Diagnosis
Of Multiple SclerosisThe diagnosis should be made by a neurologist with
a special interest in multiple sclerosis. These specialists see most cases and
diagnose it best. There is quite a number of other neurological diseases that
need to be excluded. Among these are for instance: Amyotrophic lateral sclerosis,
Lyme disease, syringomyelia, systemic lupus erythematosus, hereditary ataxias,
syphilis and many others. The diagnosis hinges on a good history and a
thorough neurological examination. This is complemented by some blood laboratory
tests and some imaging tests to establish the diagnosis. Often
the clinical course will tell the neurologist exactly where the demyelination
lesions are located. This can be confirmed by an MRI scan with or without Gadolinium-contrast
enhancement. Also special CT scans with a double dose iodine contrast material
and delayed films (called double-dose delayed CT scan) make multiple sclerosis
lesions visible with these imaging techniques. Here is a link
to a site where MRI
scan images are shown where a demyelinated MS lesion can be clearly
seen (scroll halfway down). Other electrophysiological tests called "evoked
potential tests" document the interference of the electrical impulse traveling
along the sensitive pathways and being interrupted by the demyelination process.
All of these various elements of testing and examining will tell the neurologist
the correct diagnosis (Ref. 1-3).
Prognosis:
Despite the overall depressing litany of possible symptom presentation, the life
expectancy for most patients is not diminished. Most people learn to live
with their disability and function well for decades. Also, most people have only
a few of the symptoms mentioned above and never get the full array that only a
minority would get. Remissions
in the beginning can last more than 10 years. On the other hand, some patients
have frequent attacks and these are the ones that likely have more lesions and
have a poor prognosis. Men who get the first attack in middle age appear to be
deteriorating more rapidly. Care needs to be taken not to get exposed to heat
as mentioned above (avoid hot tub, fever, hot climate). |
