Dr. Hendin shares the most common multiple sclerosis (MS) symptoms and explains how this condition is diagnosed.
The way we diagnose multiple sclerosis is by taking a good history in a population that we think is a susceptible population. So for example, if a 25-year-old woman presented to her neurologist with one of these typical symptoms, which I discussed earlier, such as loss of vision in one eye or double vision or incoordination or numbness and weakness below a certain level involving the legs and arms, a neurologist would say this is a possible first episode of MS, a first episode of multiple sclerosis, to the extent that further history taking suggest that this wasn’t the first attack, but rather that attacks that occurred earlier we’d fulfill the criteria of multiple sclerosis - more than one attack in more than one part of the nervous system.
We try to make the diagnosis earlier and earlier today so that we can treat earlier. We think that earlier treatment makes it more likely that we will prevent disability down the line. So neurologists are keeping a much lower threshold for making that diagnosis.
After taking the history we do an examination. Examination looks to those areas that were problematic, and then classically there are some laboratory tests, almost always that includes an MRI scan, sometimes that includes a spinal fluid evaluation, and sometimes some other tests as well.
The classic symptoms of MS tend to be loss of vision, painful loss of vision in one eye called optic neuritis, things that refer to the brainstem and cerebellum, the back of the brain, double vision, incoordination, numbness on one side of the body, weakness on one side of the body, or alternatively, problems that relate to a spinal cord attack or episode, numbness and weakness of the arms and legs, trouble walking.
About Dr. Barry Hendin, M.D.:
Dr. Hendin is a graduate of the Washington University School of Medicine. He completed his neurology residency at Barnes Hospital in St. Louis. He is board certified by the American Board of Psychiatry and Neurology where he has served as an examiner for the Board for more than 30 years. He is a member of the American Academy of Neurology where he had been honored as a fellow.