Doctors now have new tools to diagnose multiple sclerosis, or MS, earlier, sometimes even before a person experiences the symptoms of the autoimmune disease.
Doctors now have new tools to diagnose multiple sclerosis, or MS, earlier, sometimes even before a person experiences the symptoms of the autoimmune disease.
MS is a disease where the immune system attacks the protective covering around nerves known as myelin.
“We can now diagnose MS before someone even has a symptom. It’s really earth shattering,” said Julie Fiol, the associate vice president of Clinical Innovation and Strategy at the National MS Society.
The new guidance for neurologists comes in updates to the McDonald criteria, the checklist doctors use to diagnose MS.
Doctors now check the optic nerve, the part of the eye that helps you see, for damage. Even if someone hasn’t noticed vision problems, scans like an MRI or OCT, which is a special eye scan, can reveal signs of MS.
While doctors in the past often waited for a second MS episode to confirm the diagnosis, that’s no longer required if other signs are present. “We no longer require someone to have what was called dissemination in time… that’s one way that we’re helping people get to an MS diagnosis more quickly,” Fiol said.
Whether someone is a child or an adult under 50, the same criteria now apply when reaching a diagnosis. This makes diagnoses more consistent and helps avoid delays.
Doctors can now use special brain scans to look for signs like a central vein or a dark rim around lesions, which are features that help confirm MS and rule out other diseases. There’s also a newer spinal fluid test called the kappa free light chain (KFLC) index, which is easier to get in some places and helps doctors make a more accurate diagnosis.
If someone has brain scans that look like MS but no symptoms, they may still be diagnosed if other tests support it. This helps catch MS even earlier.
“The treatments we have work best when started early,” Fiol said. “We’re helping people get to a diagnosis more quickly and with more certainty.”
Multiple sclerosis symptoms can vary widely, but common ones include fatigue, vision problems, numbness or tingling, muscle stiffness, known as spasticity, as well as walking difficulties. Some people also experience cognitive changes, dizziness and bladder issues.
When it comes to vision, MS can cause pain with eye movement, blurred vision, dim vision or even loss of color when it comes to what a person sees.
For people already living with MS, these changes won’t affect their diagnosis, but their experiences helped shape the new guidelines. Their stories, according to Fiol, pushed researchers to find better ways to diagnose MS faster and more accurately.
Fiol said the updates mean more people can get answers sooner, no matter their age or where they live.
“I want people to feel reassured that if they were to develop symptoms, for most, they will be able to reach a diagnosis more quickly — and to have greater certainty in that diagnosis,” Fiol said.
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