Multiple Sclerosis: Diagnosis and Therapy.

Secondary progressive MS (SPMS) is initially relapsing-remitting and then becomes progressive. Primary

progressive MS (PPMS) has a progressive course from the beginning of the disease with no remissions. Progressive-relapsing MS

(PRMS) has a progressive course from the beginning with acute relapses, with or without full recovery.

MS is believed to be an autoimmune disease, where the immune system targets the myelin in the central nervous system. MS is the

most common demyelinating disease. During an attack (exacerbation), inflammation occurs in the white matter of the central nervous

system. This process is followed by destruction of myelin causing areas called plaques. Not only is the myelin damaged, but the attack

may also damage or sever the nerve fibers underneath the myelin. The nerve cannot conduct or send a signal properly without the

myelin sheath.

MS can be difficult to diagnose because there are other diseases with similar symptoms, and there is no specific test to confirm the

diagnosis. A process of elimination may be done along with a combination of imaging technologies such as MRI, CSF analysis , evoked

potentials (EVP), medical history, and clinical examination.


The symptoms of MS are unpredictable, can vary greatly from person to person, and can be intermittent. The neurological symptoms

of MS are the result of demyelination. Symptoms include:

blurred, double vision, and blind spots

numbness, tingling, and paresthesias (pins and needles)

fatigue, dizziness, and vertigo

difficulties with memory loss, concentration, and attention

difficulty with coordination, balance, and gait

muscle and nerve pain, muscle weakness, and tremors

bladder and bowel problems

According to the National Center for Health Statistics, stroke is the fourth leading cause of death in the United States. In order to

improve this statistic, patients need prompt interventions. The public education campaign, “Know Stroke: Know the Signs. Act in Time,”

promoted by the National Institute of Neurological Disorders and Stroke (NINDS) teaches people how to recognize the signs and

symptoms of stroke and the importance of prompt medical treatment to improve recovery. Tissue plasminogen activator (t-PA), the first

Food and Drug Administration (FDA) approved acute ischemic stroke treatment, needs to be given within a three-hour window of the

onset of symptoms to dissolve the clot. Stroke is diagnosed by a neurological examination, blood tests, brain imaging scans, Doppler

ultrasound, or arteriography.