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Multiple sclerosis (MS) is an autoimmune disease that damages myelin, the fatty membrane that surrounds the neurons in the brain. Around 2.8 million people worldwide live with this disease. Early diagnostics of multiple sclerosis allows for quicker response, which significantly improves a patient’s prognosis.
 
Read more about how multiple sclerosis is diagnosed in specialist neurological centres abroad in this article.

 

 

The first symptoms of multiple sclerosis

The most common first signs of multiple sclerosis are:

 

    иконка галочкиBlurred vision, 

    иконка галочкиPartial or complete loss of vision in one eye (especially if accompanied by pain), 

    иконка галочкиDouble vision, 

    иконка галочкиDizziness, 

    иконка галочкиBalance and coordination problems, 

    иконка галочкиMemory issues, 

    иконка галочкиCognitive issues, 

    иконка галочкиFatigue, 

    иконка галочкиDepression, 

    иконка галочкиUnexplained pain in different parts of the body, 

    иконка галочкиSpeech issues and slurring, 

    иконка галочкиMuscle weakness, 

    иконка галочкиTremors, 

    иконка галочкиTingling or numbness in the tips of the fingers or toes, 

    иконка галочкиUrination and bowel dysfunction, 

    иконка галочкиSexual dysfunction, 

    иконка галочкиPartial or complete paralysis.

 

The initial symptoms, through which multiple sclerosis most often manifests itself, are similar to many other neurological diseases. A correct diagnosis can therefore be hard to achieve, in particular, if it is not carried out in a specialist neurological centre. Multiple sclerosis is often mistaken for optical neuromyelitis or MOGAD syndrome.

 

The most characteristic feature of multiple sclerosis is the sudden onset of symptoms that persist for 2-3 weeks but then go away on their own. This sudden inflammation is called a clinically isolated syndrome and is characteristic of 75% of patients.

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How is multiple sclerosis diagnosed in its early stages?

    Multiple sclerosis is a disease that occurs when the immune system mistakenly attacks neurons in the brain. This results in a kind of scar tissue forming on them that slows down the electrical impulses. This causes the symptoms of the disease, which vary depending on the location of the lesion. Modern diagnostic methods can detect such lesions directly or indirectly.

 

рассеянный склероз мрт

The most accurate method of diagnosing multiple sclerosis is magnetic resonance imaging (MRI). With this method, it is possible to directly detect multiple brain lesions at the time of the initial presentation of the disease and subsequent inflammations. Moreover, if the patient remains under the care of a neurologist and undergoes regular MRI examinations, a flare-up can be detected even before the first symptoms appear.

 

On an MRI scan, multiple sclerosis appears as illuminated spots in different areas of the brain. In some cases, at the time of initial diagnostics, the patient is found to have several lesions that have been present for some time but have not caused any prior symptoms.

 

Foci of inflammation can appear and disappear in different parts of the brain. This makes it difficult to diagnose the disease, so it is important to repeat brain scans as instructed by your doctor. Combined with a complex clinical pattern that varies greatly from patient to patient, MS is considered to be a very difficult disease to diagnose. Patients are advised to seek neurological diagnosis at experienced specialist clinics to obtain a quality diagnosis and treatment plan.

 

MRI scans are also important to determine the correct type of disease. These include:

 

    иконка галочки classic multiple sclerosis (Charot type),  

    иконка галочки tumefactive multiple sclerosis,  

    иконка галочкиMarburg type, also known as acute malignant MS,  

    иконка галочки diffuse myelinoclastic sclerosis, also known as Schilder MS,  

    иконка галочкиBaló concentric sclerosis.  

 

The doctor will need this information to choose the right treatment and care plan.

 

For most patients, an MRI scan is sufficient to diagnose multiple sclerosis with a high level of confidence. However, 10-15% of people fall outside the standard diagnostic criteria. They will need additional examinations: cerebrospinal fluid analysis (lumbar puncture), evoked potential testing, and optical coherence tomography (OCT).

    Lumbar puncture

    The analysis of cerebrospinal fluid can rule out other diseases and detect signs of inflammation in the brain characteristic of multiple sclerosis. The method is also used to monitor the progression of the disease. The “golden standard” for diagnosis is the detection of oligoclonal bands. Some modern centres also test for free light chains (FLC). A lumbar puncture is a good method of checking if MS inflammation has already occurred in the past.

    Evoked potential testing

    This is an older method of diagnosing multiple sclerosis. Electrodes are attached to the patient’s scalp that can measure the speed of impulse transmission by neurons in the brain. In multiple sclerosis, this process is slowed down. The test is painless and takes 30-45 minutes, during which time you simply have to look at the screen.

    Optical coherence tomography

    Optical coherence tomography is a non-invasive diagnostic method that produces 3D images of the retina. It achieves an image scaling of about 2-3 times that of an MRI scanner. This makes it possible to detect small foci of inflammation that would be invisible with other methods.

When multiple sclerosis is suspected, doctors may also prescribe blood tests. Their main purpose is to rule out other diagnoses that may have similar symptoms.

 

Doctors are developing tests that will be able to diagnose multiple sclerosis based on biomarkers. This technology could also be used to create more effective drugs that can target the disease.

Doctors are developing new methods of diagnosing multiple sclerosis based on virtual reality systems.

What are the criteria for a diagnosis of multiple sclerosis?

Most foreign clinics use the McDonald’s criteria for the diagnosis of multiple sclerosis. They have increased the rate of correct diagnosis of MS within the first year of onset from 30% to 80%.оту верной диагностики РС в течении первого года после дебюта с 30% до 80%.

 

The main requirement for diagnosis is evidence of damage to the central nervous system that has occurred at different times and in different parts of the brain. This feature distinguishes multiple sclerosis from other neurological diseases.

 

According to this classification, three criteria must be met for a diagnosis of multiple sclerosis:

 

    иконка галочкиWithin 24 hours (or more) the patient has at least two symptoms of MS, among the ones listed above; 

    иконка галочкиAn MRI scan of the brain shows at least two foci of inflammation of at least 3 mm in size. Particular attention is given to the underlying areas of the brain – clusters of white matter near the ventricles of the brain; 

    иконка галочкиOther neurological diseases that might cause similar symptoms have been ruled out. 

рассеянный склероз симптомы диагностика

 

In ~75% of patients, multiple sclerosis takes the form of alternating flare-ups and remissions. In other cases, the disease may progress very rapidly without relief; or proceed benignly for 10-15 years without treatment.

 

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Foreign clinics offer comprehensive packages for neurological examinations. Contact our coordinating doctors by leaving an application form on our website and we will introduce you to current offers from leading clinics.

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What should you do if you have been diagnosed with multiple sclerosis?

рассеянный склероз симптомы диагностика

Do not panic. Modern medicine offers great opportunities in the treatment of multiple sclerosis and makes it possible to maintain functionality and high quality of life for many years.

 

There are different groups of drugs that are used to treat multiple sclerosis. They aim to speed up recovery from relapses, slow down the progression of the disease and control symptoms.

 

Disease-modifying drugs (DMTs) are the most advanced in this field. They slow down the progression of multiple sclerosis. The effect is much stronger if treatment is started early in the course of the disease. An intensive course of medication can reduce the rate of relapse, slow down the formation of new lesions and potentially reduce the risk of brain atrophy and disability.

 

Another innovation in the treatment of multiple sclerosis is stem cell therapy. This method is still being investigated, but some specialist clinics are already using it in the treatment of MS. Stem cells can significantly reduce and potentially eliminate autoimmune activity in some people, and even partially repair damage to the nervous system.

 

Physiotherapy plays a major role in the treatment of multiple sclerosis. Because the course of the disease differs from patient to patient, there is no single treatment protocol. Instead, physiotherapists draw up individual exercise plans depending on the symptoms of the disease. Physiotherapy can maintain mobility, increase endurance, prevent muscle cramps and recover from an exacerbation of the condition. Technologies such as robotic rehabilitation and the use of VR technology are available in modern rehabilitation centres.

The best multiple sclerosis clinics

 

 

 

 

    Summary

    иконка галочкиMultiple sclerosis is a serious autoimmune disease that affects the nervous system. Early diagnosis of MS has a significant impact on the effectiveness of treatment. 

    иконка галочкиDiagnostics are complicated by the fact that the clinical picture differs considerably from one patient to another. The main method of early diagnosis of multiple sclerosis is MRI. It can be supplemented by a lumbar puncture, evoked potential testing, and optical coherence tomography. 

    иконка галочкиIn 75% of cases, multiple sclerosis begins with an abrupt flare-up – pain, dizziness, vision loss, tingling in the extremities, etc. – which then resolves itself after 2-3 weeks. In most patients, the course of the disease is characterised by alternating exacerbations and remissions. 

    иконка галочкиModern multiple sclerosis treatment with drugs, physiotherapy and stem cells can slow down the progression of the disease and maintain the patient’s functionality. 

    иконка галочкиFor early diagnosis of multiple sclerosis, it is best to go to experienced neurological centres such as the Liv and Memorial networks in Turkey, the Quironsalud network and Uniclinica Navarra in Spain, Uniclinica Motol in the Czech Republic, Kardiolita Clinic in Lithuania, SoonChunHyang in South Korea and Ichilov in Israel. 

 

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For a quick appointment for neurological diagnosis abroad please leave your request on our website. Our coordinating doctors will call you back to help you find the best foreign clinic.

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Sources:

  1. 1. University of Pittsburgh Medical Center (UPMC)
  2. 2. International Federation for the Surgery of Obesity and Metabolic Disorders (IFSO)


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