Learn About MS

A set of diagnostic parameters, known as the McDonald Criteria, makes the process easier and more efficient in diagnosing MS in new patients. To fulfill a definite diagnosis of MS, an individual must have met the following criteria:

• Evidence of damage in at least two separate areas of the central nervous system (CNS), including the brain, spinal cord, and optic nerves.
• Evidence of damage occurring at least one month apart.
• All other possible diagnoses have been ruled out.

If an individual does not meet all the criteria, the case will not be considered MS.

The first step in diagnosing the disease is thoroughly reviewing your medical history. During this time, your healthcare provider will gather information about birthplace, family history, environmental exposures, and other illnesses that may meet any risk factors for MS.

Along with your medical history, a physical and neurological exam is used to confirm MS symptoms while testing the nerves that control your vision, strength, and hearing.

The medical history and exam can often provide enough evidence to meet the diagnostic criteria. However, additional testing may be necessary to confirm the diagnosis further or rule out other conditions that may cause symptoms like MS.

MRI scans

An MRI is the best imaging technology to detect scarring or MS plaques in different parts of the central nervous system (CNS). This test can also distinguish old MS plaques from those currently active or new ones.

Visual evoked potential (VEP) tests

An Evoked potential (EP) test records the nervous system’s electrical response to stimulation to isolated sensory pathways such as visual, auditory, or general sensory. Because slowed response time results from damage to myelin, EPs can often find the existence of scarring along nerve pathways, something neurological exams may miss. Visual evoked potentials are found to be most useful in confirming MS diagnosis.

Spinal fluid analysis

A spinal tap can reveal whether you have any antibodies linked to MS. It can also work like a blood test to rule out other diseases and infections that cause similar symptoms.

Blood tests

While there are no definitive blood tests for diagnosing MS, they can rule out other conditions that may mimic MS symptoms, including Lyme disease, collagen-vascular diseases, rare hereditary disorders, and acquired immune deficiency syndrome (AIDS).

Many people often ask, “How do you get MS?” While the cause of MS is still unknown, scientists believe that certain genetic makeups are more predisposed to MS, and when exposed to certain environmental factors, can trigger the change in the immune system that causes MS.

Genetics

Genes play a role in MS, but they are only part of the story. While there’s no single gene that will cause someone to develop MS, having certain genes can make a person more susceptible.

Environments

Your environment may play a role in your risk for developing MS. For example, locations farther from the equator have higher rates of MS, possibly due to less intense sun exposure and lower vitamin D levels.

Infections and viruses

Many latent viruses and bacteria, such as measles and Epstein-Barre virus (the virus that causes mononucleosis), may play a role in triggering MS symptoms and disease activity.

Lifestyles

Lifestyle factors, like smoking and obesity in childhood, adolescence, and early adulthood, are linked to increasing a person’s risk of developing MS.

The most common MS symptoms tend to indicate early signs of MS and can occur alone or in combination with other symptoms such as:

• Fatigue
• Heat intolerance
• Sensory dysfunction (such as numbness, stiffness, dizziness, or vertigo)
• Pain
• Motor dysfunction (such as muscle weakness, muscle spasticity, or impaired motor control)
• Bladder dysfunction
• Bowel dysfunction
• Vision (such as blurred vision, poor contrast, pain, optic neuritis, or other impairments)
• Sexual dysfunction
• Cognition (such as problems processing information, learning new information, problem-solving, focusing, or understanding the environment)
• Mood (such as depression, mood swings, anxiety, laughter, crying, or irritability)

• Speech disorders include slurring and dysphonia
• Swallowing problems or dysphagia
• Hearing loss
• Seizures
• Tremors
• Breathing problems

If you are experiencing early MS symptoms that are out of the ordinary and last for more than 24 hours, make an appointment to see your doctor or specialized MS care team for investigation and diagnosis. Early diagnosis and treatment can help manage symptoms, slow disease progression, and enhance overall quality of life.

The MS care team at Shepherd Center has exceptional knowledge and experience treating patients with MS, so we understand how to differentiate the disease from similar conditions. We offer second opinions to confirm your initial diagnosis. We also offer continuation of treatment or adjustments to your medical care plan once you are diagnosed.

The exact cause of MS flare-ups remains unclear. However, several factors contribute to their occurrence. Risk factors such as age, gender, family history of MS, and certain genetic factors can contribute to MS flare-ups. Lifestyle factors like smoking, lack of exercise, and poor diet may also increase the likelihood of flare-ups.

Environmental triggers can also contribute to MS flare-ups. Changes in temperature, particularly extreme heat or cold, can increase symptoms. Exposure to certain infections, such as the flu or urinary tract infections, can also trigger a flare-up. Stress, both emotional and physical, can contribute to flare-ups as it may disrupt the immune system, leading to increased inflammation and symptom onset. Managing stress through relaxation techniques, exercise, and seeking support from loved ones can help minimize stress’s impact on MS.

Varying from mild to severe, MS flare-ups may cause new symptoms and/or the exacerbation of existing symptoms. Some flare-ups produce only one symptom related to inflammation in a single area of the central nervous system. Other flare-ups cause two or more symptoms simultaneously related to inflammation in more than one area of the central nervous system. To be a true exacerbation, the attack must last at least 24 hours and be separated from the previous attack by at least 30 days.

Common symptoms of MS flare-ups include:

• Fatigue
• Dizziness
• Balance and coordination problems
• Vision trouble
• Bladder issues
• Numb or tingling feelings (pins and needles)
• Memory problems
• Trouble concentrating

Managing and preventing MS flare-ups is essential, and various strategies exist to reduce their frequency and severity. A comprehensive treatment plan for managing and preventing MS flare-ups may include various components such as:

• Disease-Modifying Therapies (DMTs)
• Corticosteroids to reduce nerve inflammation
• Plasma exchange (plasmapheresis)
• Infusion treatments
• Oral and injectable treatments
• Muscle relaxants
• Physical, occupational, and/or speech therapy
• Health and wellness strategies

It’s crucial to consult with your healthcare provider before making any changes to your medication, lifestyle, or exercise routine. They can provide personalized advice and develop a comprehensive plan tailored to your needs to effectively manage and prevent MS flare-ups.

At the MS Institute at Shepherd Center, we understand the unique challenges posed by MS flare-ups. Our specialized care is designed to provide comprehensive treatment plans addressing the specific needs of patients experiencing flare-ups. Our team of experienced healthcare professionals is committed to providing high-quality care. We develop personalized treatment plans tailored to individual symptoms and goals.

Our comprehensive treatment plans include medication management, physical therapy, occupational therapy, and counseling services, addressing both the physical and emotional aspects of flare-ups. We believe in collaborating with other healthcare professionals, including neurologists, primary care physicians, and specialists, to ensure patients receive comprehensive and coordinated care.