Multiple Sclerosis Diagnosis and Treatment

While the progression of multiple sclerosis is different for each patient, individuals experience one of four courses:

• Clinically Isolated Syndrome (CIS): The initial neurological event that precedes multiple sclerosis. CIS does not always progress to MS in all patients
• Relapsing-Remitting MS: Clearly defined deterioration of neurologic function (referred to as exacerbations, relapses, attacks, or flare-ups) followed by limited or full recovery
• Primary Progressive MS: Slowly deteriorating neurologic function from the onset of the disease with no remission or relapses
• Secondary Progressive MS: Steadily worsening of the disease after initial relapsing-remitting MS

There is no single medical test or set of physical findings that conclusively diagnoses multiple sclerosis. Our physicians use a variety of tools to determine whether an individual has MS or another, similar neurological condition. These tools may include:

• Medical history
• A neurological exam
• Blood tests
• Magnetic resonance imaging (MRI), which provides information about brain lesions
• A cerebral spinal fluid analysis, which looks for chemical abnormalities associated with MS
• Evoked potential (EP) tests that measure electrical activity of the brain in response to stimuli
• An optical coherence tomography (OCT) scan, which examines the optic nerve and retinal tissue at the back of the eye. This non-invasive scan is being tested as a "bio-marker" for asymptomatic patients who are at high-risk for developing multiple sclerosis and other neurological disorders.

Although there is currently no cure for multiple sclerosis, the past three decades have brought new treatments that can slow progression of the disease and reduce severity of symptoms. In addition to having access to the latest medications and procedures, UChicago Medicine neurologists have the experience, skills and expertise to help patients manage multiple sclerosis and lead the fullest lives possible. We provide compassionate and personalized care and examine the course of each person's disease before recommending a course of action.

Some of the effective strategies for treating flare-ups and managing symptoms include:

• Steroids to reduce inflammation during exacerbations
• Medications to manage and treat various MS symptoms, such as spasticity, pain, fatigue, numbness, vertigo, vision problems, issues with balance and gait, bladder and bowel dysfunction, cognitive dysfunction, depression and sexual dysfunction
• Botulinum toxin (Botox) injections to reduce spasticity in specific muscles and also in an overactive bladder
• Intrathecal baclofen pump (ITB therapy) to manage spasticity
• Deep brain stimulation (DBS), a neurosurgical treatment to relieve tremors by electrical stimulation of brain areas that control movement
• Rehabilitation therapy to improve mobility, fitness, energy, speech, memory, swallowing, etc.
• Lifestyle adjustments such as healthy eating, vitamin D supplements, exercise and smoking cessation
• Radiofrequency lesioning to control facial pain in association with MS. This is a surgical treatment to selectively destroy pain fibers just beneath the skin of the face.