Diagnosing Multiple Sclerosis is often very difficult as many of the symptoms overlap with those of other diseases and conditions. This means it can often take a lot of time and a lot of tests for doctors to get the diagnosis and other conditions usually have to be tested for and ruled out to aide in a correct diagnosis. A doctor will review the patient’s medical history and do a physical exam before recommending one or more of the following tests: blood work, lumbar puncture (also known as a spinal tap), and an MRI. In achieving an MS diagnosis, the MRI is an extremely important tool and is also vital to monitoring the progression of the disease.
MRI scans reveal abnormalities (such as lesions) in the majority (90-95%) of MS patients. Radiologists and neurologists use the MRI scans to search for evidence of new damage, primary lesions, and evidence of chronic damage to the Central Nervous System. The other generally necessary tool in confirming an MS diagnosis is the lumbar puncture. Unfortunately this is made difficult in that an LP is only an effective tool if the patient is currently in the midst of a relapse. The reason an active relapse is necessary is the LP is done specifically to see if the spinal fluid contains bits of myelin floating around; this will confirm MS as the myelin can only be found in CSF if one is in an active MS relapse.
Now you know you have MS – what next? What symptoms are to be expected? Because MS causes communication issues between the brain and body, symptoms can range from inconvenient and irritating to debilitating and sometimes fatal. There is no short and sweet answer for exactly what to expect as this disease has a wide array of possible symptoms and because MS is unique to each individual patient, it is possible to have 20 patients in a room and nobody have a single matching symptom.
The most common (and potentially disabling) symptom is fatigue and affects between 75-90% of patients. Few people understand the magnitude of Multiple Sclerosis fatigue – it is akin to being up for 3 days then running a marathon while juggling newborn kittens and wearing rollerskates. Once you have that lovely visual, realize that you are still not even close to how a person suffering from MS fatigue feels. It drains everything out of you to the point that even listening to someone talk is too exhausting, but sleeping or napping does nothing to improve the feeling.
Some symptoms may not be noticeable in the early stages of the disease while others may cause a severe impact on a person’s quality of life. If untreated, MS symptoms will almost certainly get worse over time. Some very common symptoms are bladder and bowel problems, trouble walking and/or balancing, sexual dysfunction, stiffness, numbness and tingling (which is caused by damage to nerves that transmit sensations from body surfaces to the brain), muscle weakness, muscle spasticity, tremor, speech difficulties, swallowing difficulties, memory problems, vision issues, depression, and anxiety. People with MS may experience a variety of emotional problems like mood swings, stress, pseudobulbar affect (this is when a person spontaneously bursts into crying or laughing that is involuntary and uncontrollable), anxiety, and up to 50% of patients will develop significant depression over the course of their lifetime.
Another common, yet less understood symptom of Multiple Sclerosis is pain and said pain exists in many different forms including, but not limited to: sharp pain, throbbing pain, static or electric shock feeling pain, and pins and needles. Paralysis is one of the most severe symptoms but only affects about 1/3 of patients. Most people with MS are able to maintain mobility, although some may need assistive devices like canes or walkers.