Odpovedal: EDUSAN - neurologist Re: multiple sclerosis - undiagnosed (číslo príspevku 9.805, zo dňa 14.07.2002. videné 394x) ODPOVEDAŤ / Predchádzajúci príspevok   Text príspevku číslo 9805: Dear Christina, more then 50 % of multiple sclerosis (MS) cases begin between the ages of 20 and 40 years. The incidence of initial symptoms is: motor weakness in limbs (40 %), optic neuritis (22 %), paresthesia (21 %), diplopia (12 %), vertigo (5 %), disturbance of bladder function (5 %) - according to McAlpine et al. Altered mental status is more common in the later stages (13 %). Approximately 10 % of patients with MS develop focal or generalized seizures during the course of the disease, but usually not as initial symptoms. Magnetic resonance imaging (MRI) can demonstrate areas of demyelination in the brain or in the spinal cord. Electrophysiological methods most frequently used are: evoked potentials and nerve conduction studies. Cerebrospinal fluid can be useful in the diagnostic assessment of patients suspected for MS. Differential diagnosis: neuroborreliosis, collagen-vascular disease, acute disseminate encephalomyelitis, postinfectious (or postvaccination) encephalomyelitis, myelopathy, vitamin B12 deficiency, heredodegenerative disease, motoneuron disease and other. Your questions: 1./ complex partial seizures can be symptoms of MS, but usually not initial, and not alone, 2./ A person can have MS also if no lesion in the brain show up on the scans (a lesion of demyelination can affect spinal cord only). Pain in joints is not symptom of MS but usually appear in inflammatory disease (tick-born borreliosis). Other symptoms seams be due to cerebellar or brainstem lesion (vertigo, „walk like a drunk person“, eyes jerking, slurring speech) and cortical lesion (short memory, difficulty in finding a correct word). Multiple sclerosis appears more frequently in the attacks of worsening (relapsing-remitting course). Approximately 10 % of the patients exhibit chronic progressive form from the onset. Many patients don´t tolerate heat, hot weather or hot bath. Diagnosis of MS is based on history, physical examination and laboratory tests. Diagnostic criteria for definite, probable and possible multiple sclerosis were established. Dear Christina, according to my opinion your symptoms can be due to MS, but also other diseases must be taken in account and/or excluded. I recommend you basic examination of the blood, serological examination (antibodies - Borrelia and other antigens), neurological examination and laboratory tests (MRI – brain and spinal cord, evoked potentials, nerve conduction study – EMG, EEG, cerebrospinal fluid examination – if necessary). All these tests can be done during short hospitalization at Department of neurology. Some information you can find also in Re: Multiple sclerosis.