diagnosis

The Food and Drug Administration (FDA) issued a safety alert about gadolinium, the dye that’s injected when our doctors order a brain MRI “with and without” contrast. The dye provides the contrast that “lights up” areas of MS inflammation in the brain. But the FDA advisory is…

As we all know, MS is difficult to diagnose. Put another way, it’s easy to misdiagnose. There’s no single diagnostic test for MS. Neurologists use their clinical examination, the patient’s medical history, and lab tests. They also rely on MRI imaging of the brain and sometimes of the…

The U.S. Food and Drug Administration (FDA) has updated a safety bulletin about gadolinium-based contrast agents (GBCAs), after studies raised new concerns about them. Doctors often use GBCAs to diagnose multiple sclerosis (MS), monitor disease activity and verify the effectiveness of MS therapies. Gadolinium is a metal ion, or electrically charged molecule, that…

An international panel of multiple sclerosis (MS) experts has proposed revising the McDonald criteria guidelines to improve and expedite the diagnosis of this disease. Co-chaired by Dr. Jeffrey Cohen of the Cleveland Clinic and Dr. Alan Thompson of the University College London, the 30-member panel reviewed newly available research…

University of Huddersfield researchers have developed a blood test for diagnosing multiple sclerosis that avoids the invasive, painful process of collecting fluid from the brain and spine. The team at the British discussed the test in an article titled “Sphingosine and dihydrosphingosine as biomarkers for multiple sclerosis identified by…

Blood levels of the nerve damage marker neurofilament light provide a reliable picture of multiple sclerosis activity in both the relapsing-remitting and progressive forms of the disease, a Swedish study reports. The University of Gothenburg researchers also discovered a close link between its levels in blood and spinal fluid. This means the…

My neurologist orders an annual MRI to see if any major changes have occurred, and last year my imaging included NeuroQuant software. NeuroQuant is still relatively unknown in the multiple sclerosis patient community. It is a measuring software that gives us real numbers we can comprehend instead of subjective…

The Mayo Clinic has developed a test that allows doctors to distinguish other inflammatory demyelinating diseases from multiple sclerosis in the early stages of a disorder. The test, the first of its kind in the United States, looks for an antibody against a protein known as myelin oligodendrocyte glycoprotein…

Anniversaries often invoke reflection about the beginning, the journey, and where we now find ourselves. With luck, lessons will have been learned from the invariably good and bad experiences that couple any passage of time. In November 2010, I sat, eyes firmly affixed, as my neurologist read my…

Editor’s note: Tamara Sellman continues her occasional series on the MS alphabet with this first of two columns about terms starting with the letter M. Symptoms of MS Memory problems Memory loss is a common complaint for people with MS. Even for those with no physical or…

In the future, a blood test may make diagnosing multiple sclerosis (MS) much easier, thanks to newly identified biomarker patterns that distinguish between MS patients and healthy people. The test could also correctly detect primary progressive MS (PPMS) in patients who also had relapsing-remitting disease (RRMS). Australian researchers suggest that…

Life is full of curveballs, with a mix of sliders, split-fingered fastballs, and sinkers thrown in. And, it is the curveballs that can be the hardest to take. Multiple sclerosis (MS) is one of the major “curveballs” thrown into my life; I didn’t see it coming and it…

Editor’s note: Tamara Sellman continues her occasional series on the MS alphabet with this first of two columns about terms starting with the letter L. Symptoms of MS Lesion Lesions are a defining feature of MS. They also are referred to as scars or plaques. These areas of damage…

The numbers of people being diagnosed with multiple sclerosis is rising worldwide, though distinct differences in factors thought to drive this rise are evident among regions, according to MS data represented by researchers on patients in Asia, Latin America, and the Australia-New Zealand. The data was part of the session “Prevalence and…

The Consortium of Multiple Sclerosis Centers has updated guidelines for using magnetic resonance imaging to evaluate people suspected of having multiple sclerosis. Doctors use the MRI guidelines not only to diagnose MS but also to track treatment results. A task force is reviewing the new guidelines before they're published. The working document is called  "Revised Guidelines of the CMSC MRI Protocol for the Diagnosis and Follow-up of MS." The task force, composed of neurologists, radiologists and imaging scientists experienced in MS, met in January 2017 to revise the guidelines. They also updated information about the situations for which standardized brain and spinal cord MRI scans should be used. One change is a recommendation that gadolinium, a contrast agent in scans, be used cautiously. The previous update, published in 2015, included no constraints on the use of gadolinium-based contrast agents. But soon after publication, information emerged showing that gadolinium, although not toxic, accumulates in the brain. This prompted the U.S. Food and Drug Administration to recommend limiting the use of gadolinium to “appropriate clinical circumstances.” To mirror the increased awareness of gadolinium deposits, the new guidelines say: “While there is no known central nervous system toxicity, these agents should be used judiciously, recognizing that gadolinium continues to play an invaluable role in specific circumstances related to the diagnosis and follow-up of individuals with MS.” Since 2009, the Consortium of Multiple Sclerosis Centers has addressed a number of other issues. One is encouraging the use of three-dimensional MRI for brain scans. Another is developing protocols for monitoring severe optic nerve inflammation and progressive multifocal leukoencephalopathy, or PML, a brain disease caused by a virus. The guidelines have been revised to recommend the specific timing of scans for monitoring PML. The update also includes recommendations for the timing of scans on patients receiving disease-modifying drugs. Since 2009, the guidelines have included recommendations on scans of radiologic isolated syndrome, a condition where MS-like MRI lesions are present without symptoms. And they have included provisions on the value of using MRI changes to evaluate treatment effectiveness. The centers' goal "is to standardize the MRI protocol and make these recommendations a useful guideline for neurologists, neuroradiologists, and related healthcare professionals during initial evaluations and during follow-up of patients with MS, and ultimately provide optimum care for those individuals dealing with this unpredictable disease,” June Halper, the centers' chief executive officer, said in a press release.

The year’s largest gathering of multiple sclerosis “minds” starts on Oct. 25 in Paris. More than 8,000 neurologists, researchers and others who specialize in treating and curing MS will be attending MSParis2017. It’s a joint meeting of the European and the Americas Committee for Research in Multiple Sclerosis…

Magnetic resonance imaging (MRI) brain scans of children could reveal changes associated with multiple sclerosis (MS) before any symptoms are developed, according to a study by scientists at Yale University School of Medicine. The findings suggest that brain and spinal cord scans can identify children at high risk for developing MS.

We are familiar with the “why me” moments? I reference this often because it is a recurring subject in the lives of people with chronic illness. As a little girl I’d ask my parents why my heart is sick, and as an adult, I still ask why have I…

Groundbreaking evidence of the existence of lymphatic vessels in the human brain could answer the question of how the brain gets rid of waste products, and holds clear implications for neuroinflammatory disorders such as multiple sclerosis. The lymphatic system is a network that helps the body to rid itself of toxins and waste products. Lymphatic vessels, which are similar to blood vessels, transport a clear fluid – lymph – which is filtered in lymph nodes. It has long been thought that the brain lacks lymphatic vessels. However, a team of researchers at the National Institutes of Health (NIH), building on previous research in rodent brains, recently found evidence that the brain may actually drain waste through lymphatic vessels. The researchers injected healthy volunteers with a magnetic dye called gadobutrol, which is usually used as a contrast agent to image blood vessels. They then scanned the brains of these individuals using magnetic resonance imaging (MRI) under specific settings. This allowed them to view the dye within the outer layer of the brain, known as the dura. The MRI revealed that the dye was visible both as dots and straight lines, which might indicate lymph vessels. This suggested that the dye leaked out of blood vessels into the dura and were later 'picked up' by lymphatic vessels. These vessels were not seen when the volunteers were injected with another dye that does not leak out of blood vessels. Evidence of lymphatic vessels in the brain was also found in autopsied human brain tissue. Although a pair of 2015 studies had shown evidence of lymphatic vessels in the brains of mice, this is the first study that demonstrates that a similar system exists in human brains. “For years we knew how fluid entered the brain. Now we may finally see that, like other organs in the body, brain fluid can drain out through the lymphatic system,” Reich said . In addition to changing the way we think about the lymphatic system and the brain, this study lays the foundations for future research to investigate whether the function of the lymphatic system is altered in the brains of patients with multiple sclerosis or other disorders affecting the nervous system.

It took two years and many doctors to finally receive my MS diagnosis. Frequent painful sensations, such as burning, itching, stabbing, and tingling in my arm and shoulder, led my providers and me on a wild-goose chase in search of other problems. When my speech and balance were…