Multiple Sclerosis Symptoms

Multiple sclerosis is a chronic disease of the nervous system, which involves loss of the protective covering of nerves (called myelin). Symptoms are varied but reflect damage to any part of the nervous system. Therefore patients can experience  visual disturbances, weakness, abnormal sensation and balance difficulties. There are several types of the disease: 1) relapsing-remitting: a form in which patients experience discrete attacks interspersed with periods of little to no disease activity. 2)primary-progressive: in which patients experience a slow a constant decline from the time the disease starts, 3)secondary-progressive: in which patients start as a relapsing remitting form and over 10-20 years start to slowly and progressively decline without having discrete attacks anymore.

The disease is diagnosed by a combination of a patients clinical history, neurologic exam and laboratory testing.  MRI scans of the brain show areas of the brain involved with the inflammation, and these areas are known as white matter lesions.  In some cases the changes seen on MRI are so specific that the disease can be diagnosed by this test alone. Unfortunately many people have these white matter lesions and do not have MS. Therefore we may need to use other testing. One of the other tests which is very helpful is a lumbar puncture, or spinal tap.  This relatively simple test allows us to look at disease activity in the spinal fluid. Electrodiagnosis is sometimes used to help in making the diagnosis of multiple sclerosis. A special electrodiagnostic test known as visual evoked potentials are used to study the quality of the main nerve that controls vision (the optic nerve). Multiple sclerosis often affects the optic nerve and visual evoked potentials are usually helpful in detecting these abnormalities.