An attack on the nervous system
Multiple sclerosis (MS) is a disease of the central nervous system. (CNS) The bodies immune system attacks the outer nerve sheath. (Myelin) This causes scarring (sclerosis) in random spots throughout the CNS. (multiple) The effect of this scarring interferes with the transmission of the signals required for normal operation.
Although the exact cause of MS is unknown, it is thought to be an inflammatory process that attacks a substance in the nervous system called myelin. Myelin is the material that surrounds neurons (the cells of the nervous system). Myelin acts much like insulation around electrical wiring. When the myelin is broken down, the nerve impulses do not travel as efficiently, causing the symptoms that are characteristic of MS.
Possible Symptoms of Multiple Sclerosis:
- Spasticity in muscles
- Numbness (Impairment of pain, temperature, touch, senses.)
- Pain (moderate to severe)
- Ataxia (uncoordination)
- Speech disturbances (dysarthria)
- Vision disturbances (double vision, optic neuritis.)
- Dizziness or vertigo
- Bladder dysfunction
- Bowel dysfunction
- Sexual dysfunction
- Cognitive dysfunction (memory problems, brain fog)
- Parasthesias ("pins and needles" feelings)
How Does a Doctor Diagnose MS?
Your doctor must find proof of more than one attack in different parts of the nervous system. This proof includes the clinical history that you provide, the neurologic exam that your doctor performs (which examines the functioning of the brain and its nerves), magnetic resonance imaging (MRI) results (which uses a magnetic field to view internal soft tissue such as organs, muscle, nerves), and perhaps spinal tap results.
A spinal tap may be done for two reasons. First, it is often necessary to rule out other diseases that mimic MS, such as Lyme disease. Second, if the spinal fluid contains distinct proteins called oligoclonal bands, it helps to support the diagnosis of MS. A normal spinal tap does not exclude MS, as it may be normal, especially in the early stages of the illness.
It is also very important to perform blood-work to rule out other disease processes that mimic MS. These include infections such as Lyme disease, autoimmune problems such as lupus, inflammatory diseases, thyroid abnormalities, and vitamin deficiencies (specifically B12 and folate).
MRI scans may be helpful to follow patients with MS. We now know that there may be lesions that appear on MRI that do not cause overt clinical symptoms. In this way, MRI can be used to measure disease activity.
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