You know that something is not right and your doctor has referred you to a specialist. Your next step is to Consult with a Neurologist.
A neurologist is a medical doctor or osteopath who has trained in the diagnosis and treatment of nervous system disorders, including diseases of the brain, spinal cord, nerves, and muscles. They also use diagnostic tests such as:
§ CAT (computed axial tomography) scan
§ MRI/MRA (magnetic resonance imaging/magnetic resonance angiography)
§ Lumbar puncture (spinal tap)
§ EEG (electroencephalography)
§ EMG/NCV (electromyography/nerve conduction velocity)
The Initial Appointment
Prepare in advance for your first visit to the neurologist. Compile a summary (or chronology) of your illness (and other diagnoses) which should include:
§ When did symptoms begin? What symptoms did you have at the beginning?
§ What brought on the symptoms or made them worse?
§ What other symptoms have occurred? When did they occur?
§ What tests have been done? What were the results?
§ What medications have you taken? What were the results of the treatment?
§ List all current medications and the dose you are currently taking.
Symptoms to Consider
§ Changes in Vision
§ Weakness and/or numbness in arms/hands/legs/feet
§ Coordination problems in arms or legs
§ Balance problem
§ Trouble walking or falling
§ Speech problems
§ Memory loss/cognitive problems
§ Decreased attention/concentration
§ Poor judgement/reasoning
§ Fatigue (constant or intermittent)
§ Bladder or Bowel problems
§ Sexual dysfunction
The neurologist will want to discuss your current symptoms and history of symptoms. He will want to know what other diseases you may have and those of your immediate and extended family members. Be as accurate and truthful as possible. After the interview, the doctor will conduct a neurological exam looking for clinical evidence of impairment of the central nervous system, which includes the brain, spinal cord and optic nerves.
CRITERIA TO DIAGNOSIS MULTIPLE SCLEROSIS
Evidence of damage in at least two separate areas of the central nervous system (dissemination in space), AND, Evidence that the damage occurred at least one month apart (dissemination in time), AND, Elimination of all other possible diagnoses
The Revised McDonald Criteria (2005) includes the following:
§ At least two attacks with objective clinical evidence of at least two lesions;
§ At least two attacks with objective clinical evidence of one lesion plus dissemination in space shown on MRI or two or more MRI lesions consistent with MS plus positive CSF finding or second clinical attack;
§ One attack with objective clinical evidence of at least two lesions plus dissemination in time on MRI or second clinical attack;