This was taken from [url]www.neurologychannel.com[/url]
Multiple sclerosis (MS) is a chronic, progressive, degenerative disorder that affects nerve fibers in the brain and spinal cord. A fatty substance (called myelin) surrounds and insulates nerve fibers and facilitates the conduction of nerve impulse transmissions.
MS is characterized by intermittent damage to myelin (called demyelination) caused by the destruction of specialized cells (oligodendrocytes) that form the substance. Demyelination causes scarring and hardening (sclerosis) of nerve fibers usually in the spinal cord, brain stem, and optic nerves, which slows nerve impulses and results in weakness, numbness, pain, and vision loss.
Because different nerves are affected at different times, MS symptoms often worsen (exacerbate), improve, and develop in different areas of the body. Early symptoms of the disorder may include vision changes (e.g., blurred vision, blind spots) and muscle weakness.
MS can progress steadily or cause acute attacks (exacerbations) followed by partial or complete reduction in symptoms (remission). Most patients with the disease have a normal lifespan.
Multiple sclerosis is classified according to frequency and severity of neurological symptoms, the ability of the CNS to recover, and the accumulation of damage.
Primary progressive MS causes steady progression of symptoms with few periods of remission.
Relapsing-Remitting MS causes worsening of symptoms (exacerbations) that occur with increasing frequency, along with periods of reduced symptoms (remission).
Secondary progressive MS is initially similar to relapsing-remitting MS and eventually progresses to MS with no remission.
Relapsing-Progressive MS causes accumulative damage during exacerbations and remissions.
Diagnosis of MS is based on medical history, physical and neurological examination, blood tests, MRI, spinal tap, and neurological tests.
Blood tests may be used to help rule out other conditions that cause similar symptoms.
Magnetic resonance imaging (MRI)
MRI scan uses a magnetic field to create detailed images of the brain and spinal cord. This imaging test can be used to detect white matter lesions (sclerosis in the ventricles [cavities that contain cerebrospinal fluid]) in the brain.
Spinal tap, or lumbar puncture, is performed to detect oligoclonal bands in cerebrospinal fluid. [U]Oligoclonal bands result from elevated levels of the antibody immunoglobulin G (IgG) and myelin basic protein, which is a byproduct of demyelination, and are present in more than 85% of MS cases.[/U] In this procedure, a needle is inserted between two lower spine (lumbar) vertebrae and cerebrospinal fluid is collected and analyzed.
Evoked Potential Tests
Evoked potentials are electrical signals generated by the nervous system in response to stimuli. Evoked potential tests (i.e., somatosensory evoked potentials, visual evoked potentials, brainstem auditory evoked potentials) are performed to evaluate sensory, visual, and auditory functions and detect slowed nerve impulse conduction caused by demyelination.
In these tests, nerves responsible for each type of function are stimulated electronically and responses are recorded using electrodes placed over the CNS (brain and spine) and peripheral nerves (e.g., median nerve in the wrist, peroneal nerve in the knee).
Early signs of MS are often mistaken for other disorders, including the following:
Cerebrovascular disease (e.g., stroke, transient ischemic attack [TIA])
Degenerative disc disease
Vitamin B-12 deficiency
Weakening of the nerves (neuropathy)
Conditions that may appear similar to MS on MRI include the following:
Congenital biochemical disorders (e.g., adrenaleukodystrophy, metachromatic leukodystrophy)
Inflammation of blood vessels (vasculitis)
Lupus (an autoimmune disorder)
Progressive multifocal leukencephalopathy (HIV-related disorder)
Viral infection (may produce a response that causes demyelination)
In the very beginning stages of my illness, I presented to the ER doctor with weakness in my knees & numbness on my palms & on the bottom of my feet. I also had no relexes in my arms or legs. I was told it was probably MS & sent for a complete set of MRIs. I was called the next day & told that I did not have MS, & so I was fine. When my knees began giving out a few days later & I went back, I was told it was probably GBS & sent to a larger hopital for a LP & EMG. I was then dx with GBS & given 5 PP in 8 days.
After I continued to deteriorate to quad status, I was sent by ambulance to the Mayo & would spend the next 3 months there. I was refractory to IVIG, PP, & even steroid infusions, but I did maintain my low level of functioning. I would be rediagnosed with CIDP after 6 weeks there. I remember at the time that my husband & I both thought that I had the worst possible illness one could get. Maybe because it had all happened so fast for me.
But now I realize, having gotten the ability to walk back, & about 80% usage of my hands, that I would rather have CIDP than MS. I know too many people with the progressive form of MS, who are deteriorating very rapidly. They cannot seem to get anything back. Anyone notice how many younger people now have autoimmune illnesses? My mother is 81 & healthy & we have talked about how few people in her generation had an autoimmine illness. What is going on with our generation? BTW I am 53 now, got sick at age 48.