Multiple Sclerosis

What is Multiple Sclerosis:

Multiple Sclerosis is primarily a T-cell mediated immune inflammatory disease that disrupts the regular functions of our central nervous system. Our central nervous system, the brain and the spine, are responsible for many of our voluntary and involuntary movements. However, in patients with Multiple Sclerosis, the immune system attacks the myelin sheaths that protect the nerves of the CNS. After repeated attacks, the myelin sheath will fall apart, and the immune cells will continue to attack the nerves themselves, which can be irreversibly damaged. Symptoms of Multiple Sclerosis include fatigue, numbness, weakness, vision problems, depression, and walking difficulties. In the United States, more than 350,000 patients

MS, as discussed, can be slow or fast progressing. Also, there are other neurological diseases that are symptomatically similar to MS as they also show signs of demyelination. MS is often diagnosed using both clinical and MRI results. The physician would usually first take a family history as genetics also play a role (albeit small) in MS presentation. The physician would move on to complete a physical examination, often looking signs such as lack of balance and coordination, loss of vision, and decreased emotional and language functions. After taking a family history and completing the physical exam, the physician would order an MRI to verify the results of their clinical examinations. At the moment, there are no blood exams which could definitively diagnose MS. However, blood exams can rule out other possible diseases which have similar symptoms to MS itself. There are only a few biomarkers that are in clinical use for the diagnosis of MS. One such biomarker is the Oligoclonal band, whose presence indicates the inflammation of central nervous system.1,4

There is a diagnostic criterion used for diagnosing MS, known as the McDonald criteria. The McDonald criteria requires dissemination in space and time to make an MS diagnosis. Dissemination in space is observed when at least two lesions appear near an MS-typical region in the brain. Dissemination in time is the presence of more lesions over time in the MS typical region. However, in order for the McDonald criteria to be useful, the physician would first need to suspect the possibility of MS from clinical examinations.