Diagnosis Multiple sclerosis is difficult to diagnose in its early stages. In fact, definite diagnosis of MS cannot be made until there is evidence of at least two anatomically separate demyelinating events occurring at least thirty days apart. The McDonald criteria represent international efforts to standardize the diagnosis of MS using clinical data, laboratory data, and radiologic data.[4] Clinical data alone may be sufficient for a diagnosis of MS. If an individual has suffered two separate episodes of neurologic symptoms characteristic of MS, and the individual also has consistent abnormalities on physical examination, a diagnosis of MS can be made with no further testing. Since some people with MS seek medical attention after only one attack, other testing may hasten the diagnosis and allow earlier initiation of therapy. Magnetic resonance imaging (MRI) of the brain and spine is often used to evaluate individuals with suspected MS. MRI shows areas of demyelination as bright lesions on T2-weighted images or FLAIR (fluid attenuated inversion recovery) sequences. Gadolinium contrast is used to demonstrate active plaques on T1-weighted images. Because MRI can reveal lesions which occurred previously but produced no clinical symptoms, it can provide the evidence of chronicity needed for a definite diagnosis of MS. Testing of cerebrospinal fluid (CSF) can provide evidence of chronic inflammation of the central nervous system. The CSF is tested for oligoclonal bands, which are immunoglobulins found in 85% to 95% of people with definite MS (but also found in people with other diseases). [5] Combined with MRI and clinical data, the presence of oligoclonal bands can help make a definite diagnosis of MS. Lumbar puncture is the procedure used to collect a sample of CSF. The brain of a person with MS often responds less actively to stimulation of the optic nerve and sensory nerves. These brain responses can be examined using Visual evoked potentials (VEPs) and somatosensory evoked potentials (SEPs). Decreased activity on either test can reveal demyelination which may be otherwise asymptomatic. Along with other data, these exams can help find the widespread nerve involvement required for a definite diagnosis of MS.[6] Another test which may become important in the future is measurement of antibodies against myelin proteins such as myelin oligodendrocyte glycoprotein (MOG) and myelin basic protein (MBP). As of 2005, however, there is no established role for these tests in diagnosing MS. The signs and symptoms of MS can be similar to other medical problems, such as stroke, brain inflammation, infections such as Lyme disease (which can produce identical MRI lesions and CSF abnormalities[7][8][9][10]), tumors, and other autoimmune problems, such as lupus. Additional testing may be needed to help distinguish MS from these other problems.

The available treatments work differently for each person, as does the course of the disease. There are a number of treatments that have been approved by the FDA that are recommended to be taken soon after a diagnosis of MS. They are Avonex, Copaxone, Betaseron and Rebif. These drugs are supposed to help stop the progression of the disease. However, one may be effective for you while not effective for another person. There are other drugs that can be effective as well. IV steroids can be effective for treating exacerbations, and there are some other drugs that can be effective for progressive forms of the disease. If you've been diagnosed with MS, talk to your neurologist about which treatment will be best for you - you may have to try a few over a number of years if one isn't helping.

I think the most important thing is to get on a course of long-term treatment as early as possible. There is a significant body of research that shows that those who start on the maintenance drugs early in the course of the disease (even when remissions may be few, far between, and relatively mild) have a *much* better long term prognosis than those who wait. There are four main drugs that are generally used to treat MS: Avonex, Betaseron, Copaxone, and Rebif. (My wife has been on Betaseron since around the early 90's with great results.) There are other drugs either available now or becoming available soon. One of those that shows great promise is Tysabri. Tysabri showed in clinical trials to be extremely effective in treating relapsing-remitting MS. Unfortunately, soon after it was approved by the FDA there were a couple of people that died while taking Tysabri (along with some other meds and complicating factors). Tysabri was pulled from the market for a while to study the issue, but has recently been made available again. My understanding is that it is limited to mono-therapy only (not in conjunction with one of the other MS drugs) due to the difficulties with a couple of those that were on multiple-drug therapy.

best treatment for me was removing my amalgam filling. and replacing with compatable composits. almost recovered.