Feb 1, 2003
Real Living with Multiple Sclerosis
WHEN MY HUSBAND'S physician said "MS" to us for the first time, we looked at each other blankly. Although Colin and I had heard of MS, neither of us knew what it really meant. To the best of our knowledge, no one on either side of his family had ever had MS.
If medical science could prove MS with only one test, it would be much easier to diagnose. Unfortunately, it takes several tests to give a possible diagnosis. No one really knows why, how, or when someone will contract MS. On your first visit, the health care provider will take your and your family's medical history.
Your provider will ask about your signs and symptoms, which vary from one person to another. Some signs and symptoms include vision change, loss of bladder control, sensations that seem unusual, weakness, falling for no reason, or awkward limb movement. An individual may have all of these signs and symptoms at one time or another. Unfortunately, these symptoms could be caused by many factors, not only MS. Sometimes a person is not even aware of their symptoms.
Your health care provider may look for altered reflex responses by tapping your knees with a small rubber mallet. He may also perform coordination tests or have you push against his hand or arm with your hand to test your upper body strength. Your eyes will be examined for any damage. He will also look for any jerky eye movements or abnormal pupil response. You may be tested to see if you have difficulty pronouncing certain words.
My husband's physician pricked Colin's feet with a pin to gauge his body sensations. Your provider may want to perform a lumbar puncture or spinal tap to test the cerebrospinal fluid for antibodies, called oligoclonal bands. Although they're found in 90% of individuals with MS, the antibodies can occasionally be present in other diseases.
There is no definitive blood test for MS, which would make the diagnosis easier. At the present time, the preferred test is magnetic resonance imaging (MRI) of the brain. The MRI allows the health care provider to detect abnormalities, such as myelin loss or plaques and scarring; it also shows how far the MS has developed. MRI is noninvasive, painless, requires no physical preparation, and has no side effects.
Even an abnormal MRI isn't always a definitive confirmation. You can also have MS and not have lesions in the brain area. The lesions may be on the spinal cord or be undetectable by MRI scan. Other diseases (such as strokes) can cause brain lesions. In older persons, spots on the brain may not be related to any illness or condition.
Each of us has to interpret and understand our bodies in our own way. My husband, Colin, visualizes the myelin as the covering on an electrical cord that's broken in several places. The "breaks in the cord" cause skips in the electric signals traveling from his brain to the affected part of his body.
Sometimes, the MRI will provide evidence of two or more areas of myelin loss or demyelinating lesions that are separate in time and space. When all other possible diseases have been ruled out, a diagnosis of MS is often made.
If your health care provider suggests an MRI, or any test you're not familiar with, don't hesitate to ask questions. It's your body. As much as possible, I prefer to know exactly what's going on and what's happening next.
If you suspect your loved one has MS, contact your local NMSS chapter
and ask for a referral to a provider in your community.
© 2003, Real Living with Multiple Sclerosis