Multiple sclerosis (MS) can present different symptoms in different people at different times and the process of diagnosis can be a lengthy one for some.
How is MS diagnosed?
Formal diagnosis is based on a number of things such as looking into medical history, neurological examinations and a series of tests. Other conditions need to be ruled out before a diagnosis can be confirmed.
In October 2014, the National Institute of Health and Care Excellence (NICE) issued new guidelines for the management of multiple sclerosis, including guidelines for the steps medical advisors, such as GPs and neurologists, should take to reach (or exclude) a diagnosis of MS.
NICE states that the most common symptoms or ‘clinical presentations’ a person would visit their GP with are:
- Loss or reduction in vision in one eye, with painful eye movements
- Double vision
- Ascending sensory disturbance or weakness (a change in sensation or strength that moves up the body)
- Balance problems or clumsiness
- Altered sensation travelled down the back when bending the neck forward called Lhermitte’s Syndrome, this can feel like a finger being run down the spine, or a tingling feeling
NICE also suggests that, to be recognised as a symptom of MS, these should last over 24 hours and may have persisted over several weeks or months.
If you are experiencing symptoms, it is important to make an appointment with your GP to discuss them.
Only a neurologist can make the diagnosis of MS. A neurologist will perform tests to ensure that symptoms are consistent with an inflammatory process in the body and that all other alternative diagnoses have been excluded.
You may undergo a series of tests during your diagnosis journey, including:
- Blood tests
- MRI scanning
- Lumbar puncture
- Evoked potentials
Questions to ask your health professional
Here is a list of questions you could ask your health professional about multiple sclerosis, including questions about medication and treatment options.
The McDonald Diagnostic Criteria
The McDonald Criteria are used to seek to establish evidence of damage to the central nervous system (CNS) comprising of the brain and spinal cord.
The MRI, together with the lumbar puncture in some cases, provides the evidence to be reviewed alongside the McDonald criteria to diagnose MS.
What causes MS?
Although it is not yet certain why people develop MS, research suggests that combinations of genetic and environmental factors are involved:
MS is not directly inherited; however there does appear to be a genetic component – possibly a combination of certain genes – which makes people more susceptible. Family members of someone diagnosed with MS have a slightly higher chance of developing MS themselves.
Studies have found that the further north from the equator you live, the higher the chance of developing MS. It appears that there is a higher rate of MS in the UK (MS is more common in Scotland than in the rest of the UK), North America and Scandinavia but a very low chance in countries like Malaysia which are very close to the equator.
Some research suggests that there is a link between MS and vitamin D deficiency. Vitamin D mostly comes from exposure to sunlight so this could be a factor. Research on this matter is on-going.
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