A doctor suspects Multiple Sclerosis (MS) when a patient presents with varied neurological symptoms like numbness, tingling, vision problems (blurred/double vision, eye pain), weakness, balance/walking issues, fatigue, or cognitive difficulties, especially if these symptoms appear in different episodes or affect different parts of the nervous system over time, pointing to damage in the brain and spinal cord. Common initial signs often involve optic neuritis (vision loss/pain) or spinal cord inflammation (numbness, weakness, balance problems).
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)
Some of the most common symptoms include:
Other Conditions To Rule Out in Diagnosing Multiple Sclerosis
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.
Babinski Reflex. The Babinski Reflex is often used to test MS. Normally when stimulated with a blunt instrument, the toes naturally respond by pointing downwards. In newborns and some people with nerve damage, the big toe points up and the toes splay outwards.
Tests used to diagnose MS may include: MRI, which can reveal areas of MS on the brain and spinal cord. These areas are called lesions. A contrast dye may be given through an IV to highlight lesions that show the disease is in an active phase.
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.
Magnetic resonance imaging (MRI) and MS
Magnetic resonance imaging scans (MRI) are vital in diagnosing MS and in monitoring and predicting how someone's MS is changing.
MS is not an easy diagnosis to make. In some ways, multiple sclerosis is a “leftover” condition. The primary way medical professionals diagnose someone is by ruling out many other issues, a process known as differential diagnosis.
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.
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.
The diagnostic hallmark of MS is the presence of large confluent demyelinated lesions in the white and gray matter of the CNS (Fig. 1) (Charcot 1880). The most important feature is the selective and primary nature of demyelination with the destruction and loss of oligodendrocytes (Babinski 1885; Prineas 1985).
The exact trigger for Multiple Sclerosis (MS) is unknown, but it's believed to be a combination of genetic predisposition and environmental factors, including certain infections (like Epstein-Barr Virus), low Vitamin D levels (linked to less sunlight), smoking, obesity, stress, and potentially genetic susceptibility. These factors can trigger an autoimmune attack where the immune system mistakenly damages myelin in the central nervous system.
MS Flare-up Symptoms
Multiple sclerosis flare-up symptoms are the same as the general symptoms of MS: Difficulty or urgency using the bathroom. Cognitive difficulties like trouble concentrating, memory problems, brain fog, and difficulty learning new things. Eye pain.
Four common signs of Multiple Sclerosis (MS) are vision problems (like blurriness or double vision), numbness or tingling, fatigue, and balance/coordination issues that affect walking. Other frequent symptoms include muscle weakness, spasms, cognitive changes (memory/focus), bladder/bowel problems, and mood changes like depression.
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.
Research suggests that stress can worsen MS symptoms, triggering flare-ups and increasing fatigue (National Multiple Sclerosis Society). Managing mental health proactively can help stabilize symptoms, improve well-being, and enhance overall quality of life.
Vision problems
The most common problems with vision in MS are optic neuritis and eye movement problems. Optic neuritis is often an early symptom of multiple sclerosis, although you might have problems with your eyes at any time.
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.
More specifically, a brain or head MRI can show if there are any abnormalities in your brain or the surrounding tissues, including, but not limited to: Inflammation and swelling. Structural issues. Abnormal growths or masses.
A neurological examination typically assesses movement, sensation, hearing and speech, vision, coordination, and balance. It may also test mental status, mood, and behavior. The exam is usually done in a provider's office.
Your healthcare provider will review your symptoms and medical history. Tests may include blood work, MRIs of the brain and spinal cord, and spinal fluid analysis. Receiving an official MS diagnosis can take time and may require multiple visits to your provider.
Three key warning signs of Multiple Sclerosis (MS) often involve vision problems (like blurred vision or pain with eye movement), numbness or tingling sensations, and fatigue, along with balance issues, weakness, and coordination difficulties, though symptoms vary widely and can include cognitive or bladder problems too.