INTRODUCTION
MULTIPLE SCLEROSIS is a condition of the central nerves system (which indudes the brain and the spinal cord). MS does not effect any other nerves in the body! The damage to the nerves in the central nerves system is caused by the body's own immune system attacking the nerves, myelin sheath, which just as if you had cut your hand, the platelets in your blood fill the damaged area forming a scar which in tum disrupts the nerve impulses. And there you have Multiple Sclerosis.
CLINICAL DIAGNOSIS
Diagnostic criteria
Doctors should always suspect MS when someone between the ages of 20 and 50 presents with characteristic systems. These vary widely from person to person, and even over time, depending on where myelin damage has occurred. Although MS may lead to disability, one in five of those diagnosed will have no permanent disability, but in 10 per cent, disability worsens from the outset (primary progressive MS). More usally, it follows various patterns of relapse and remission. In most cases, symptoms appear suddenly.
The initial symptoms of MS often include:
- Reduced, double or blurred vision
- Pain
- Tingling or numbness in the extremities
- Vertigo and dizziness
- Balance and walking difficulties
- Weakness
- Bladder or bowel problems
The possible manifestations of MS are numerous, a combination of signs, symptoms and events can occur at separate times and in different places, but symptoms can indude:
- numbness or tingling in the hands and feet
- weakness
- balance and walking difficulties
- reduced, blurred, or double vision
- dizziness and vertigo
- bladder and bowel problems
- speech difficulties
- mood swings
- sexual dysfunction
- fatigue
- pain
- tinnitus or hearing problems
- ataxia (lack of muscle control and coordination)
- spasticity (abnormally increased muscle tone)
- tremor
- reduced breathing
- cognitive dysfunction (such as lack of concentration,
- forgetfulness)
- depression
- temperature sensitivity
- reduced exercise/activity tolerance
- anxiety,
Diagnostic procedures and tests
The diagnostic process may not provide definitive answers, and in some cases, may be lengthy, both of which can be very stressful. There is no single definitive diagnostic test for MS; diagnosis has to be based on clinical and laboratory evidence.
For this reason, the diagnosis should be the responsibility of a consultant neurologist, who has the specialist knowledge and experience to interpret results and exclude other possible conditions (Freeman et al 1997). Estimates suggest that as many as one person in 10 is misdiagnosed with MS. The introduction of more sensitive imaging and laboratory techniques has reduced, but not yet eliminated; this problem (Herndon 1994).