The following is a little scary—but well worth reading. People can get multiple sclerosis (MS) at any age. But it’s easy to miss the early warning signs because they can go away as quickly as they showed up. If they do go away, however, that doesn’t mean you’re out of the woods. If you’re in the process of developing MS, it’s a sure thing that more is coming.
Missing early clues of MS can delay your getting the right diagnosis and early treatment. And early treatment is your best bet for avoiding not just another MS episode but also the long-term disability that used to be an unavoidable consequence of this disease.
There’s something you can do to avoid the above scenario, though—understand, and do, what’s explained below.
CHANGES IN HOW MS IS DIAGNOSED
There’s no single test to diagnose MS. Instead, doctors use the McDonald Diagnostic Criteria, a combination of symptoms, imaging tests showing damage in multiple locations in the nervous system and some lab tests. It’s also typically necessary to rule out other diseases as part of the process.
In late 2017, revisions were made to update the McDonald Criteria. They mostly apply to someone being evaluated for a first attack of MS, called clinically isolated syndrome (CIS). In the past, people with CIS had to wait for a second attack for an MS diagnosis. Now a first attack and a brain MRI showing one or more lesions similar to the kind seen in people known to have MS, possibly along with certain changes in spinal fluid, can be used to make a diagnosis.
These revisions aim to improve the speed and accuracy of diagnosis (and reduce misdiagnoses), but this still typically depends on the patient noticing early signals and bringing them to a doctor’s attention so that the process can begin.
To have CIS, you must have one or more key symptoms of MS that last 24 hours or longer…
- Tingling and numbness in your face, body, arms or legs. Some people may also experience itching. This can seem like a minor problem, especially if it goes away after a day, but don’t minimize it.
- A sudden change in vision in one eye that occurs because of inflammation of the optic nerve, called optic neuritis. The change could be blurred vision, changes in perceived color and contrast, or pain when you move your eye.
- Other symptoms you might experience include dizziness, clumsiness or trouble walking…muscle spasms, stiffness or weakness…sexual dysfunction, bladder- or bowel-control problems, changes in speech or swallowing, tremor or hearing loss.
Note: Some of these symptoms can be symptoms of stroke. Stroke is rare in the age range—20 to 40—when MS typically begins. However, stroke can occur at any age, so if you have sudden loss of vision, slurred speech, weakness of one side of your body or drooping on one side of your face, call 911 immediately.
The MS-related “event” that causes CIS is loss of the protective coating around a nerve, which can make nerve signals go a bit haywire, providing you with the above clues that something’s wrong. The fly in the ointment is that a CIS symptom usually gets less severe or even goes away, leaving you wondering whether you simply had a weird bug in your system. But pay attention to what you don’t have—CIS is not accompanied by fever or infection.
While you should first contact your regular doctor if you experience an MS warning sign, you have the best chance of getting the right diagnosis if you’re then evaluated by a health-care provider who is an expert in MS.
MS is two to three times more common in women than in men, but men do get it. In 70% of cases, it strikes during the age range mentioned above—20 to 40—but that means it starts outside this age range 30% of the time.
Though there still is no cure, today’s treatments can and do change the course of the disease. More than a dozen disease-modifying drugs help prevent future attacks and brain lesions and slow or prevent disability so that patients can lead long lives and perhaps never end up in wheelchairs. And early diagnosis and treatment add to that best outcome!
