Diagnosis of multiple sclerosis

  The disease is seen between 10 and 60 years of age, with a peak incidence between 20 and 30 years of age. Occasionally, it occurs in people under 10 years of age and over 60 years of age. It can affect both men and women, with a male to female ratio of 2:3. There are usually no prodromal symptoms before the onset of the disease, but there can be triggering factors such as upper respiratory tract infections. The most common first symptoms are numbness and sensory abnormalities in the limbs (1/3); ataxia (1/5); and ocular symptoms (nystagmus, diplopia or hypermetropia), which generally account for about 20%. The clinical manifestations of neurological symptoms vary with the anatomical site of involvement. The most common are nystagmus, dysarthria and ataxia, paraplegia, and dysuria. Most of these symptoms and neurological signs resolve after a period of time with or without treatment. After remission, most of the symptoms and signs are reduced or disappear, but recovery is mostly incomplete with varying degrees of residual functional impairment. After relapse, new neurological signs and symptoms may appear. In young patients, the brain, brainstem and optic nerve are mostly involved in acute or subacute onset. The disease is characterized by progressive spastic paraplegia or trunk ataxia. Most patients are prone to fluctuations and remission-relapse. Residual neurological signs and symptoms increase with the number of relapses, and significant memory and cognitive dysfunction occurs. Young female patients are often associated with migraine attacks. After multiple relapses, they may be accompanied by seizures, which should be taken seriously.  Based on the course of the disease, MS can be clinically classified into the following types: 1. Benign type is common in young women. It has an acute onset and remits relatively quickly, with minimal or no recurrence, complete recovery of neurological impairment, and few residual neurological signs.  2. Relapsing type is common. Acute onset, recurrent attacks, partial or complete recovery of neurological function. The stabilization period can last for several months to several years.  3, Relapsing-progressive type patients with acute onset and rapid remission, after several remission relapses, no longer remission, and progressive, gradually increasing neurological symptoms, neurological dysfunction is more severe. This type of MS is the most common.  4. Chronic progressive type is rare. Most often seen in men with middle-aged onset of disease. The onset of the disease is insidious, the symptoms gradually worsen, and there is no remission relapse. Progressive development of the disease for more than six months is considered.