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14.03.2015

How is ms diagnosed with mri, ringing in the ear that comes and goes - Reviews

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An MRI can show the damage and help to diagnose and determine the prognosis for multiple sclerosis patients.
1 – Magnetic Resonance Imaging (known as MRI) helps to identify, describe, and date lesions in the brain through intravenous gadolinium. The most common diagnosis for multiple sclerosis such as lack of oxygen in the brain, inflammation caused by plasma and blood due to autoimmune reactions, deposition of iron from blood obstruct the flow of blood results in nerve damage. There is no single test that confirms the diagnosis of multiple sclerosis, and there are a number of other diseases with similar symptoms.
A definite diagnosis of multiple sclerosis requires evidence for dissemination of lesions within the central nervous system both in space and in time.
Recommended diagnostic criteria for multiple sclerosis: guidelines from the International Panel on the diagnosis of multiple sclerosis. This means that not only must there exist evidence of at least two distinct lesions, verifiable by clinical symptoms or by Magnetic Resonance Imaging (MRI), there must also be evidence of an occurrence of new symptoms or lesions within a time interval of at least 30 days.
Medication is indicated when stiffness, spasms, or clonus interferes with function or sleep. With disease progression, the autoimmune response of the disease may become more difficult to suppress. Plaques on MRI may be difficult to distinguish from small strokes, areas of decreased blood flow, or changes seen with trauma or normal aging. The pattern of symptoms is also critical,evidence of the relapsing- remitting pattern, so a detailed medical history is one of the most important parts of the diagnostic process.


A lumbar puncture, or spinal tap, is done to measure levels of immune proteins, which are usually elevated in the cerebrospinal fluid of a person with multiple sclerosis.
The diagnosis of multiple sclerosis should be made by a physician with experience in identifying the disease. The diagnostic process is completed by several laboratory tests to exclude other diseases that can mimic multiple sclerosis, such as sarcoidosis, vasculitis, and Lyme disease. Evoked potential tests, electrical tests of conduction speed in the nerves, can reveal reduced speeds consistent with the damage caused by plaques.
Magnetic resonance imaging with gadolinium contrast, especially during or following a first attack, can be helpful in providing evidence of lesions in other parts of the brain and spinal cord. These tests may be done with small electrical charges applied to the skin (somatosensory evoked potential), with light patterns flashed on the eyes (visual evoked potential), or with sounds presented to the ears (auditory evoked potential). In some patients, inhaled desmopressin (DDAVP) can be used to suppress nocturnal urinary production.Bowel SymptomsConstipation is common in patients with MS. Once definite disability develops, it may be too late to treat that component of the disease.The ability to diagnose and treat MS has improved considerably in the past 10 years because of the availability of MRI and partially effective immunomodulating therapies.
Short-term use of anticholinergics or antidiarrheal agents may be effective in combating incontinence associated with diarrhea.Sexual SymptomsA careful sexual history may reveal problems such as feelings of sexual inadequacy, impaired libido, or direct sexual dysfunction resulting from erectile dysfunction, impaired lubrication, spasticity, or heat-related sensory dysesthesias. Those with more severe depression should be treated with selective serotonin reuptake inhibitors (SSRIs), which are less sedating than other antidepressants. Common presenting symptoms include monocular visual impairment with pain (optic neuritis), paresthesias, weakness, and impaired coordination (Table 1).


Cost to the patient will be higher, depending on prescription filling fee.Beta InterferonsThe beta interferons are naturally occurring cytokines with a variety of immunomodulating and antiviral activities that may account for their therapeutic effects. An increased incidence of neutralizing antibodies with the more frequent subcutaneous dosing also must be considered.Influenza-like symptoms, including fever, chills, malaise, muscle aches, and fatigue, occur in approximately 60 percent of patients treated with interferon beta-1a or interferon beta-1b. These symptoms usually dissipate with continued therapy and premedication with a nonsteroidal anti-inflammatory drug. These side effects usually are not severe and rarely lead to discontinuation of treatment.Treatment with any beta interferon can result in the development of neutralizing antibodies.
Routine laboratory monitoring is not considered necessary in patients treated with glatiramer, and the development of binding antibodies does not interfere with therapeutic efficacy.31MitoxantroneA phase-III, randomized, placebo-controlled, multicenter trial32 found that mitoxantrone, an anthracenedione antineoplastic agent, reduced the number of treated MS relapses by 67 percent and slowed progression on the Expanded Disability Status Scale, Ambulation Index, and MRI measures of disease activity.
Mitoxantrone is recommended for use in patients with worsening forms of MS.Acute side effects of mitoxantrone include nausea and alopecia. In a phase-II clinical trial,33 this drug appeared promising in that it reduced active MRI lesions by 90 percent and decreased MS relapses by more than 50 percent.
The drug is administered intravenously once a month.Despite lack of FDA approval and definitive evidence of efficacy, several other drugs commonly are used in patients with MS.



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