Diagnosing MS More than 90% of people with MS have scar tissue that shows up on an MRI scan. A spinal tap can check for abnormalities in the fluid that bathes the brain and spinal cord. Tests to look at electrical activity of nerves can also help with diagnosis.
MS brain lesions may appear on the brainstem—the lowest part of the brain right above the spinal cord. Among the symptoms that can appear with MS brainstem lesions are blurred or double vision, trouble swallowing, slurred speech, dizziness, coordination problems, weakness, and decreased sensation.
Brain lesions are a hallmark of MS, but they're not the only way MS can affect your brain function. MS can also contribute to brain atrophy, or shrinkage, over time — a process that occurs in all people as they age, but typically happens much more quickly in people with MS.
For the diagnosis of multiple sclerosis, there should be at least one typical multiple sclerosis lesion in at least two characteristic regions [periventricular (abutting the lateral ventricles), juxtacortical/cortical, infratentorial, spinal cord] to support dissemination in space (Thompson et al., 2018).
When a damaged nerve “short circuits,” it can cause a sharp pain or a burning or squeezing sensation. A common pain in MS is what's known as Lhermitte's sign. “This occurs when there's a lesion on the cervical spine, the neck area of the spinal cord,” says Dr. Scherz.
Signs and Symptoms
Characteristic lesions are located in the periventricular and juxtacortical regions, in addition to the brainstem, cerebellum, spinal cord, and optic nerve.
Lesions may be observed anywhere in the CNS white matter, including the supratentorium, infratentorium, and spinal cord; however, more typical locations for MS lesions include the periventricular white matter, brainstem, cerebellum, and spinal cord.
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.
Most symptoms develop abruptly, within hours or days. These attacks or relapses of MS typically reach their peak within a few days at most and then resolve slowly over the next several days or weeks so that a typical relapse will be symptomatic for about eight weeks from onset to recovery.
The diagnosis of MS cannot be made solely on the basis of MRI because there are other diseases that cause lesions in the CNS that look like those caused by MS. And even people without any disease — particularly the elderly — can have spots on the brain that are similar to those seen in MS.
An MRI scan can detect MS activity early on , sometimes before an individual experiences any worsening symptoms.
People should consider the diagnosis of MS if they have one or more of these symptoms: vision loss in one or both eyes. acute paralysis in the legs or along one side of the body. acute numbness and tingling in a limb.
Context. Progressive myelopathy can be a manifestation of a variety of disorders including progressive multiple sclerosis. However it is extremely uncommon for a single lesion to cause a progressive myelopathy in MS.
MRI plays a vital role in how we diagnose and monitor MS. In fact, over 90% of people have their MS diagnosis confirmed by MRI.
While it is true that almost all people with MS will have evidence of brain lesions on MRI, not all people with brain lesions have MS.
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.
In MS, the term lesion refers to an area of damage or scarring in the central nervous system. Lesions are caused by inflammation or the immune system attacking the myelin sheath on nerves in the brain, spinal cord or optic nerve.
MS lesions developed preferentially in the supratentorial brain, particularly the frontal lobe and the sublobar region.
What Does MS Feels Like? A lack of feeling or a pins-and-needles sensation can be the first sign of nerve damage from MS. It usually happens in your face, arms, or legs, and on one side of your body. It tends to go away on its own.
Thus, MS lesions themselves cannot be felt. Instead, they may induce symptoms that result from tissue damage to the nervous system. The symptoms and signs of MS can vary depending on the particular location of the lesion.
It is also known as neuromyelitis optica (NMO) or Devic's disease. Some of its symptoms are similar to the symptoms of multiple sclerosis, so it may be misdiagnosed as such.
An MRI scanner uses a strong magnetic field to create a detailed image of inside your brain and spinal cord. It's very accurate and can pinpoint the exact location and size of any inflammation, damage or scarring (lesions). MRI scans confirm a diagnosis in over 90 per cent of people with MS.
MS can be present even with a normal MRI and spinal fluid test although it's uncommon to have a completely normal MRI. Sometimes the MRI of the brain may be normal, but the MRI of the spinal cord may be abnormal and consistent with MS, so this also needs to be considered.
MRIs are not a 100 percent positive in the diagnosis of MS. In 5 percent of the people showing clinical MS disease activity, lesions were not visible on the MRI. However, if follow-up MRI studies continue to show no lesions, the MS diagnosis should be reconsidered.