Multiple Sclerosis: A New Approach to MS Diagnosis

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Even though the long-term benefits are unclear, most people with MS would probably agree that they’d rather have fewer relapses and less disability, at least in the short term. That’s one of the reasons why doctors have recently modified the way in which they diagnose multiple sclerosis.In the past, doctors usually waited for a second clinically isolated syndrome, or MS attack, before actually diagnosing the disease and starting therapy. But as a result of recent studies, they’ve made some changes. Two medical factors are used to diagnose multiple sclerosis:

• A "clinically isolated syndrome." These are actual physical symptoms associated with multiple sclerosis that last at least 24 hours. This might be as dramatic as Williamson’s paralysis, or could be more subtle, like persistent numbness in one arm or leg, or a sudden loss of vision in one eye (known as optic neuritis).
• Evidence of lesions on the brain. MS lesions are usually detected using magnetic resonance imaging. These lesions are caused when inflammation leads to the loss of myelin, the protective substance that insulates nerves in the brain and spinal cord.

A single clinically isolated syndrome is now enough to diagnose MS if doctors see the right kind of evidence on the MRI."Previously, once a person had an MS attack and you found evidence of MS lesions on the brain on an MRI, you’d have to wait and repeat that MRI to see if there were new lesions developing," Keegan says.But that, too, has changed. In 2010, the group that establishes the procedures for diagnosing MS published new guidelines. "Now, patients who have had a single attack and have evidence of both old and new lesions on the initial MRI can be diagnosed with MS," Keegan says.

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