If you suspect you have Multiple Sclerosis (MS), you should first see your General Practitioner (GP) to discuss your symptoms, who will then refer you to a neurologist, a specialist in the brain, spinal cord, and nerves, for proper diagnosis and treatment. A neurologist uses specific criteria (McDonald criteria) and tests like MRI scans to confirm MS, as it can only be diagnosed by a specialist.
MS is diagnosed by a specialist doctor called a neurologist. They'll use a detailed checklist to diagnose MS, known as the McDonald criteria.
Biomarkers are molecules and signs, often in spinal fluid, blood or imaging. They signal disease and are used in diagnosis because they can be measured accurately and repeatedly. At this time, no symptoms, physical findings or laboratory tests can, by themselves, prove that you have multiple sclerosis.
Some of the most common symptoms include:
While this might sound easy to determine, there is still no single clinical test to provide a definitive diagnosis. Therefore a careful combination of clinical examinations, MRI scans and lumbar punctures are required.
Diagnosis of MS
A GP will ask about your symptoms and may arrange for you to have blood tests. If they think you may have MS, your GP will refer you to a neurologist, a doctor who specialises in conditions that affect your nervous system. Your neurologist will ask questions about your symptoms and general health.
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.
Ms. – Can be used for any woman over the age of 18. So when in doubt, you can always use this.
Invisible symptoms of MS – fatigue, pain, blurred vision, numbness, and brain fog – which often go unnoticed by other people, can also interfere with daily functioning and be just as debilitating.
The exact cause of Multiple Sclerosis (MS) is unknown, but it's triggered by a combination of genetic susceptibility, environmental factors (like low Vitamin D, infections, smoking, and stress), and immune system dysfunction that leads the body to attack its own nervous system. Triggers that can worsen existing MS include heat, infections, stress, lack of sleep, and childbirth, while factors like smoking, obesity, and low sun exposure increase risk or severity.
Early signs and symptoms of MS include: Changes to your vision (optic neuritis, double vision, vision loss) Muscle weakness (usually affecting one side of your face or body, or below your waist) Numbness or abnormal sensations (usually affecting one side of your face or body, or below your waist)
Ocrelizumab (Ocrevus).
This medicine is approved by the FDA to treat both the relapsing-remitting and primary-progressive forms of MS. This treatment reduces the relapse rate and the risk of disabling progression in relapsing-remitting multiple sclerosis.
Fatigue in MS is not just an ordinary tiredness, like you might get at the end of a hard day's work. People describe it as an overwhelming sense of tiredness with no obvious cause.
If your GP suspects you have a neurological condition like MS, they'll refer you to a neurologist. Or you might see a neurologist if your symptoms get treated at hospital. Suspected cases of MS should be seen by a specialist as soon as possible.
Fibromyalgia is often diagnosed and managed by a rheumatologist, which is an internal medicine doctor who has specialized training in joint and musculoskeletal diseases. Multiple sclerosis is diagnosed and managed by a neurologist, which is a doctor who specializes in treating disorders of the brain and nervous system.
New therapies are emerging
Ublituximab-xiiy (Briumvi) was approved by the FDA in 2022. It is used to treat relapsing-remitting and active secondary-progressive forms of MS. Ublituximab-xiiy is given in a vein and stops certain immune system cells from making antibodies that may damage the brain and spinal cord in MS.
What are the early symptoms of MS?
Stage 1 - Clinically Isolated Syndrome (CIS) or Relapsing-remitting Multiple Sclerosis (RRMS) Relapsing-remitting MS (RRMS) is characterised by distinct episodes of symptom flare-ups, known as relapses or exacerbations, followed by periods of partial or complete remission where symptoms improve or disappear entirely.
You cannot test yourself for MS at home. Medical professionals and equipment are needed for an accurate diagnosis. However, tracking and recording your symptoms can help doctors understand what you are experiencing and the conditions that may be linked.
Numbness and tingling can occur in your feet, legs, hands, arms or face. In my example, it started in my feet and then spread to my legs.
Other more advanced symptoms include hand weakness, wrist drop (difficulty raising hand), curling fingers, poor sensation. You may notice that you drop items or have difficulty gauging how to pick up an item.
The first signs of Multiple Sclerosis (MS) often involve vision problems (like blurred or double vision, pain with eye movement), sensory changes (numbness, tingling, pins and needles), and balance issues (dizziness, unsteadiness). Other common early symptoms include overwhelming fatigue, muscle weakness, stiffness, spasms, cognitive difficulties (memory/concentration), and bladder/bowel problems, though symptoms vary greatly from person to person.
Neuromyelitis optica is often misdiagnosed as multiple sclerosis, also known as MS, or is seen as a type of MS . But NMO is a different condition. Neuromyelitis optica can cause blindness, weakness in the legs or arms, and painful spasms.
The symptoms can be similar, but people with fibromyalgia are more likely to experience depression, irritable bowel syndrome, and widespread, persistent pain. Symptoms more common with MS include weakness, vision problems, muscle spasms, and bowel or bladder issues.
The "worst" autoimmune diseases are subjective but often cited for severity, impact on life expectancy, or organ damage, with top contenders including Giant Cell Myocarditis (highly fatal), Vasculitis (damages blood vessels), Systemic Lupus Erythematosus (Lupus) (multi-organ), Multiple Sclerosis (MS) (nervous system), and Type 1 Diabetes (pancreas, life-long management). Other severe conditions include Scleroderma and Myasthenia Gravis.