagnosed in some patients after a clinically isolated syndrome (CIS) using new MRI diagnostic criteria.
MRI, which can reveal areas of MS (lesions) on your brain, cervical and thoracic spinal cord. You may receive an intravenous injection of a contrast material to highlight lesions that indicate your disease is in an active phase.
MRI scan. An MRI scan is a painless scan that uses strong magnetic fields and radio waves to produce detailed images of the inside of the body. It can show whether there's any damage or scarring of the myelin sheath (the layer surrounding your nerves) in your brain and spinal cord.
The hallmark of MS pathology is the focal demyelinated lesion, or “plaque,” present in the white matter of the optic nerves, brain, and spinal cord.
Here's where MS (typically) starts
You may experience eye pain, blurred vision and headache. It often occurs on one side and can eventually lead to partial or total vision loss. Spinal cord inflammation, or what's called partial transverse myelitis, is the second most common symptom Shoemaker typically sees.
Vision problems
In around 1 in 4 cases of MS, the first noticeable symptom is a problem with one of your eyes (optic neuritis). You may experience: some temporary loss of vision in the affected eye, usually lasting for days to weeks.
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 erythematosus, Sjogren's syndrome, vitamin and mineral deficiencies, some infections and rare hereditary diseases.
Can I have multiple sclerosis for years and not know it? Yes. MS can go undetected for years. Research has suggested that many patients experience MS-related symptoms and signs several years before receiving a definite diagnosis of the disease.
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.
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.
Sjogren's syndrome is an autoimmune disease that can mimic some of the symptoms of MS such as fatigue and joint pain. However, Sjogren's syndrome is known to cause dry mouth and eyes, which are not associated with MS.
Lupus and Other Autoimmune Diseases
Several autoimmune diseases have symptoms that mimic those of MS. An autoimmune disease is one in which your immune system attacks your body's tissues and organs. One of the more common autoimmune conditions is lupus.
If you are deficient in vitamin B12 you can get symptoms that are similar to some of the symptoms of MS, such as fatigue, weakness, numbness or tingling and problems with memory.
Some people are told they have benign MS. The term benign MS is sometimes used to describe a version of relapsing remitting MS with very mild or no attacks separated by long periods with no symptoms. 'Benign' means 'something doesn't cause any harm'.
Outlook. The outlook for benign MS isn't clear. Some people who are diagnosed with it never go on to have a more serious disease progression, while others do. Remember, just because you have mild symptoms when you're first diagnosed with MS doesn't mean that they'll stay that way.
These factors may increase your risk of developing multiple sclerosis: Age. MS can occur at any age, but onset usually occurs around 20 and 40 years of age. However, younger and older people can be affected.
Characteristics of the MS gait pattern
You may walk more slowly, with shorter steps. You may lack in confidence when you walk – leading to hesitation and stumbling. You might feel unsteady when turning or walking. You might find placing your foot on the ground difficult.
Therefore a careful combination of clinical examinations, MRI scans and lumbar punctures are required. To differentiate MS from other similar neurological conditions, most neurologists use what is called the McDonald criteria.
Factors that may trigger MS include: Exposure to certain viruses or bacteria: Some research suggests that being exposed to certain infections (such as Epstein-Barr virus) can trigger MS later in life. Where you live: Your environment may play a role in your risk for developing MS.
The early signs and symptoms of MS can be the same for women and men. 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.
My brain goes fuzzy, I can't think clearly, my speech slurs and my eyesight goes. Swallowing becomes more difficult, my balance gets worse and my legs feel heavy and clumsy. Unlike the limits of normal, everyday tiredness, which may give a little when pushed against, MS fatigue can feel like a barrier.
Disease Course of MS Is Unpredictable
A person with benign MS will have few symptoms or loss of ability after having MS for about 15 years, while most people with MS would be expected to have some degree of disability after that amount of time, particularly if their MS went untreated.
The case for Epstein-Barr virus (EBV)
The studies found that: Antibodies (immune proteins that indicate a person has been exposed) to EBV were significantly higher in people who eventually developed MS than in control samples of people who did not get the disease.
Of the infectious diseases that are most commonly mistaken for MS the clinician should take into account Whipple's disease, Lyme disease, Syphilis, HIV/AIDS, Brucellosis, HHV-6 infection, Hepatitis C, Mycoplasma and Creutzfeld-Jacob disease, among others.