How we diagnose Multiple Sclerosis

hello i'm dr. alex ray grant staff neurologist at the cleveland clinic at the Mellon Center for multiple sclerosis I'm here talking with one of my patients about topics in multiple sclerosis and my patient was kind enough to let us share this conversation with you do you have any questions for me actually do how do you go about diagnosing ms so the diagnosis of MS is not based on any one feature it's a combination of the history the examination and things like the MRI scan there's no one test that makes the diagnosis and in fact there's no test that rules that out so sometimes it's pretty complicated you know the typical story of ms is one of people having relapses these are events that last for days or weeks where they have new neurological symptoms for example losing vision in one eye for a few days or weeks getting numb from the waist down for a few weeks getting double vision something like that it's a pretty characteristic story for multiple sclerosis in some cases it's not like that in some cases the gradual progression over months to years for example somebody may have trouble with one leg dragging and gradually gets more trouble with that the exam that we do neurologically helps us to see signs of problems with the nervous system so we can see reflex changes we can see vision changes we can look in the eye and see changes in the optic nerve all these things help us to define the diagnosis as multiple sclerosis so you mentioned the an MRI what does the MRI show and how would you use that to diagnose someone so the MRIs become really important to diagnose MS it's part of our criteria to make the diagnosis that we put together with the story and the MRI shows deep in the brain areas where the lining of the nerves has been stripped off we call that myelin and just like in your house there's wires in your house and they have insulation around them well the myelin is the insulation of the brain and so these are spots deep in the brain where the insulation is stripped on as soon as the characteristic look to that that we look for in the brains of patients with MS now sometimes people in have little white spots and it's not multiple sclerosis and there's things like diabetes blood pressure or cholesterol smoking which may cause that so that can be a little complicated for us and then we look for things lighting up with the die with a gadolinium with the MRI and these are all helpful in making the diagnosis of MS sometimes we'll look at the spinal cord too because sometimes changes can occur in the spinal cord that are also helped with the diagnosis so when you make a diagnosis how certain are you that that is the accurate diagnosis of having MS yeah so I mean there's times when it's really simple those times when the story is very characteristic when the MRIs characteristic and it's a bit of a slam-dunk there's other times when it's very hard so sometimes for example we will do spinal fluid testing and that helps to see if the immune system is active in and around the brain and spine but we don't always go to that we don't like to go to that unless we have to there's other times when we have to follow the MRI and the story and the patient over a number of months or years before we make a diagnosis so sometimes it could be quite difficult thanks for attention we appreciate your joining us for this program if you have any more questions you need answered please check our website which you'll see below

Channel: ClevelandClinicCME

Views: 78,134

Keywords: Mellen Center, Cleveland Clinic, multiple sclerosis, MS patient videos

Id: n802xecIYaQ

Length: 3min 34sec (214 seconds)

Published: Tue Jun 16 2015