Diagnosing Multiple Sclerosis
Multiple sclerosis is a disease of neurological origin in which myelin producing cells (also called oligodendrocytes) get affected. There is an autoimmune attack in the cells in this illness.
The disease is more common in females, higher in temperate climates and in people of European origin. Genetic influence is also suggested with susceptible increase in first degree relatives. It is multifactorial in origin.
Clinical signs and symptoms
In multiple sclerosis, initially the patient feels weakness, numbness, tingling and unsteadiness in the limbs. Retrobulbar neuritis, diplopia, urinary troubles as urgency and hesitancy are also seen. After a few days symptoms may disappear spontaneously.
There are several forms of multiple sclerosis like:
Relapsing and Remmiting type
It is the most common type. There is an interval of several months after the initial episode, before the new symptoms develop or the original one reoccurs.
Secondary Progressive type
Optic atrophy, nystagmus, dysartheria, sensory or cerebellar deficits in some or all the limbs are seen. In some patients, the clinical course changes and steady deterioration occurs.
Primary Progressive disease
It is a less common variety, which is steadily progressive from onset. The disability develops in early stage only.
Investigations
MRI of brain and cervical region is helpful in detecting the presence of multiplicity of lesions. CT scan and laboratory examinations are also done.
Definite diagnosis is made in the patients with relapsing and remitting course with evidence of atleast two lesions involving different regions.
Probable diagnosis is made in patients with multifocal disease with only one clinical attack, or those with history of atleast two clinical attacks and sign of only one lesion.
Diagnosing MS is a difficult job and it should not be diagnosed unless there are two or more regions affected at different times.
Treatment
Recovery from acute relapses may be achieved with corticosteroids.
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