Depending on the patient, multiple sclerosis can manifest in several ways and affect patients differently. The autoimmune disease, known as MS, is chronic and often progressive, and affects the brain and spinal cord.
While there’s no known cause or cure, genetic and immunological factors are often present in the roughly 1 million people in the U.S. affected by the disease. And because MS can be difficult to diagnose, symptoms vary. They range from fatigue to blurry vision, and from numbness in the limbs to bladder problems. Some patients experience lesions, which are inflammation of the spinal cord (known as transverse myelitis) or optic nerve (known as neuritis).
“Compared to other neurological conditions, MS is broader because it can affect any part of the central nervous system,” said Dr. Nancy Rosales, who provides specialty neurological care at Novant Health Neurology & Sleep - Kimel Park. “My job is to see if the patient’s clinical history is consistent for MS.”
This fall, Rosales will relocate to the new Novant Health Multiple Sclerosis Care - Kernersville clinic. Here she answers common questions patients have after being diagnosed.
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How am I diagnosed with MS?
This is one of the main questions I get from patients, and I explain that there is no single test that will tell me if they are positive or negative for MS. In addition to the clinical history, the exam, and the imaging we use ancillary testing, such as a spinal tap or optical coherence tomography to assess the optic nerve. And with that, we see if the patient meets the McDonald criteria for MS.
MS is usually diagnosed in young females. Many ask if they can still have children. In general, yes. Pregnancy can protect females with MS, meaning their symptoms usually don’t get worse, known as relapsing. But once they deliver the baby, the patient is once again at high risk. If they are taking medication for MS and want to get pregnant, I meet with them and we create a schedule of when it is safe for them to get pregnant. And depending on the treatment, there is usually no problem for the mother or the baby.
What type of MS do I have?
This is an important question because most of the medications that are approved are for treating patients who have relapsing-remitting MS (the most common type), rather than progressive MS (gradual).
Usually, patients who have relapsing-remitting MS will have neurological symptoms that with time will get better. Some patients are able to go back to baseline and others are not. But there will be some neurological improvement, as compared to the patients who have progressive MS, where symptoms get worse. Some patients may have both components, and as they get older they may develop secondary progressive MS.