Multiple sclerosis diagnosis and progression

Multiple Sclerosis – Diagnosis and ProgressionTo determine the presence of multiple sclerosis (MS) disease, various tests are performed. If MS is diagnosed, patients must learn to live with uncertainties about the course of the disease.

Since multiple sclerosis is associated with a wide variety of symptoms, it is not easy to make a clear diagnosis. Therefore, in addition to taking the medical history, a physical and neurological examination and a magnetic resonance imaging (MRI) are performed for the diagnosis. Nerve fluid, blood or urine are also examined to bring more clarity to the diagnosis.

MRI as a standard examination in suspected MS cases

Accordingly, various examinations are performed to establish a diagnosis. The description of the symptoms as well as the results of the physical examination and additional technical examinations are also taken into account. The Magnetic resonance imaging (MRI) is one of the standard examinations when MS is suspected. It can be used to visualize minimal changes in the brain and spinal cord caused by inflammation.

In order to confirm a suspected diagnosis of MS, neurology specialists arrange for an analysis of the cerebrospinal fluid (cerebrospinal fluid). For the so-called cerebrospinal fluid analysis, this fluid is taken from the lower part of the spine with a fine needle. This procedure is called lumbar puncture. In MS sufferers, this fluid shows changes that are indicative of Inflammatory processes in the central nervous system interpret and rule out other diseases such as Lyme disease.

Differentiating multiple sclerosis from other diseases

The differential diagnosis, i.e. the differentiation of multiple sclerosis from other diseases, comprises a large number of diseases. In addition to infectious diseases, other chronic inflammatory diseases must also be ruled out.

MS belongs to the demyelinating diseases, as the layer around the nerve fibers – the so-called myelin layer – is attacked and damaged. Therefore, other inflammatory-demyelinating diseases should also be considered at diagnosis. Metabolic diseases can also lead to similar symptoms. In particular, imaging findings such as those in multiple sclerosis result in.

Course often in relapses

Multiple sclerosis has different forms of progression. The MS relapses are important for understanding the disease and its course, because more than 80 percent of those affected have clearly definable relapses from the beginning. Only about 10 percent of MS patients have slowly increasing symptoms.

A relapse is defined as the occurrence of new or the flare-up of already known clinical symptoms that last longer than 24 hours and are accompanied by a inflammatory-demyelinating disease of the central nervous system.

These acute phases with new or increasing symptoms disappear partially or completely after days to months. Depending on whether the symptoms have completely or incompletely disappeared, one speaks of a complete or incomplete remission. A Remission is the short-term or long-term attenuation of symptoms of a chronic disease.

Between relapses the disease seems to be calm, without increase of symptoms. In about half of those affected, the relapsing course progresses to a further stage after several years. In the progressive MS form there is also a slowly increasing deterioration between relapses.

Uncertain course

Those diagnosed with MS must learn to live with uncertainties. Because the long-term individual course of the disease cannot be predicted exactly. In the long term, about one in five MS patients has a mild course of the disease, even ten years after the onset of the disease hardly any restrictions. Three quarters of MS patients are able to lead their lives independently and largely without aids, even after a long illness.

Multiple sclerosis is not a fatal disease. Fear of dying from multiple sclerosis stems from times when the effects of impairment and disability could not be well treated. Today, however, multiple sclerosis hardly leads to a shortening of life span. For those affected, therefore, the primary concern must be to Quality of life and not to preserve the life span as long as possible.


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