Common Signs & Symptoms of MS include:
Signs |
Symptoms |
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There is no single definitive test to diagnose MS. Diagnosis is made by clinical and paraclinical evidence
Clinical
Paraclinical
Magnetic resonance imaging (MRI) is used to confirm a MS diagnosis. However, brain MRIs are normal in approximately 5% of patients with MS. A challenge in understanding MS is the observation that plaques can be "clinically silent." There is often no direct relationship between the number of lesions visualized on MRI and the severity of clinical symptoms.
2017 McDonald Criteria for the Diagnosis of Multiple Sclerosis |
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Prerequisites → |
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MS Diagnostic Criteria for a person who has experienced a typical MS attack/CIS at onset | |||
Clinical Presentation |
Data Still Needed for MS Diagnosis |
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Attacks (DIT) |
Lesions (DIS) 1 newer lesion and 1 older lesion in another location |
Evidence of (DIS) and evidence of (DIT) have been met. | |
OR |
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2 or more |
1 lesion associated with prior attack in different location | ||
Clinical Presentation |
Additional Data Still Needed for MS Diagnosis |
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Attacks |
Lesions Evidence of 1 lesion Plus→ |
DIS data -1 or more MS-typical MRI T2 lesions in 2 or more areas of CNS: periventricular, cortical, juxtacortical, infratentorial or spinal cord |
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Clinical Presentation |
Additional Data Still Needed for MS Diagnosis |
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Attacks |
Lesions Evidence of 2 or more lesions |
DIT shown by one of these criteria: |
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Attacks |
Lesions Evidence of 1 lesion |
DIS shown by one of these criteria: - Additional attack implicating different CNS site AND DIT shown by one of these criteria: - additional clinical attack |
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MS Diagnostic Criteria for a person who has steady progression of disease since onset | |||
1 year of disease progression | DIS shown by at least two of these criteria: - 1 or more MS-typical MRI T2 lesions (periventricular, cortical, juxtacortical or infratentorial) - 2 or more MRI T2 spinal cord lesions - CSF oligoclonal bands |
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Adapted from source: Thompson AJ, Banwell BL, Barkhof F, et al. (2017) Diagnosis of multiple sclerosis: 2017 revisions of the McDonald criteria. Lancet Neurol 2018; 17: 162–173 |
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Laboratory
and radiological tests are used to confirm the diagnosis of MS.
Because there is no single diagnostic test specific for MS, and time between attacks can range from months to years, obtaining a diagnosis of MS can be a long and challenging process. In addition, symptoms differ among patients and are often subjective. Healthcare providers often minimized or dismissed patient concerns.
Some individuals may have minor symptoms and others may experience major, ongoing problems with symptom progression. MS symptoms may occur at the beginning of the disease process, resolve, and never recur, or they may reoccur often throughout the individuals lifetime. Symptom severity can vary as well in the same patient or within a group of patients.
Some patients express anger
or grief when informed of the diagnosis. Others may express relief that they
finally know the cause of their symptoms and can begin treatment. Healthcare
professionals can assist patients and families by educating them about the array
of potential symptoms and how MS may affect them. Patients also need current
information regarding MS management, research toward a cure, and new drug treatments
information.
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The National Multiple Sclerosis Society web site provides an excellent MS resource.
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