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Neurology online by Dr. Strizhak

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Do I have Multiple Sclerosis?

MS Phobia – When is Time to Worry about MS? – What are Not MS Symptoms? – My Sister has MS – Do I?

Do I have Multiple Sclerosis?

Multiple sclerosis is a tremendous physical and psychological burden for those who are unfortunate to have it and for their families. Impact of MS on the society does not stop here.

Modern hysterical society is overfed with shallow useless information about multiple health conditions. Most of this pseudo-knowledge is supplied by unprofessional sites successfully playing the “Google-Game”.

The detailed information about MS symptoms is displayed on the separate page.

MS phobia is an extremely common issue. Wide-spread multiple sclerosis fear prompted me to address the most common MS concerns.

These are Not MS Symptoms!

People with anxiety disorder often experience numerous body sensations. Numbness is the most common one. Hyperventilation is typical in panic attacks. Hyperventilation produces temporary metabolic changes, which may cause a profound sensation of numbness and tingling in the body. It starts in the face and moves down, sometimes engulfing the whole body. This tingling attack subsides shortly after the panic attack is over. In some people, it may persist for a few hours.

I’ve never had a panic attack myself, but my own experience with hyperventilation related tingling at high altitude was pretty spectacular. Once, I ascended too fast at a high altitude. This tingling in the head was dramatic and persisted for a few days.

This type of tingling is not a symptom of MS. Anxiety makes people hyper-vigilant about body senses. Traveling sensation of numbness from one part of the body to the other is not a symptom of multiple sclerosis. If you are numb today in the pinky, tomorrow in the thigh, and after tomorrow in the face – it is not MS.

Multiple sclerosis attack related numbness is fixed to a particular part of the body for days or weeks before it subsides. It does not come and go back and forth (even in the same place). MS symptoms are caused by lesions in specific areas of the brain and/or the spinal cord. They simply cannot jump from one place to the other and back within hours or even days.

The most common MS related sensation is a neuropathic type of numbness. It is not just tingling or loss of sensation. It is an unpleasant, hard to describe sensation with some element of pain, itching, burning. The pain element is mild but annoying. It is usually hard to pinpoint the exact location. It may involve a limb, some part of the trunk, the face, or the whole body below specific level.
As any other symptom of MS, sensory symptoms start insidiously rather than abruptly.

Fine muscle twitching is never a sign of MS. Muscle spasms do occur but not as a first symptom, though. There are a few sudden onset symptoms in MS described on the MS symptoms page, but they all have very specific qualities and occur in patients with a long history of MS.

Trigeminal neuralgia raises MS red flag only if it comes at a young age, involves both sides, or associated with other suspicious symptoms.

Fatigue is a very common associated symptom of multiple sclerosis. Please, don’t be concerned about MS with fatigue alone. Fatigue is not the first symptom of multiple sclerosis.

Vertigo, dizziness, lack of coordination, tinnitus might be the symptoms of MS. It is hard to say anything specific about it without neurological examination and detailed history. I see patients with these complaints every single office day. When was the last time I diagnosed someone with MS based on these symptoms? I don’t even remember. In this case, statistics is not on MS side.

Sudden weakness in any part of the body is never a first sign of MS. It is more typical for strokes. Similar to numbness, it takes some time to develop and to improve (days to weeks).

Blurred vision is technically a potential sign of optic neuritis. Please note, optic neuritis cannot come and go or switch sides back and forth. Once it started it has to run its course from worsening to improvement over some time.

“My sister’s got MS, Doc. I have tingling and I feel tired. Do I have MS?” Statistics is on your side. Yes, the chance is increased relative to the general population, but it is still low. It is between 3% and 5% in nonidentical siblings.

“I have white spots on the MRI. Do I have MS?” The answer is no unless you have other symptoms described in MS symptoms article and the lesions are in specific and multiple locations, combined with evidence of old and new lesions. Unless you meet specific criteria, you don’t have MS. Simply having “white spots” on the MRI is not enough for diagnosis of multiple sclerosis. Radiologically isolated syndrome has its own proposed criteria as well.

MS phobia is not uncommon among doctors either. The vast majority of patients referred to MS Centers in the US to rule out multiple sclerosis don’t have it.

Hysteria about missing MS diagnosis is not medically justified. Premature MS scare does more harm than good. Considering the fact that our society is hyper-vigilant about this condition, doctors have to think twice before sharing premature MS concerns with their patients; unless there are sufficient data for the diagnosis.

The reason is simple. There is no urgency in MS treatment. Acute attack treatment does not affect the long-term prognosis. There is always time to think. A few inappropriate words may do lots of damage to the person.

Rear fulminant forms of multiple sclerosis are the only cases requiring urgent care. The symptoms are dramatic, relentlessly progressing, often associated with mental status changes, and are hard to miss. If you are reading it in the comfort of your home rather than in the ER, you probably don’t have it!

The last advice: If you are concerned about having multiple sclerosis, the best action is to see a specialist in this field rather than speculating and reading stuff off the internet and blogs. It is a complex part of neurology field even for physicians.
Don’t try to make this diagnosis by yourself!

Any comments about this page will be greatly appreciated at doctorstrizhak@gmail.com Content copyright 2017. DOCTORSTRIZHAK.COM. All rights reserved.
Disclosure: This Web Site is intended for education purpose only. The information provided on this site must not be perceived as a guide for self-diagnosis or self-treatment. Every effort is made to keep the information current, but there are absolutely no guarantees of timely updates. By Andre Strizhak