Multiple Sclerosis: Diagnosis and Treatment

Multiple Sclerosis (MS) can be a devastating disease. Over time, patients with this immune-mediated disease  have progressive symptoms and may become disabled. In the elderly population, it is key to understand treatment options and each patient’s prognosis. This article will pick up from our last article on multiple sclerosis and will cover the initial diagnosis of MS, the different types of treatment options, and how to live fully with MS.

Multiple sclerosis - Word CloudDiagnosis of MS

Multiple sclerosis is extremely difficult to diagnose. So far, there has not been one diagnostic tool found that can specifically be utilized to diagnose MS. For this reason, many doctors are hesitant to diagnose a patient with MS by their symptoms alone. Instead, doctors look at a patient’s symptoms and complaints, their medical history, their neurological findings and various tests to compile a broad overlook of a patient’s health. This allows doctors to fully assess the patient and determine if they do or do not have MS. The tests that physicians run often include tests that will determine the patient’s mental and physical functions. Patients may also receive blood tests in order to rule out other disease processes. Plus, numerous diagnostic images may be taken to look at the patient’s central nervous system. MRI images and CT scan images are often employed to look at a patient’s brain. Other tests that physician’s may run include a spinal tap to test the patient’s cerebral spinal fluid and an evoked potential test that can check the electrical activity of a patient’s brain.

Once the physicians have ran their abundance of tests, they will look over all of the tests and utilize the following criteria to determine if a diagnosis of MS is possible. To diagnose a patient with MS a doctor must:

  • See evidence of damage in two different areas of the central nervous system, and
  • Ensure that the damage occurred at least one month apart and the damage did not occur at the same time, and
  • Rule out every other type of neurological disorder that could cause the damage found.

This criterion for diagnosing MS is known as the Revised McDonald Criteria and it has been used for many years to diagnose patients with MS. The most vital part of diagnosing the disease is to see that there has been damage to the myelin sheaths surrounding nerve fibers in the central nervous system. The damaged areas are known as lesions, and can occur anywhere in the central nervous system. Depending on where the lesions occur, the patient could show a myriad of symptoms, and it is up to the doctor to correlate the patient’s symptoms with the placement of their lesions. If after undergoing numerous tests, the patient does fit into the criteria above, then they will be given a diagnosis of MS. Next, they will have to be classified as having a certain type of MS. At first, most patients are diagnosed with Relapsing-remitting MS. This is the most common type of MS, and is characterized by time periods of flare-ups and periods of remission. As a patient’s disease progresses and physicians see how they react to treatment, the physician could change the patient’s type to any of the other three types.

Treatment of MS

Multiple sclerosis does not have a cure, and thus its treatment is focused on managing the disease. Managing MS is a complicated process that may change drastically over the course of your disease. As more symptoms become apparent, your treatment plan could change to help you function easier and to diminish your symptoms. The first step in finding the appropriate treatment for your disease is to get a diagnosis. Once you have been diagnosed, it is vital that you find a doctor with whom you feel comfortable. The right doctor can help you navigate through your disease process and help you feel comfortable with your treatment plan and your health.

Multiple sclerosis is treated in a comprehensive manner. Due to its complexities, it must be treated by many health care providers. MS patients will have one specific neurologist, but they may have many doctors and health care providers working behind the scenes on their case. Along with your doctor, this team will help fight your MS by trying to modify its disease course, treating the flare-ups, managing your symptoms, helping you retain your functions, and providing emotional support.

Modifying your disease process is key to keeping your disease at bay. Through disease-modifying medications you can reduce the frequency and the severity of your MS flare-ups. This will help you to retain functions and keep your symptoms reduced. While taking these drugs, you will have to undergo diagnostic imaging tests to ensure that you do not have any more lesions growing in your central nervous system.

Flare-ups will happen in patients with MS. Unfortunately; flare-ups can be debilitating and can last for a variable amount of time. During a flare-up, your team will work hard to get your body back to a homeostatic level and put you back into remission. Corticosteroids are often employed to help put you back into remission.

Once lesions have occurred, you will have some symptoms. They could range from slight to severe loss of function. To help improve your quality of life, your team will provide rehabilitation strategies and medications to help you manage your symptoms. Rehabilitation can help both manage your symptoms and retain functions as your disease progresses.

Finally, your team will help you emotionally. MS can be a hard disease to process, and its key to your health that you stay in good spirits.  Emotional health can be addressed in therapy sessions.

Living with MS

The treatment plan for MS can often be daunting, especially since it is so multi-faceted. However, following a treatment plan is vital to maintain a high quality of life. If you have been diagnosed with MS and feel overwhelmed, then talk about your fears with your doctor. They can help you find peace with your diagnosis and help you live a fulfilled life. Living with MS may seem impossible, but in reality, with the right treatment plan, you can live a fairly normal life with your family and friends. Simply watch your symptoms closely, and always listen to your doctor’s advice about your health.