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Life with Multiple Sclerosis: Symptoms and Diagnosis

A diagnosis of multiple sclerosis (MS) can be life-changing and scary. MS is a chronic autoimmune disease affecting the central nervous system. Having this condition means the body’s immune system attacks myelin, which is the protective covering that surrounds nerve cells in the brain and spinal cord. Damage to the myelin can disrupt signals to and from the brain, potentially disabling some patients.

Signs and Symptoms to Watch

MS is a complex disease with a range of different types of symptoms, making it difficult to diagnose. A common form is relapsing-remitting MS, which occurs when a person’s symptoms may resolve before they see a doctor and they may go years before being diagnosed.

“Remission occurs because the myelin can repair, though often only partially,” says Dana DeWitt, MD, the medical director for inpatient neurology service at University of Utah Health. “There can also be silent areas of the brain involved so that many lesions can occur over time without clear symptoms.”

Symptoms usually start between the ages of 20 and 40, and women are more often affected than men. The most frequently seen symptoms of MS include:

  • Vision problems: Optic neuritis, blurred vision, or pain in one eye are often some of the first symptoms of MS.
  • Numbness or tingling: Loss of or altered sensation in the face, body, or extremities is another symptom that is typically experienced first.
  • Fatigue: About 80% of MS patients suffer from fatigue that interferes with daily life.
  • Gait difficulties: Mobility limitations are common in MS, due to factors such as muscle tightness (spasticity), balance issues, or numbness in the feet.
  • Muscle weakness: Fatigue and chronic pain from MS can cause a person to become inactive, thus weakening their unused muscles. Damage to the nerve fibers that stimulate the muscles can also cause this symptom.
  • Balance difficulties: Dizziness and vertigo can cause MS patients to feel off balance or like their surroundings are spinning.
  • Bladder and bowel dysfunction: Incontinence, frequent nighttime urination, constipation, and loss of bowel control can get worse as MS progresses. Fortunately, these symptoms can usually be treated quite well with medication and fluid management.
  • Pain: Neuropathic and musculoskeletal pain are unfortunately common in MS. Nearly half of all patients experience chronic pain. A doctor can help identify the source of pain and manage it accordingly.
  • Cognitive changes: For many patients, changes in cognitive function are mild but may include memory and concentration problems, brain fog, verbal fluency, and information processing.
  • Emotional changes: An MS diagnosis and subsequent life changes can cause depression and anxiety. It’s important to remember that emotional health is an important part of a person’s overall health and shouldn’t be neglected. 

Diagnosis Difficulties

Nearly 1 million Americans are living with MS, but experts still aren’t totally sure what causes it, which contributes to the difficulty in diagnosing it.

Currently, no single test can determine if someone has MS. Instead, the process involves physical exams and blood tests to rule out other conditions that may cause similar symptoms.

An MRI may be done to look for lesions that are indicative of MS on the brain or spinal cord. In some cases, a spinal tap (lumbar puncture) may need to be performed. 

Moving Forward After Diagnosis

Many effective treatments are available for MS patients. DeWitt strongly recommends finding a neurologist and medical team who have expertise in treating MS.

“It is extremely important to have a neurologist who understands MS,” DeWitt says. “There are many treatments, and it can be confusing to choose the correct treatment for the patient’s presentation.”

Prompt treatments with these MS specialists can make a huge difference in patients’ overall health as they navigate life with MS. Besides symptom management, healthy lifestyle changes can slow the progression of the disease, such as:

  • Eating a healthy diet, especially foods high in Vitamin D
  • Regular physical activity
  • Not smoking or quitting if you do smoke
  • Getting plenty of sleep
  • Managing stress with techniques such as yoga or meditation
  • Staying on top of preventive health care

“The aim now is to attempt to achieve NEDA, which means No Evidence of Disease Progression,” DeWitt says. “The important thing is to be diagnosed early, be compliant with medication, and closely follow neurological changes.”

While many unknowns still surround MS, the medical world has made huge strides in treatment over the decades, and promising clinical trials are currently underway. The initial diagnosis may be overwhelming, but most people with MS live full, productive lives.