Multiple Sclerosis in Seniors: Mental Health and Wellbeing

What Are Exams and Tests?

Symptoms of MS may mimic those of many other nervous system problems. MS is diagnosed by determining if there are signs of more than one attack on the brain or spinal cord and by checking for other conditions.

People who have a form of MS called relapsing-remitting MS have evidence of at least two attacks separated by a remission.

In other people, the disease may slowly get worse in between clear attacks. This form is called secondary progressive MS. A form with gradual progression, but no clear attacks is called primary progressive MS.

Your health care provider may suspect MS if there are decreases in the function of two different parts of the central nervous system (such as abnormal reflexes) at two different times.

An exam of the nervous system may show reduced nerve function in one area of the body. Or the reduced nerve function may be spread over many parts of the body. This may include:

• Abnormal nerve reflexes
• Decreased ability to move a part of the body
• Decreased or abnormal sensation
• Other loss of nervous system functions, such as vision

An eye exam may show:

• Abnormal pupil responses
• Changes in the
  visual fields
• Changes in eye movements
• Damage to the nerve in the eye ( optic nerve atrophy )
• Decreased visual acuity
• Problems with the inside parts of the eye
• Rapid eye movements triggered when the eye moves

Tests to diagnose MS include:

• Blood tests to check for other conditions that are similar to MS.
• Lumbar puncture
  (spinal tap) for cerebrospinal fluid (CSF) tests, including CSF oligoclonal banding may be needed.
• MRI scan of the brain
  , or the spine, or both are important to help diagnose and follow the progress of MS.
• Nerve function study (evoked potential test, such as visual evoked response) is less often used.

How Is It Treated?

There is no known cure for MS at this time, but there are treatments that may slow the disease. The goal of treatment is to stop progression, control symptoms, and help you maintain a normal quality of life.

Medicines are often taken long-term. These include:

• Medicines to slow the disease
• Steroids to decrease the severity of attacks (more effective for relapsing-remitting form of MS than for other forms)
• Other medicines are used to control symptoms such as muscle spasms, urinary problems, fatigue, or mood problems

The following may also be

helpful for people with MS

:

• Physical therapy, speech therapy, occupational therapy, and support groups
• Assistive devices, such as wheelchairs, bed lifts, shower chairs, walkers, and wall bars
• A planned exercise program early in the course of the disease
• A healthy lifestyle, with good nutrition and enough rest and relaxation
• Avoiding fatigue, stress, temperature extremes, and illness
• Changes in
  what you eat or drink if there are swallowing problems
• Making changes around the home to
  prevent falls
• Social workers or other counseling services to help you cope with the disease and get assistance
• Vitamin D or other supplements (talk to your provider first)
• Complementary and alternative approaches, such as acupuncture or cannabis, to help with muscle problems
• Spinal devices can reduce pain and spasticity in the legs