Multiple Sclerosis and autoimmune disease affecting the central nervous system (the brain and spinal cord). The immune system attacks the protective sheath covering the nerve fibers causing a disruption the flow of communication within the brain and between the brain and the rest of the body. Symptoms of Multiple Sclerosis develop as a result to the damage and deterioration to the nerves affected by the interrupting in communication.

Four disease courses have been identified in Multiple Sclerosis. Patients will generally follow one of the four disease courses with symptoms varying in severity. The four courses of Multiple Sclerosis are:

Clinically Isolated Syndrome: Considered the first episode of neurological symptoms, lasting at least 24 hours, caused by nerve damage in the central nervous system. While clinically isolated syndrome is a characteristic of Multiple Sclerosis, not all patients who experience CIS may develop Multiple Sclerosis. Early diagnosis and treatment of clinically isolated syndrome can potentially delay the onset of Multiple Sclerosis.

Relapsing Remitting Multiple Sclerosis: The most common disease course, characterized by clearly defined attacks of new or worsening neurological symptoms and radiological changes followed by periods of remission. Exacerbations, also referred to as relapses, are followed by periods of remission in which symptoms appear to stabilize and no signs of disease progression are evident. Development of new lesions on the central nervous system, seen on radiological scans, occur as part of a relapse but do not always occur with new or worsening symptoms.

Secondary Progressive Multiple Sclerosis: Occurs when neurological symptoms worsen and increasing disability develops over time. Patients experience a gradual increase in symptoms with or without evidence of disease activity, occasionally experiencing relapse with periods of stability.

Primary Progressive Multiple Sclerosis: Characterized by worsening neurological functioning and increased disability without early stages of relapse or remission. Patients may experience brief periods of stability or periods of increasing disability with or without new relapses or radiological changes.

 

Multiple sclerosis signs and symptoms may differ greatly from person to person and over the course of the disease depending on the location of affected nerve fibers.

Symptoms can include but are not limited to:

• Numbness or weakness in one or more limbs occurring on one side of the body
• Electric-shock sensations that occur with certain neck movements, especially bending the neck forward (Lhermitte sign)
• Lack of coordination
• Impaired/unsteady gait and balance, dizziness
• Vision problems such as partial or complete loss of vision, prolonged double vision, blurry vision
• Fatigue
• Bladder dysfunction
• Slurred speech
• Tingling or pain in parts of your body
• Problems with sexual, bowel and bladder function

 

There is no specific test to conclusively diagnose Multiple Sclerosis (MS). Instead, a diagnosis of MS often relies on ruling out other conditions that might produce similar signs and symptoms, known as a differential diagnosis. Diagnosing MS requires a neurological evaluation, complete with a medical and family history, as well as additional tests and procedures as appropriate.

Common tests and procedures include:

• Radiological images such as an MRI (which can aid in a quicker diagnosis as they can show the presence of lesions on the central nervous system)
• Blood tests, to help rule out other diseases with symptoms similar to MS
• Lumbar puncture, which will allow testing of cerebral spinal fluid (the fluid surrounding the brain and spinal cord) to evaluate for cellular or chemical abnormalities indicative of Multiple Sclerosis
• Evoked potential tests, which record the electrical signals produced by your nervous system in response to stimuli

In most people with relapsing-remitting MS, the diagnosis is fairly straightforward and based on a pattern of symptoms consistent with the disease and confirmed by brain imaging scans, such as MRI.