MS Symptoms Multiple Sclerosis

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MS Symptoms Multiple Sclerosis
MS Symptoms Multiple Sclerosis
Video: MS Symptoms Multiple Sclerosis
Video: MS: The Basics - Symptoms of Multiple Sclerosis 2023, February

Multiple Sclerosis: Symptoms & Diagnosis

Multiple sclerosis (MS) is different for everyone. It is also known as the "disease with a thousand faces" due to the wide range of symptoms. In order to confirm the diagnosis of multiple sclerosis, the doctor must consider the symptoms, course and examination results together. Magnetic resonance imaging (MRI) of the brain often provides important information.


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  • Which complaints can arise?
  • How is the diagnosis made?
  • Whom can I ask?
  • How are the costs going to be covered?

Which complaints can arise?

At the beginning, the disease manifests itself through the following symptoms:

  • Sensory disorders: for example, abnormal sensations such as tingling or pins and needles, impairment of the sensation of touch ("numb feeling") etc.;
  • Deterioration in visual acuity (inflammation of the optic nerve);
  • Dizziness, imbalance, stumbling;
  • Paralysis: Muscle weakness in several muscles of an arm or leg, eg with a feeling of heaviness or unsteady gait etc.;
  • rapid physical and mental fatigue.

Depending on the course of the disease, further symptoms may appear later:

  • Paralysis associated with increased muscle tension (so-called spastic paresis) - e.g. stiff paralysis of both legs (paraspasticity);
  • Urination disorders: frequent urination, sometimes incontinence, but also delayed and incomplete urination;
  • Defecation disorders: constipation, more rarely fecal incontinence (bowel contents go uncontrollably);
  • Muscle spasms, decreased dexterity;
  • Dizziness, disorders of coordination, balance and movement ("atactic movement disorders"): eg clumsiness in everyday activities;
  • Pain: joints, muscles, face and head area (e.g. trigeminal neuralgia);
  • Visual, speech, swallowing, taste and hearing disorders;
  • mental problems (e.g. depression);
  • cognitive (mental) impairments (eg attention, memory);
  • Sexual disorders: decreased libido / ability to orgasm, erectile dysfunction and ejaculation disorders (disorders of ejaculation);
  • rapid physical and mental fatigue ("MS Fatigue").

Note on sensitivity to heat ("Uhthoff phenomenon"): Fever or heat can temporarily worsen pre-existing symptoms that are reminiscent of the effects of a flare-up (“pseudo-flare”). As soon as the body or the ambient temperature falls back to normal, these symptoms pass. Discomfort is also exacerbated by pain, exhaustion, excitement, anxiety and stress.

How is the diagnosis made?

In an anamnesis interview with the specialist in neurology, the type and timing of the symptoms as well as any previous and family illnesses are discussed. The initial symptoms are often not characteristic and therefore cannot be clearly assigned to an MS disease. Basically, the diagnosis of MS is a diagnosis of exclusion. Therefore, other possible causes for the inflammatory marrow damage of the CNS (e.g. certain infections or autoimmune diseases) must be ruled out.

As part of a clinical neurological examination, the individual neurological functional systems are tested and a degree of disability (EDSS scale from 0 to 10) is determined. The collected numerical value (EDSS grade) expresses the extent of the neurological impairment / handicap and helps in control examinations to determine changes in the course of the disease.

By examining the nerve water ("liquor"), it is possible to determine whether there is an inflammation in the central nervous system.

MS can be diagnosed at an early stage using a number of diagnostic procedures. Magnetic resonance imaging (MRI) of the brain and spinal cord can be used to visualize inflammation foci and areas of scarring.

Furthermore, so-called evoked potentials are used to measure the conductivity and speed of nerves. By measuring “visually evoked potentials” (VEP), for example, the functions of the optic nerve and the visual pathway are recorded.

Using evoked potentials, the conductivity and speed of the nerve structures can also be measured, which are responsible for:

  • Emotional perceptions - e.g. touch and pain (somatosensitive evoked potentials - SSEP) or
  • hearing (acoustic evoked potentials - AEP)
  • the coordination of muscle movements (motor evoked potentials - MEP)

are responsible.

In addition, blood tests are carried out in the laboratory.

The nerve cells of the retina in the eye are also damaged at a very early stage in multiple sclerosis. Using so-called optical coherence tomography (OCT), the retina is examined with bundled light. This allows nerve damage to be detected. The bundled light is guided into the eye from outside via the pupil. This examination can be repeated for follow-up checks.

Whom can I ask?

The earlier MS is recognized, the better the chances of influencing the course of the disease positively. Therefore, if you experience symptoms that indicate a neurological dysfunction (e.g. muscle weakness, sudden visual disturbances, dizziness, numbness), you should immediately consult your family doctor or a neurologist to clarify the cause.

When symptoms

  • occur suddenly,
  • deteriorate rapidly,
  • fever or
  • develop severe headaches
  • focal or generalized epileptic seizures or
  • Disturbances of consciousness occur,

the emergency doctor (Tel.: 144) should be contacted immediately or a hospital should be visited.

How are the costs going to be covered?

All necessary and appropriate diagnostic measures are taken over by the health insurance carriers. Your doctor will generally settle accounts directly with your health insurance provider. With certain health insurance providers, however, you may have to pay a deductible (treatment contribution) (BVAEB, SVS, SVS, BVAEB). However, you can also use a doctor of your choice (ie doctor without a health insurance contract). For more information, see Costs and Deductibles.

In the case of certain examinations (e.g. MRI), approval from the health insurance provider responsible for the benefits (medical service - "chief physician") may be required. In the case of certain services (e.g. inpatient stays) - depending on the health insurance provider - patient co-payments are provided.

For more information about the respective provisions, please contact your health insurance provider, which you can find on the website of your social insurance, for example.

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