Understanding Walking Tests for Multiple Sclerosis?

The usual course of a diagnosis of multiple sclerosis begins with a patient suffering from a few or even many unexplained neurological symptoms. This can be accompanied by other more alarming problems, including the appearance of lesions in the brain and/or spinal cord on an MRI, loss of balance, weakness in limbs, and eyesight problems, such as double vision.

The diagnosis is reached by elimination:

following all medical possibilities such as autoimmune conditions which produce similar symptomatology until no remaining probable source for the problem can be found. Eventually “MS” becomes part of that list.

When this process is complete and MS remains in contention, the neurologist will embark upon a so-called “work-up,” to reach a firm diagnostic conclusion through gathering all the data that is necessary. One of the key parts of this process is a series of neurological and general medical tests which will help to divide MS from other possible conditions.

The following are some examples:

(1) Electromyogram (EMG)-

The EMG is a test whereby the electrical activity of muscles is recorded via electrodes placed at various points on your body. To obtain the best results, it’s important for you not to move during testing so you will be asked to relax while holding very still or even just lying down with your eyes closed during the procedure.

This helps ensure that any problems with muscle function can be identified clearly. If there seems to be a problem with nerve signals getting from the brain into the muscles or from the muscles back to the brain, it can be better determined with this test.

(2) Nerve Conduction Velocity Test (NCV)-

In this study, a nerve conduction velocity stimulator is used which emits electrical impulses and transmits them through electrodes placed on your skin. The time and intensity of these signals are measured as they travel down nerves in different parts of the body.

This test helps diagnose conditions that damage nerve fibers and can help locate where demyelination (the loss of protective sheath around nerve cells) may be occurring. It also helps determine how fast messages move between different areas of your central nervous system (brain and spinal cord).

(3) Magnetic Resonance Imaging (MRI)-

An MRI is a diagnostic procedure that uses a combination of large magnets, radiofrequencies, and a computer to produce detailed images of organs and structures within the body. An MRI does not use ionizing radiation (x-rays). However, people with some medical devices, such as pacemakers or metallic implants cannot be examined with MRIs because of the effects of the strong magnetic field on these devices.

(4) Evoked Potentials Tests-

One type is a visual evoked potentials test in which electrodes are placed at strategic points on your scalp to monitor electrical activity from your brain in response to visual stimuli flashed before your eyes. In another form, auditory evoked potentials, specific sounds are played through headphones electrodes to assess any changes in electrical activity in response to these sounds.

Both tests may be recommended to assess your nerve pathways allowing your doctor to determine the degree of damage that’s taken place if any.

(5) Lumbar Puncture-

The test itself is not painful but a local anesthetic may be injected into the area where the spinal tap will take place before this procedure begins. During a lumbar puncture, a needle is used to remove a small amount of cerebrospinal fluid from your lower spine for testing. This helps determine whether you have multiple sclerosis or another condition affecting the brain and spinal cord such as Lyme disease or certain types of tumors.

In addition to these tests, various other procedures are sometimes employed including:

· Blood tests to look for antibodies that may be associated with multiple sclerosis.

· Spinal taps or punctures of the fluid surrounding your brain and spinal cord.

· Nerve conduction studies (a series of electrical impulses are passed along nerves in your neck, arms, and legs).

(6) Visual Evoked Potential (VEP)-

This test is used to evaluate the optic nerve and visual pathways located at the back of your brain; it can detect demyelination or scarring on these issues. The patient must wear a special pair of goggles (called an Oculus Rift) which displays large moving spots on a screen.

Electrodes measure any changes in electrical activity produced by this image moving before the individual’s eyes. The electrodes are attached to the scalp and neck, and the machine is adjusted for each eye. The patient is then asked to press a button whenever he or she sees one or more of these spots. This test takes about 20 minutes to perform.

Multiple sclerosis walking scale:

Multiple sclerosis or MS is a disease in which there are lesions of scar tissue in the brain, spinal cord, and optic nerves. These lesions cause symptoms such as muscle weakness, problems with balance and coordination, vision problems, feeling tired easily, bladder issues, pain, and more.

To keep track of how symptoms change over time, doctors may use a scale called the neurologic disability score which ranges from 0-3. A score of 0 means no symptoms and 3 means paralysis or death due to MS.

(1) Walking scale for MS:

A walking scale is a tool used by healthcare providers to assess how individuals with multiple sclerosis walk. The following categories are rated: 1 – Normal gait without aid 2 – Slightly abnormal gait needing cane/walker/other support device but still able to walk unassisted 3 – Gait impaired such as to impair normal activities (i.e., unable to walk at all) 4 – Unable to stand independently and require a wheelchair for mobility

MS causes can:

MS is caused by damage to the myelin sheath, the protective covering that surrounds nerve fibers. This damage interrupts messages between the brain and body. MS is considered an autoimmune disease because it occurs when the immune system mistakenly attacks healthy tissue in your central nervous system. Although there’s no known cure for MS, treatments are available to help prevent new attacks, manage symptoms and reduce related complications of MS.

Several factors may increase your risk of developing MS including having a family history of the disorder or exposure to certain viruses during childhood. But overall, more women are affected with multiple sclerosis than men. Scientists think this difference is due to some genetic factor that remains elusive as yet, but environmental factors may play an important role.

MS signs and symptoms may vary from one person to another. Some people are affected with multiple sclerosis more severely than others, but there are also the lucky ones who don’t experience any symptoms at all.

The first sign of MS is often numbness or tingling in your arm or leg on only one side of your body. Other early signs include vision changes, loss of balance, and trouble walking.

This can progress to more severe signs including paralysis, weakness, and loss of bladder control as well as speech problems. As time goes by, most people experience additional symptoms such as cognitive issues such as memory problems, and fatigue among others. When the disease gets worse over time it’s known as progressive-relapsing remitting multiple sclerosis.

MS causes:

Symptoms may be mild, such as numbness in the limbs, or severe, such as paralysis or loss of vision. Most people have a mixture of these symptoms at different times. In acute MS exacerbations, symptoms come on suddenly and severely. With the progression of the disease, MS can cause cognitive impairment and problems with coordination and balance. The earlier the onset of MS the more likely the person will experience a more severe disability later in life.


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