Last week, we started a conversation about multiple sclerosis (MS), a disease that can lead to significant disability. Today, we’ll take a closer look at how MS is diagnosed and treated, and how patients with MS can reduce their risk of complications.
Are There Different Types of Multiple Sclerosis?
Yes. There are several types of MS, including:
Relapsing-remitting MS (RRMS) – The most common form, in which there are periods of progression (relapses) followed by improvement (remission), with an overall slow progression of disease over time, sometimes over decades.- Secondary progressive MS (SPMS) – Steady worsening after initial relapses and remissions.
- Primary progressive MS (PPMS) – Steady progression from the start.
How Is MS Diagnosed?
Doctors use a combination of the following to make a definitive diagnosis:
- Neurological exams – to assess strength, reflexes, sensation, and coordination
- Eye exam with dilation – to assess the optic nerves in the back of the eye
- MRI scans – to look for lesions in the brain and spinal cord
- Lumbar puncture (spinal tap) – to look for markers of inflammation in the spinal fluid
- Specialized nerve tests – to measure how quickly and effectively nerves respond
The diagnosis requires evidence of damage occurring at different times and in different areas of the nervous system.
How Is MS Treated?
There is no cure for MS. When I was in training, there were very limited treatment options. Today, thanks to ongoing quality scientific research, there are many effective treatments that can slow disease progression and reduce relapses. These include:
- Disease-modifying therapies (DMTs) – These medications reduce inflammation and help prevent new lesions. Options include oral medications, injections, and infusions. Your neurologist will help choose the best fit based on your own specific circumstances.
- Relapse treatment – High-dose steroids or other treatment may be used to shorten the duration of relapses, particularly if the relapse is severe.
- Medications to manage symptoms – Several medication options are available to help with muscle stiffness, fatigue, bladder issues, pain, mood changes, or other symptoms.
- Rehabilitation – Physical, occupational, and speech therapy can help maintain mobility and independence.
How Can MS Patients Reduce Their Risk of Complications?
- Avoid smoking – which is strongly linked to faster progression
- Maintain healthy vitamin D levels
- Stay physically active
- Maintain a healthy weight
- Follow your treatment plan consistently
- Keep regular neurology appointments and notify your neurologist as soon as you have symptoms of a relapse.
Lifestyle choices can make a meaningful difference in long-term outcomes.
The National Multiple Sclerosis Society can provide more detailed information about MS as well as resources and support for MS patients. Use this link to access their website:
If you have any questions about Multiple Sclerosis, please log into your account and send us your question. We are here to help.
Dr. Anita Bennett MD – Health Tip Content Editor