Multiple Sclerosis Program

Diagnosing Multiple Sclerosis

Sometimes the diagnosis of MS is straightforward and sometimes, it can take a long time while other neurological conditions are ruled out. There is no specific single diagnostic test for MS, so there are a set of criteria that doctors look for to confirm a diagnosis. These include:

• Confirming that inflammation has occurred in two separate areas of the central nervous system (CNS).
• Confirming that inflammation occurred at different times, at least a month apart.
• Ruling out other reasonable possible causes.

These criteria assume that MS is the most common cause of relapsing neurological problems that affect multiple areas of the brain or spinal cord, with abnormal MRI scans in people at risk. Depending on geography, ethnicity and family history, other diagnoses need to be considered and other tests may be needed.

Once MS is suspected, a doctor will then use the following tools to confirm a diagnosis:

• Medical history: Your doctor will discuss your history of symptoms that might be caused by MS in detail and will also ask about your family history.
• Neurologic exam: There are several types of neurological exams that the doctor might perform, including assessing vision, movement, balance, and reflexes.
• MRI scan: This can detect scarring on the brain or spinal cord, which shows up as white spots/lesions, and highlights where nerve damage has occurred.
• Lumbar puncture: A small amount of fluid may be taken from the spinal canal in the lower back, which is then examined for features of inflammation and MS.
• Blood tests: A blood test might help to rule out other causes of symptoms.
• Visual evoked responses: A test that assesses the visual pathway from the back of the eye to the brain. It is done by flashing lights in front of the eye and placing some wires on the scalp to record responses.

Treating Multiple Sclerosis

MS is a complex condition and treatment is a long-term process that lasts the course of the disease. Having access to comprehensive, multidisciplinary care is key to treating MS and improving quality of life. The Multiple Sclerosis Program at Cleveland Clinic Abu Dhabi provides a team of specialists who work together to help you manage the disease and its symptoms. Each team member provides unique insights into ways to modify the course of the disease, deal with relapses, treat the symptoms, and address other factors such as emotional wellbeing.

These include a neuro rehabilitation physician, physiotherapist, occupational therapist, nutritionist, psychologist, gastroenterologist, speech and swallow therapists, and many other professionals.

While there is no cure for MS, many types of treatment are available that can slow or prevent attacks from occurring, and delay or hopefully stop progression of the disease. The Program offers FDA (United States Food & Drug Administration) and EMA (European Medicines Agency) approved disease modifying medications for MS patients, including intravenous medication that can be administered at the Cleveland Clinic Abu Dhabi Infusion Center. Treatment can also help to manage symptoms and speed-up recovery following a relapse.

Treatment may include:

• Medication therapy
• Treatment for an attack or relapse
• Disease modifying therapy (DMT) which can include:
  • Tablets
  • Intravenous drugs
  • Subcutaneous injections
• Symptomatic therapy (a range of medications used to manage symptoms of MS, including pain, muscle stiffness, urinary urgency or frequency, muscle spasms, and fatigue. Various options, including botox injections, may be offered).
• Rehabilitation
• Educational support.