Recognizing the symptoms of multiple sclerosis – how the doctor diagnoses ms

Experts estimate that up to 250 people in Germany suffer from multiple sclerosis.000 people suffer from multiple sclerosis (MS). The chronic inflammatory disease of the nervous system often develops in secret and is usually only recognized at a late stage.

Multiple sclerosis: Why diagnosis is difficult

Because the symptoms of multiple sclerosis (MS) are very complex, diagnosis is difficult and lengthy. In contrast to many other diseases, there are no typical symptoms that are unique to MS. Therefore, no specific test or procedure currently exists to detect MS.

Rather, the diagnosis is made up of several examination steps. The results can be compared to pieces of a puzzle, which in the end form a concrete clinical picture.

Seven misconceptions about multiple sclerosis

Typical symptoms of MS

Multiple sclerosis is also known as" disease with the 1.000 faces" described, as the symptoms can be very varied. Affected people initially see double images, have visual disturbances or feel an indefinable tingling in their feet. Later, depression, visual disturbances, balance problems, sexual and bladder dysfunctions can occur.

The diagnosis of multiple sclerosis can then only be made by a neurologist through comprehensive examinations. When the disease becomes visible to the outside world and patients can no longer walk well or need a wheelchair, the disease is usually already well advanced.

If the first neurological symptoms appear, those affected should contact a doctor as soon as possible. Often the symptoms disappear after a few days. However, only early therapy can halt the progression of multiple sclerosis and positively influence the course of the disease. The autoimmune disease is not curable until today.

Four stages of diagnosis in MS

A confirmed diagnosis for multiple sclerosis is made in stages. The first contact person is the family doctor. If necessary, the physician refers the patient to a specialist, usually a neurologist. The diagnosis is based on four pillars:

1. Anamnesis (recording of medical history) 2. Physical examination (clinical neurological examination) 3. Apparative examinations (magnetic resonance imaging) 4. Laboratory tests (examination of the cerebrospinal fluid, blood tests)

First stage: Medical history

In a detailed anamnesis discussion, the doctor first obtains information about the patient's medical history and possible previous illnesses. The reports help to narrow down the possible causes of the symptoms and to confirm the suspicion of MS. It is also important to know whether the patient or his relatives suffer from an autoimmune disease.

Second stage: physical examinations

Following the preliminary consultation, the doctor checks, among other things, the function of the eyes and the cranial nerves, sensitivity to touch and temperature differences, muscle strength and muscle tension, reflexes and coordination of movement.

One test, for example, consists of the patient moving his index finger from his outstretched arm to the tip of his nose with his eyes closed. Many MS patients have massive problems with this motor exercise. In addition, neurological examinations can also be performed. These test various mental functions such as learning ability, memory and language processing.

recognizing multiple sclerosis symptoms this is how the doctor diagnoses ms

Multiple sclerosis affects patients in many ways.

If an initial suspicion is confirmed, the physician attempts to record so-called evoked potentials. These are electrical voltages that occur in the nerve and muscle cells of the human body when a stimulus is applied externally. This can be used to measure conduction velocity in different sensory systems.

For example, the nerves of the eye are stimulated by a checkerboard pattern. The optic nerve then transmits the visual stimulus to the cerebral cortex. Electrodes are used to measure how quickly the impulse reaches the brain. In this way, it can be determined whether the nerve pathways are intact. A slowed conduction velocity is an indication of multiple sclerosis.

Third stage: magnetic resonance imaging

In the third stage, a magnetic resonance imaging (MRI) scan of the brain and spinal cord is performed. Possible inflammatory lesions or plaques are often found adjacent to the lateral nerve fluid spaces of the organ. Contrast can also be used to distinguish between fresh and older MS lesions.

If the patient suffers from bladder dysfunction , the doctor may recommend a micturition protocol and perform residual urine determination. The patient documents how often he urinates. The doctor also determines the amount of urine that remains in the bladder after urination.

Fourth stage: Lumbar puncture and blood tests

Another important step on the way to diagnosis is the so-called lumbar puncture (CSF diagnostics). During this examination, cerebrospinal fluid is taken from the spinal cord. This is done in the area of the lower lumbar spine. The procedure is performed with a thin, hollow needle and takes only a few minutes.

Evaluation of the nerve fluid sample can reveal inflammation of the brain and spinal cord: If the patient has multiple sclerosis, the number of certain immune cells in the nerve fluid is increased and antibodies can be detected.

Blood tests and urine tests are equally important. They serve above all to exclude other illnesses, which have similar complaints as with MS. Most laboratory values are normal in patients with multiple sclerosis.

Prognosis: MS is incurable so far

In severe MS it often does not remain with the invisible symptoms. A relapse then has the consequence that those affected can suddenly no longer move their arms or legs. It is also possible that the function of the legs remains permanently impaired and the patient needs a wheelchair.

Experts ame that a malfunction of the immune system is responsible for the occurrence of MS. But genetic causes are also suspected. Investigated by researchers. To date, there are no drugs that can cure multiple sclerosis.

Disease of the 1.000 faces:How to recognize multiple sclerosis

"Invisible" symptoms:How multiple sclerosis changes your life

Seven MS misconceptions:Multiple sclerosis does not mean ending up in a wheelchair

Incurable disease:Multiple sclerosis increasingly common in Germany

However, certain medications can reduce the frequency and severity of relapses and slow the progression of the disease. Corticosteroids, which include cortisone, are often administered during an acute episode. Immunotherapy can also alleviate symptoms. The symptoms described above, such as spasticity or depression, can also be treated. However, the medications used in this case can cause significant side effects.

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