Multiple sclerosis – How is MS diagnosed?

New Multiple Sclerosis Treatment
New Multiple Sclerosis Treatment

[Original article on NHS Choices website]

It can be hard to tell whether your symptoms might be caused by multiple sclerosis (MS) at first, as some of the symptoms can be quite vague or similar to other conditions.

See your GP if you think you have symptoms of MS. Letting them know about the type and pattern of symptoms you’re experiencing in detail will help them determine whether you might have the condition.

If your GP thinks you could have MS, you should see a neurologist (a specialist in conditions of the nervous system) for a specialist assessment.

Tests for MS

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 one “attack” of MS-like symptoms. A diagnosis can only be made with confidence once there’s evidence of at least two separate attacks, although this may include signs of attacks on an MRI scan that you may not realise you have had.

Some of the tests you may need to confirm MS are outlined below.

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.

Magnetic resonance imaging (MRI) scan

A magnetic resonance imaging (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. Finding this can help confirm a diagnosis in most people with MS.

A standard MRI scanner is like a large tube or tunnel. The machine is noisy and some people feel claustrophobic while the scan is done. Tell your neurologist if you’re worried about this.

Newer scanners are more open and work quicker than those used in the past, and most people have scans without any problems.

Evoked potential test

There are several types of evoked potential test.

The most common type assesses how well the eyes work. Light patterns are shown to the eyes while your brainwaves are monitored using small, sticky patches called electrodes placed on your head.

It’s a painless test and can show whether it takes your brain longer than normal to receive messages.

Lumbar puncture

lumbar puncture is a procedure to remove a sample of your spinal fluid by inserting a needle into the lower back. Spinal fluid is the fluid that surrounds your brain and spinal cord, and changes in the fluid can suggest problems with the nervous system.

The procedure is done under local anaesthetic, which means you’ll be awake, but the area the needle goes in will be numbed. The sample is then tested for immune cells and antibodies, which is a sign that your immune system has been fighting a disease in your brain and spinal cord.

Lumbar punctures are very safe, but are often uncomfortable and can cause a headache that occasionally lasts for up to a few days.

A lumbar puncture will often be performed to provide extra information if your symptoms or scans are unusual.

Blood tests

Blood tests are usually performed to rule out other causes of your symptoms, such as vitamin deficiencies or a very rare, but potentially very similar, condition called neuromyelitis optica.

Determining the type of MS

Once a diagnosis of MS has been made, your neurologist may be able to identify which type of MS you have.

This will largely be based on:

the pattern of your symptoms – such as whether you experience periods when your symptoms get worse (relapses) then improve (remissions), or whether they get steadily worse (progress)

the results of an MRI scan – such as whether there’s evidence that lesions in your nervous system have developed at different times and at different places in your body

However, the type of MS you have often only becomes clear over time because the symptoms of MS are so varied and unpredictable. It can take a few years to make an accurate diagnosis of progressive MS, as the condition usually worsens slowly.

Brain
The brain controls thought, memory and emotion. It sends messages to the body controlling movement, speech and senses.
Inflammation
Inflammation is the body’s response to infection, irritation or injury, which causes redness, swelling, pain and sometimes a feeling of heat in the affected area.
Lesions
A lesion is an abnormal change in an organ or body tissue because of injury or disease.
MRI
MRI stands for magnetic resonance imaging. It is the use of magnets and radio waves to take detailed pictures of inside the body.

Why do young people with Type-2 Diabetes go on to develop heart damage?


Diabetes Awareness
Diabetes Awareness
A new study led by a research team at Leicester’s Hospitals hope to reveal, using magnetic resonance imaging (MRI), why young people with Type-2 diabetes develop heart damage.

The research team, led by Dr Gerry McCann, Consultant Cardiologist at Leicester’s Hospitals and NIHR Fellow and Professor Melanie Davies, Honorary Consultant at Leicester’s Hospitals, Director of the Diabetes Centre and Professor of Diabetes Medicine at the University of Leicester, are going to use MRI scanning to determine what causes early heart failure in 100 younger adults with diabetes.

The study will randomly allocate patients to different treatment arms. The first group will receive optimal blood sugar lowering treatment and lifestyle advice. The second, a very low calorie diet and the third, moderate intensity exercise training. The research team hope that conducting MRI scans throughout this period will indicate whether early heart damage can be completely reversed.


Dr McCann stated “Patients with diabetes are four times more likely to develop heart failure and other circulation problems. Younger diabetics have the greatest life-time risk of complications and death. It is essential that we develop tools to diagnose heart failure early and effective treatments to prevent this serious life threatening condition progressing. This NIHR award will see Leicester’s cardiovascular and diabetes research units working together to combat heart failure developing in patients with diabetes.”

It is hoped that by using the evidence produced by the MRI scans to compare the different treatment methods, it will lead to better treatments that prevent hospitalisation with heart failure and premature deaths.

Prof. Davies noted “We have seen a dramatic increase in the numbers of people developing Type-2 diabetes at a younger age. Our previous work has shown that younger people already have evidence of heart damage. We want to see if we can intervene and reverse these really worrying changes.

I am delighted that we have been awarded this prestigious award funding to allow us to carry out this important and innovative work in Leicester.”

Water and Walking! Have you any advice for somebody who has just been diagnosed with multiple sclerosis? Check out the results of our recent Vox Pop

 Multiple Sclerosis Support
Multiple Sclerosis Support
As you may know one of our objectives when we set up this blog is to provide a place for people with multiple sclerosis to share their tips and advice.

This is very important for people undergoing tests for multiple sclerosis or who have just been diagnosed with MS.

So last week we asked the members of our Facebook page MultipleSclerosisTalk to share their answers to the following question “Have you any advice for somebody who has just been diagnosed with multiple sclerosis?”

We have shared a number of the comments below. It would be great if you could add your thoughts and ideas in the comments box below.

“I’m 26 just got diagnosed 2 months ago and the doctors told me that they were shocked I could even walk because my MRI looked so horrible, so me being the Irish red head that doesn’t listen to anyone went straight home from the hospital and started walking! I have lost close to 60 lbs on my own. I HAVE MS BUT MS WILL NEVER HAVE ME!”

“So, YOU have MS…it doesn’t have you. Your attitude will make all the difference….you can choose to be handicapped, or a person with a physical challenge… Choose to smile and live the life you are given…it could be worse.”

“Have a positive attitude , very important . Drink plenty of water and keep moving , lots of walking ! Don’t let it bring you down , be a fighter you can do it ! Good luck and God bless ”

“Go to the MSAA website (mutiple sclerosis association of America)…. They give the best nonBiased advise…. It has been 12 yrs since diagnosis, I’m 42, and have a 5 yr old son. Keep up the fight! No matter what!!”

“Learn sign language to help with the hand tremor and the depression because it gives you something to do”

“Do your research but remember no 2 people are the same. Don’t stress because that makes it worse. You will be ok, take it easy on yourself & breathe.”

“My daughter has found Yoga to be a tremendous help emotionally and physical”

“Every case of MS is unique. Be careful when reading and researching to not compare yourself to everybody else. You may cause yourself terrible heartache and worry if you do this (as if having MS is not already bad enough…) The things that help me are to eat healthy, get plenty of vitamin D, exercise regularly, and to take my disease modifying drugs. I also have a great group of people around me for support. It’s not a battle I have to fight alone. I hope this helps someone out there ”

“Immediately get into hydrotherapy! I don’t care what the symptoms are physically. The whole reason I’m not in a permanent chair is because of the pool. Also look into the Swank diet for nutrition. I’ve had damn near everything this f’n disease can throw at us and I’m still holding on. Internally and externally. Also, learn to laugh at this disease. Making fun of myself and having family and friends do it has been a saving grace. Trust me! Best of luck to all of us!”

” I encourage people to make healthy life style changes…be positive…start drinking lots of water… walking…decrease processed foods and increase fresh dark and colorful veggies and fresh fruits to your diet. Try to eliminate all gluten sugar and breads etc…to help with the inflammation. And start taking vitamins. A great book to read for health Is The Wahls Protocol…by Dr Terry walhls.”

So health food, lots of water and exercise seem to be key

But what is your advice?

What advice would you give to a person who had just been diagnosed with fibromyalgia?

Advice for people with fibromyalgia
Advice for people with fibromyalgia

As many of you know by now one of the objectives of this blog is to provide a space where people with fibromyalgia can share their experiences.

So to facilitate this we ran a Vox Pop on our Facebook page FibromyalgiaTalk. Vox Pops are where we start a conversation on the page and then share the results here on the page.

So a couple of days ago we asked our members the question “What advice would you give to a person who had just been diagnosed with fibromyalgia?”

The results were very interesting and we would like to thank everyone who took part. One of the most liked comments and one I think is very true was:-

“Educate yourself and don’t depend on the info just from your doctor.”

But also

“Take one day at a time. If it’s a bad day, be kind to yourself, tomorrow may be better. Try to be positive when you can, it stops you going crazy, and surround yourself with good people, who understand what “it’s just a bad fibro day! ” means. These things take time, but you can get there. Never lose hope”

“Stay as strong as you can and read read read up on Fibromyalgia … and pace yourself… and last but not least join groups like this one and talk to others that CAN relate. ♡”

” When you need rest, then rest! It will perk you up more than anything to give your body the rest it needs. I might go a day or two where I sleep so much it’s crazy, but I will finally wake up and feel so much better. Take care of yourself, period!”

“Sudden weather changes, it can be cold or hot. Rain, snow, etc. it can be near or far (barometric) , air and fans can be a killer and any artificial sweaters or caffeine can affect you.”

“Get regular massages! Find a therapist who specializes in pressure points.Don’t feel guilty. It’s not a luxury or indulgence, it’s necessary!”

” It will take a while to get the mix of meds right…be greatfull for everything good in yer life because that is what gets you through the bad times. Love and do as much as ya can because there will be a day you will not be able to do those things. Keep this in yer thoughts it won’t always work but it helps 80-90 percent of the time.
Laugh when you can
Apologise when you need to
And let go of things you cannot change”

” Don’t stop pushing yourself and insist on living a full life. Go to work and take full part of family life. If you ever stop, you want begin again. Take your meds, get enough rest, and for the most part, ignore the pain.”

” Dont compare yourself to another because no two cases are alike plus no one has your body! You have to pay attention to your self for your triggers, how long you can do this and that for. Finding the right meds, doctors, holistic helps more then people think. The key is you! If you know something us not right, but the doctor tells you otherwise don’t listen. You know your body better then anyone keep fighting for what you know in your heart. I learned a lot about spirit, prayer, love is easier to carry then hate. We have to heal ourselves, because the doctor’s can’t do it only manage. Please bypass the angry why me phase and start on spirit learn about your chakras. Fibro might not even be your right diagnosis research everything you can to heal your, spirit, mind, and body”

” Find yourself a great rheumatologist (they specialize in inflammatory disorders such as fibro and lupus). Educate yourself, then your family and friends! Try new things (meds, yoga, foods). Do what’s best for your body. Keep fighting and soft hugs! Xoxoxo”

“Get MRIs in the trigger point areas to rule out disc degenerative disease. Because I’m pretty positive your going to have it. I’m not convinced Fibro is an actual disease. They say i have it , all 18 trigger points, but I’ve had MRI in each location and I’ve got osteoarthritis, disc degenerative, protruding discs all or at least 1 of the above. I am pretty sure its just a name they made up for folks who have too much going on in the body to fix. This way they don’t have too.”

“You know more about your illness than a doctor. YOU are the expert not them. Also, animals are fantastic to have around”

and finally

“Don’t despair as you’re not alone “

So what would your advice be?

Please feel free to share in the comments section below.

Thanks for reading and sharing!