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Facial tingling
Pins and needles
Double vision
Blurred vision
Numbness and tingling
Muscle weakness
Tingling in feet
Tingling in arm
Coordination problems
Vision problems
Pins and needles in feet
Can't focus
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Multiple sclerosis (MS) disease in which the immune system attacks parts of the brain and spinal cord. The direct cause of MS remains unknown, but certain risk factors have been identified such as low vitamin D levels, tobacco smoking, exposure to UV radiation, childhood obesity, and infection with the virus that causes mononucleosis. The disease tends to affect young people more commonly as well as people living in higher latitudes. MS typically occurs in "attacks" which can include but are not limited to painful eye movements, blurry vision in one eye, numbness or weakness in hands or feet on one side, or double vision.
Your doctor may ask these questions to check for this disease:
Treatment of MS includes medications, physical/occupational therapy, lifestyle changes, and psychological support. Some medications prevent immune system attacks on the central nervous system, whereas others speed up recovery from attacks, or others reduce MS symptoms such as urinary problems or imbalanced walking. Physical therapy accelerates recovery from attacks and Lifestyle changes like quitting smoking can help reduce risk of further attacks.
Reviewed By:
Benjamin Kummer, MD (Neurology)
Dr Kummer is Assistant Professor of Neurology at the Icahn School of Medicine at Mount Sinai (ISMMS), with joint appointment in Digital and Technology Partners (DTP) at the Mount Sinai Health System (MSHS) as Director of Clinical Informatics in Neurology. As a triple-board certified practicing stroke neurologist and informaticist, he has successfully improved clinical operations at the point of care by acting as a central liaison between clinical neurology faculty and DTP teams to implement targeted EHR configuration changes and workflows, as well as providing subject matter expertise on health information technology projects across MSHS. | Dr Kummer also has several years’ experience building and implementing several informatics tools, presenting scientific posters, and generating a body of peer-reviewed work in “clinical neuro-informatics” – i.e., the intersection of clinical neurology, digital health, and informatics – much of which is centered on digital/tele-health, artificial intelligence, and machine learning. He has spearheaded the Clinical Neuro-Informatics Center in the Department of Neurology at ISMMS, a new research institute that seeks to establish the field of clinical neuro-informatics and disseminate knowledge to the neurological community on the effects and benefits of clinical informatics tools at the point of care.
Shohei Harase, MD (Neurology)
Dr. Harase spent his junior and senior high school years in Finland and the U.S. After graduating from the University of Washington (Bachelor of Science, Molecular and Cellular Biology), he worked for Apple Japan Inc. before entering the University of the Ryukyus School of Medicine. He completed his residency at Okinawa Prefectural Chubu Hospital, where he received the Best Resident Award in 2016 and 2017. In 2021, he joined the Department of Cerebrovascular Medicine at the National Cerebral and Cardiovascular Center, specializing in hyperacute stroke.
Content updated on Nov 15, 2024
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Before using Ubie, I felt that my symptoms sounded crazy and unrelated. This experience has validated that I’m not crazy and that I’m not alone.
(Jun 19, 2025)
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I have been diagnosed with Ehlers-Danlos Syndrome, but recently have been thinking I have something that needs more intensive and direct treatment, like Multiple Sclerosis. Ubie suggested that I look at a couple different possible conditions, and I REALLY appreciated how detailed it was! I loved that I could add specifics and that it asked me to follow up on symptoms with more clarification. It genuinely feels like the people who developed Ubie care about helping people find the right resources and information to get an accurate diagnosis and find proper care. No other website has compared to my experience with Ubie, and as someone with a chronic disability, I have had an exorbitant amount of experience. The fact that this was all free was beyond my belief. I am amazed and grateful.
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I was convinced I had MS from everything I've been reading online. However, my result was not marked as MS at all. This quiz brought my wild imagination and me back down to earth and helped calm me down.
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I was having pain in the back of my eyes and constant dizziness. At first, I thought it was because of my stress, and I google my symptoms. I found the information on Google intimidating and felt like I’m dying. I used Ubie to check my symptoms, and it told me that I have MS and recommended to see a doctor. I was surprised when I took the blood test, the result was the same as what Ubie said
(Nov 15, 2022)
Q.
Strange Symptoms? Why Parts of the Brain Fail & Medical Next Steps
A.
There are several factors to consider; see below to understand more. Strange neurological symptoms often map to the brain region involved, with issues in the frontal, parietal, temporal, occipital lobes, cerebellum, or brainstem causing matching problems like weakness, numbness, speech or vision changes, imbalance, or trouble breathing and swallowing, driven by causes such as stroke, multiple sclerosis, tumors, infections, head injury, or neurodegeneration. For next steps, seek emergency care for sudden or severe deficits, and otherwise see a clinician for a neuro exam, MRI or CT, possible neurology referral, and track symptom patterns or try a reputable MS screener; key red flags, timelines, and tests are detailed below.
References:
* Wang Z, Xu B, Zhou X, Sun Y, Wang T. Advances in the diagnosis and treatment of neurodegenerative diseases. Front Cell Neurosci. 2022 Dec 1;16:1082536. doi: 10.3389/fncel.2022.1082536. PMID: 36523910; PMCID: PMC9750059.
* Galvis-Esquivel A, Mejía-Rodríguez JF, Marín-Valencia CE, Mejía-Rodríguez SA. Traumatic Brain Injury: Pathophysiology and Potential Therapeutic Targets. Int J Mol Sci. 2021 Apr 17;22(8):4176. doi: 10.3390/ijms22084176. PMID: 33924375; PMCID: PMC8071811.
* Phan T, Ma H. Stroke: Pathophysiology, Classification, and Medical Management. Crit Care Nurs Clin North Am. 2020 Sep;32(3):289-301. doi: 10.1016/j.cnc.2020.06.002. PMID: 32791986.
* Kumar A, Pandey AK. Advances in Neurological Imaging: An Update. Neurol India. 2020 May-Jun;68(3):527-534. doi: 10.4103/0028-3886.289014. PMID: 32753555.
* Deng H, Sun C, Huang F. Autoimmune Encephalitis: A Comprehensive Review. Front Immunol. 2021 Jul 26;12:694119. doi: 10.3389/fimmu.2021.694119. PMID: 34386121; PMCID: PMC8350162.
Q.
Feeling Clumsy? Why Your Proprioception Is Failing & Medical Next Steps
A.
Feeling unusually clumsy or off balance often points to impaired proprioception, which can be caused by peripheral neuropathy, vestibular disorders, vitamin B12 deficiency, brain or spinal conditions like MS, joint injuries, or age related decline. There are several factors to consider; see below to understand more. Doctors typically assess this with a neuro exam, blood tests, and sometimes MRI or nerve studies, and many causes are treatable with targeted care and balance rehab, though sudden or severe symptoms need emergency evaluation. For specifics, red flags, and step by step next steps to discuss with your clinician, see the complete answer below.
References:
* Proske U, Gandevia SC. Proprioception: Sense, Mechanism, and Dysfunction. Annu Rev Physiol. 2012;74:317-36. doi: 10.1146/annurev-physiol-021611-115005. Epub 2011 Sep 12. PMID: 21910629.
* Proske U, Gandevia SC. Proprioception and aging: a review. J Neurophysiol. 2018 Jul 1;120(1):151-159. doi: 10.1152/jn.00411.2017. Epub 2018 Jan 24. PMID: 29364177.
* Gandevia SC, Smith MA, Proske U. Proprioceptive dysfunction in neurological disorders. Brain. 2023 Apr 19;146(4):1251-1262. doi: 10.1093/brain/awac414. PMID: 36346294.
* Hillier T, Sgarlata M, Alsubaie N, Hunter SM, Johnson MI, Cramp MC. Methods for assessing proprioception and their reliability: a scoping review. Disabil Rehabil. 2022 Mar;44(6):830-843. doi: 10.1080/09638288.2020.1802928. Epub 2020 Aug 4. PMID: 32746764.
* Kemler E, van der Esch M, Krijnen P, de Vet HCW, Ostelo RWJ, van der Woude AJ. Rehabilitation of Proprioception and Balance in Patients with Ankle Sprains: A Systematic Review. Sports Med. 2021 Mar;51(3):575-591. doi: 10.1007/s40279-020-01402-1. Epub 2020 Dec 2. PMID: 33269411; PMCID: PMC7905874.
Q.
Multiple Sclerosis Symptoms? Why Your Body Is Misfiring + Medical Steps
A.
Multiple sclerosis symptoms happen when the immune system attacks myelin and disrupts nerve signals, leading to vision changes, numbness or tingling, limb weakness or stiffness, profound fatigue, balance problems, bladder or bowel issues, and changes in thinking or mood, and they often come and go. Doctors diagnose MS with history, neurological exam, MRI, and sometimes spinal fluid and nerve signal tests, and early care with disease-modifying therapies, steroids for relapses, symptom-targeted medications, and rehabilitation can slow progression and improve function; seek urgent care for sudden vision loss, severe weakness, trouble speaking, or loss of coordination. There are several factors to consider. See complete details below to guide your next steps.
References:
* Filippi M, Rossi S, Ghezzi L, Montanari E, Zardini E, Bellantonio L, Caccia G, Confalonieri P, Mauri M, Magnani G, Sessa M, Furlan R, Leocani L, Comi G, D'Alfonso S, Scarpini E. Pathogenesis of multiple sclerosis: New insights into an old disease. Autoimmun Rev. 2023 Aug;22(8):103387. doi: 10.1016/j.autrev.2023.103387. Epub 2023 Jun 20. PMID: 37348719.
* Correale J, Farez MF, Gaitán MI. Pathophysiology and mechanisms of neurodegeneration in multiple sclerosis. Cold Spring Harb Perspect Med. 2017 Aug 1;7(8):a028931. doi: 10.1101/cshperspect.a028931. PMID: 28249970; PMCID: PMC5538407.
* Montalban X, Gold R, Thompson AJ, Otero-Romero M, Rocca MA, Rio J, Nos C, De Stefano N, Barkhof F, Comi G, Filippi M. ECTRIMS/EAN guideline on the pharmacological treatment of people with multiple sclerosis. Mult Scler. 2023 Jan;29(1):1-20. doi: 10.1177/13524585221142279. Epub 2022 Dec 15. PMID: 36519106.
* Giovannoni G, Filippi M, Ghasemi N, Hegen H, Lance M, Laroni A, Macias JA, Marrodan M, Rella F, Sabino J, Sechi E, Tsantes A, Yamout B, Ziemssen T. Clinical, pathological and therapeutic aspects of multiple sclerosis. Ther Adv Neurol Disord. 2023 Dec 15;16:17562864231215446. doi: 10.1177/17562864231215446. PMID: 38115747; PMCID: PMC10729737.
* Hemmer B, Nessler S, Zhou D, Kousi M, Ritsma B, Olsson E, Mignot E, Limmroth V, Weishaupt A, Linker RA, Hohlfeld R, Meinl E. Common mechanisms and distinct features of multiple sclerosis. Nat Immunol. 2023 Sep;24(9):1443-1456. doi: 10.1038/s41590-023-01614-0. Epub 2023 Aug 24. PMID: 37620613.
Q.
Brain Issues? Why Your Corpus Callosum Is Failing & Medical Next Steps
A.
Corpus callosum problems can stem from multiple sclerosis, stroke, traumatic brain injury, tumors, infections, or congenital differences and may show up as coordination or balance issues, slowed thinking or memory problems, sensory or vision changes, seizures, or weakness; MRI is typically the key test to pinpoint the cause. There are several factors to consider for next steps, ranging from emergency care for sudden neurological symptoms to timely primary care and neurology evaluation with imaging, targeted labs or lumbar puncture, and risk factor management, since early treatment improves outcomes; see complete guidance below to decide what to do now.
References:
Ganesan S, Pal S, Anand K, et al. The corpus callosum: development, disorders, and neurodevelopmental outcomes. Ann Indian Acad Neurol. 2022 Nov-Dec;25(6):839-847. doi: 10.4103/aian.aian_460_22. Epub 2022 Dec 19. PMID: 36742512. PMCID: PMC9891823.
Gupta R, Suthar R, Jain P, et al. Corpus Callosum Anomalies: A Review of Clinical Features, Pathogenesis, and Management. J Pediatr Neurosci. 2021 Jul-Sep;16(3):195-201. doi: 10.4103/jpn.jpn_163_21. Epub 2022 Jan 10. PMID: 35140880. PMCID: PMC8822081.
Poliakova A, Krsek P, Horak M. Acquired lesions of the corpus callosum: an overview. Int J Neurosci. 2020 Jan;130(1):1-10. doi: 10.1080/00207454.2019.1645068. Epub 2019 Aug 7. PMID: 31390978.
Paul LK, Guzzetta A, Guzzetta F. The Corpus Callosum: Integrative Aspects of Neurodevelopmental Disorders and Functional Significance. Front Syst Neurosci. 2019 Jul 24;13:42. doi: 10.3389/fnsys.2019.00042. eCollection 2019. PMID: 31396030. PMCID: PMC6669927.
Ray S, Bains SK, Gupta V, et al. Imaging of the corpus callosum: a pictorial review. Br J Radiol. 2019 Sep;92(1099):20180907. doi: 10.1259/bjr.20180907. Epub 2019 May 15. PMID: 31021448. PMCID: PMC6720025.
Q.
Is it MS Symptoms? Why Your Nerves Are Misfiring & Crucial Next Steps
A.
Strange nerve sensations like tingling, numbness, blurred vision, weakness, or balance problems can be caused by multiple sclerosis when immune damage to myelin disrupts nerve signals, but many other conditions can look similar. For crucial next steps, see below for red flags that need emergency care, what patterns suggest MS, how it is diagnosed, and practical actions to take now like tracking symptoms and speaking with a clinician, since these details can change what you should do next.
References:
* Solomon SD, Bove EAC, D'Amico JG. Multiple Sclerosis: A Clinical Update. *Am J Med*. 2023 Jun;136(6):556-563. doi: 10.1016/j.amjmed.2023.01.036. PMID: 36764516.
* Zhang Z, Wang Y, Wu B, Li X, Wu X, Zeng X. Recent advances in multiple sclerosis research: pathogenesis, diagnosis, and treatment. *Front Mol Neurosci*. 2022 Nov 10;15:1055531. doi: 10.3389/fnmol.2022.1055531. PMID: 36407335.
* Thompson AJ, Banwell BL, Barkhof F, et al. Diagnosis of multiple sclerosis: 2017 revisions of the McDonald criteria. *Lancet Neurol*. 2017 Dec;17(2):162-173. doi: 10.1016/S1474-4422(17)30471-X. PMID: 29272223.
* Leite JP, Farias SF, de Castro RMF, et al. Diagnosis and differential diagnosis of multiple sclerosis: A systematic review of clinical guidelines. *Arq Neuropsiquiatr*. 2021 Aug;79(8):735-741. doi: 10.1590/0004-282X-ANP-2020-0589. PMID: 34346917.
* Ziemssen T, Schrempf W. Early diagnosis and management of multiple sclerosis: focus on disease-modifying therapies. *Pract Neurol*. 2018 Apr;18(2):115-121. doi: 10.1136/practneurol-2017-001794. PMID: 29463510.
Q.
Is it MS? Why Your Nerves Misfire & Medically Approved Next Steps
A.
Nerves misfire in multiple sclerosis when the immune system damages myelin in the brain and spinal cord, disrupting signals and causing symptoms like numbness, weakness, vision changes, fatigue, and balance problems. Many other issues can mimic MS, so there are several factors to consider; see below for key patterns and red flags that help tell MS from lookalikes. Medically approved next steps include tracking symptoms, scheduling a visit with a primary care clinician or neurologist, asking about MRI and blood tests to rule out mimics, considering disease modifying therapies if diagnosed, and seeking urgent care for sudden or severe symptoms, with important details that could change your plan outlined below.
References:
* Filippi M, Bar-Or A, Piehl F, Preziosa P, Rocca MA, Ciccarelli O, Weissert R, Enzinger C, Havrdová EK, Vukusic S, Sormani MP, Tintoré M, Kappos L, Montalban X. Multiple Sclerosis: Pathophysiology, Clinical Features, Diagnosis, and Management. JAMA. 2023 Apr 4;329(13):1106-1118. doi: 10.1001/jama.2023.2378. PMID: 37017772.
* Thompson AJ, Banwell BD, Barkhof F, Carroll WM, Coetzee RH, Comi G, Correale J, de Stefano C, Fredrikson N, Freedman MS, Fujihara K, Galetta SL, Havrdova E, Haynes PM, Hemmer M, Hincapié M, Hotter A, Kappos L, Kesselring J, Kitze K, Kujala R, Lebrun-Frenay K, Leite MI, Mountz JM, Okuda DT, Reingold SC, Rojas JI, Roos I, Rothwell A, Schmierer K, Sorensen PS, Tintoré M, Traboulsee AL, Trojano M, Vukusic S, Waubant E, Weinshenker BG, Wingerchuk DM, Wray S, Ziemssen T. Diagnosis of multiple sclerosis: 2017 revisions of the McDonald criteria. Lancet Neurol. 2017 Feb;16(2):162-173. doi: 10.1016/S1474-4422(16)30384-9. Epub 2016 Dec 20. PMID: 28017217.
* Hemmer B, Kieseier BC, Hartung HP, Deisenhammer F, Zipp F. Immunopathogenesis of multiple sclerosis. J Neurol. 2022 Jul;269(7):3513-3524. doi: 10.1007/s00415-022-11075-8. Epub 2022 Mar 26. PMID: 35338804; PMCID: PMC9201552.
* Tintoré M, Montalban X. Treatment of multiple sclerosis: what is new? Curr Opin Neurol. 2022 Dec 1;35(6):791-797. doi: 10.1097/WCO.0000000000001115. PMID: 36472289.
* Gbadamosi B, Singh A. Clinically Isolated Syndrome as the First Clinical Manifestation of Multiple Sclerosis. StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 Jan-. PMID: 33232049.
Q.
Sensory Confusion? Why Your Thalamus Is Misfiring + Medically Approved Next Steps
A.
Sensory confusion like tingling, numbness, blurred or double vision, sound sensitivity, imbalance, tremor, or brain fog often stems from the thalamus misfiring, commonly due to stroke, multiple sclerosis, migraine, concussion or other brain injury, epilepsy, chronic thalamic pain syndrome, or structural lesions. Many of these are treatable, and recovery is possible with timely care. Next steps: treat sudden one sided weakness, speech changes, severe headache, vision loss, or collapse as an emergency; otherwise track symptom patterns, see your doctor or a neurologist for an exam and MRI, consider MS screening, and optimize sleep, hydration, blood pressure, and blood sugar. There are several factors to consider; see below for complete guidance and red flags that can change which steps you take.
References:
* Halassa, M. M., & Kastner, S. (2017). Thalamic Contributions to Sensory Perception and Pathology. *Neuron*, *95*(6), 1221–1235.
* Llinás, R. R., & Steriade, M. (2017). Thalamocortical dysrhythmia: A pathophysiological mechanism in neurological and psychiatric disorders. *Progress in Neurobiology*, *150*, 1–17.
* Sherman, S. M. (2019). The Thalamus as a Sensory Gateway and an Integrative Hub. *Progress in Brain Research*, *249*, 1–25.
* Vlachos, F., Panourias, I. G., Tsitsopoulos, P. P., & Hadjigeorgiou, G. M. (2015). Deep brain stimulation for thalamic pain: a comprehensive review. *Journal of Clinical Neuroscience*, *22*(4), 609–616.
* Finneran, M., Liyanage, K., Vissavajjhala, A., & Gill, J. B. (2023). Neuromodulation for refractory sensory complaints: a systematic review. *Neuromodulation: Technology at the Neural Interface*, *26*(6), 1163–1172.
Q.
What is MS? Why Your Nerves Misfire and Medically Approved Next Steps
A.
Multiple sclerosis is a chronic autoimmune disease of the central nervous system in which the immune system damages myelin, causing nerve signals to misfire and leading to symptoms such as vision changes, numbness or weakness, fatigue, and balance or coordination problems; there is no cure, but treatments can reduce relapses and slow progression. If you have persistent neurological symptoms, schedule a medical evaluation for a neurological exam and MRI and discuss disease‑modifying therapy if diagnosed, and seek urgent care for sudden severe weakness or vision loss; there are several factors to consider, so see below for key details on diagnosis, treatment choices, red flags, and lifestyle supports that could shape your next steps.
References:
* Hauser SL, Oksenberg JR. Multiple Sclerosis: Pathophysiology and Clinical Updates. N Engl J Med. 2023 Feb 9;388(6):531-540. doi: 10.1056/NEJMra2209021. PMID: 36758253.
* Ontaneda D, Bebo B, Burks J. Diagnosis and Management of Multiple Sclerosis: A Review. JAMA. 2021 Jul 27;326(4):346-358. doi: 10.1001/jama.2021.9422. PMID: 34313682.
* Doshi A, Chataway J. Multiple sclerosis: An overview of diagnosis, prognosis, and treatment options. Pract Neurol. 2023 Feb;23(1):15-22. doi: 10.1136/pn-2022-003661. PMID: 36720970.
* Oh J, O'Connor KC, Calabresi PA. Multiple sclerosis: pathogenesis, current therapies and future strategies. Cell Mol Immunol. 2023 May;20(5):455-470. doi: 10.1038/s41423-023-01021-x. PMID: 37127608.
* Kincaid MS, Stauffer JT, Van Wagoner NJ, Racke MK. Multiple Sclerosis: A Clinical and Pathological Perspective. Int J Mol Sci. 2023 Sep 25;24(19):14555. doi: 10.3390/ijms241914555. PMID: 37830026; PMCID: PMC10573983.
Q.
Is It MS? Why Symptoms Confuse & Medically Approved Next Steps
A.
There are several factors to consider. MS symptoms can be confusing because they come and go, vary widely, and often overlap with other causes such as B12 deficiency, thyroid disease, migraines, anxiety, inner ear problems, or pinched nerves. See below for essential details that can shape your next steps; in brief, document symptoms, consider a structured symptom check, and get prompt medical evaluation with a neurological exam and MRI, sometimes a spinal tap and blood tests, and seek urgent care for sudden vision loss, new one-sided weakness, trouble speaking, or other stroke-like signs, since early evaluation can protect long-term function.
References:
* Thompson AJ, et al. The differential diagnosis of multiple sclerosis: A review. J Neurol Sci. 2014 Dec 15;347(1-2):19-25. doi: 10.1016/j.jns.2014.09.043. Epub 2014 Sep 26. PMID: 25458316.
* Solomon AJ, et al. Misdiagnosis of multiple sclerosis: a multicenter study. Neurology. 2016 Oct 18;87(16):1695-1703. doi: 10.1212/WNL.0000000000003186. Epub 2016 Sep 14. PMID: 27629631. PMCID: PMC5076127.
* Thompson AJ, et al. Diagnosis of multiple sclerosis: 2017 revisions of the McDonald criteria. Lancet Neurol. 2017 Jan;16(1):27-33. doi: 10.1016/S1474-4422(16)30383-5. Epub 2016 Dec 15. PMID: 27986217.
* Miller DH, et al. Early diagnosis of multiple sclerosis: revised definitions for radiologically isolated syndrome and a proposed clinical classification for multiple sclerosis. Lancet Neurol. 2020 Jan;19(1):97-106. doi: 10.1016/S1474-4422(19)30485-6. Epub 2019 Dec 9. PMID: 31836413.
* Manousakis G, et al. Clinical characteristics of patients with MS at presentation: a systematic review. Mult Scler Relat Disord. 2014 Nov;3(6):613-20. doi: 10.1016/j.msard.2014.08.001. Epub 2014 Aug 29. PMID: 25880753.
Q.
Is it Multiple Sclerosis? Why Your Nervous System Is Misfiring and the Vital Medical Steps to Take.
A.
There are several factors to consider. Multiple sclerosis is an autoimmune disease that attacks myelin, causing nerve misfires that can lead to numbness or tingling, vision changes, weakness, balance problems, fatigue, and other symptoms that can also be caused by look-alike conditions. Vital next steps include prompt medical evaluation, MRI and neurological exam, targeted blood tests and sometimes lumbar puncture, watching for emergency red flags, and starting treatment early if diagnosed; for the full checklist, risks, types, and what to ask your doctor, see the complete answer below.
References:
* Oh, J., et al. (2021). Diagnosis of Multiple Sclerosis. Journal of Clinical Neurology, 17(2), 209–220.
* Dendrou, C. A., et al. (2021). The Pathophysiology of Multiple Sclerosis: A Review. Cell, 184(13), 3320–3339.
* Oh, J., et al. (2022). Treatment Approaches for Multiple Sclerosis. Journal of Clinical Neurology, 18(3), 329–340.
* Thompson, A. J., et al. (2023). Multiple sclerosis: a comprehensive review of diagnosis, pathogenesis, and treatment. The Lancet, 401(10376), 841–853.
* Kalra, S., et al. (2021). Multidisciplinary care in multiple sclerosis: A review. Multiple Sclerosis and Related Disorders, 47, 102604.
Q.
Body Misfiring? The Reality of MS & Medically Approved Next Steps
A.
MS can make your body feel like it’s misfiring, with numbness or tingling, vision changes, weakness, balance problems, and overwhelming fatigue, though many other conditions can cause similar symptoms. There are several factors to consider; see below to understand more. Medically approved next steps include documenting symptoms, seeing a doctor and often a neurologist, getting an MRI and other tests as advised, and starting evidence-based care like disease-modifying therapies, short steroid courses for relapses, targeted symptom management and rehab, plus lifestyle support. Key details that could change your plan are outlined below, including when to seek urgent care for sudden vision loss, one-sided weakness, severe headache, or trouble speaking.
References:
* Hauser, S. L., & Oksenberg, J. R. (2023). The Story of Multiple Sclerosis—From Pathology to Precision Medicine. *Cell*, *186*(12), 2496-2508.e1. doi: 10.1016/j.cell.2023.05.011. [PubMed: 37302484]
* Filippi, M., Bar-Or, A., Coyle, P. K., Oh, J., Palace, J., & Rocca, M. A. (2023). Multiple sclerosis: a global update on aetiopathogenesis, diagnosis, and management. *The Lancet Neurology*, *22*(8), 754-768. doi: 10.1016/S1474-4422(23)00155-2. [PubMed: 37391163]
* Oh, J., & Calabresi, P. A. (2022). Updates on the diagnosis and differential diagnosis of multiple sclerosis. *Annals of the New York Academy of Sciences*, *1514*(1), 5-17. doi: 10.1111/nyas.14815. [PubMed: 35277717]
* Coles, A. J. (2022). What is the future of multiple sclerosis therapy?. *Seminars in Neurology*, *42*(6), 643-652. doi: 10.1055/s-0042-1755100. [PubMed: 36265691]
* Tintore, M., & Ciccarelli, O. (2023). Optimizing treatment strategies in multiple sclerosis: the role of personalization. *Current Opinion in Neurology*, *36*(3), 260-267. doi: 10.1097/WCO.0000000000001168. [PubMed: 36820546]
Q.
Drowning in Brain Fog? Why It’s Not Just Stress and the Medical Path to a Psychiatrist
A.
Brain fog is not just stress; it is a symptom with many causes, including depression, anxiety, sleep disorders, hormonal or nutritional issues, medication effects, and sometimes neurological disease, and the medical path is to start with primary care testing and, when indicated, see a psychiatrist for targeted evaluation and treatment. There are several factors to consider, including red flags, specific screenings, and step by step guidance on urgent versus routine care and what a psychiatrist actually does; see below for details that could change your next healthcare steps.
References:
* Trojano, M., Pellicano, C., Trojano, L., et al. (2023). Brain Fog: An Overview of the Current State of Knowledge. *Journal of Clinical Medicine*, *12*(15), 4905.
* Bortolato, B., Meli, F., Miskowiak, K. W., et al. (2017). Cognitive dysfunction in major depressive disorder: a comprehensive review. *Journal of Clinical Psychiatry*, *78*(Suppl 1), 8-15.
* Capone, F., D'Onofrio, F., Ruggiero, M., et al. (2023). Neuroinflammation and Cognitive Impairment: A Review of Mechanisms and Therapeutic Targets. *International Journal of Molecular Sciences*, *24*(12), 10228.
* Crivelli, L., Benussi, A., Cotti Piccinelli, S., et al. (2023). Cognitive Dysfunction in Long COVID: A Systematic Review and Meta-Analysis. *Neurology*, *100*(23), e2367-e2380.
* Chaudhuri, A., & Bhuiyan, A. (2022). Diagnosis and Management of Myalgic Encephalomyelitis/Chronic Fatigue Syndrome: A Review. *Clinical Therapeutics*, *44*(1), 1-13.
Q.
Losing Control? Why Huntington’s Rewires Your Brain + Medically Approved Next Steps
A.
Huntington's disease rewires the brain by damaging the basal ganglia and frontal lobe, leading to chorea, slowed thinking, and mood or behavior changes; it stems from an inherited HTT mutation and is confirmed with neurological evaluation and genetic testing. There are several factors to consider, so see below for key details that can change your next steps. While there is no cure, medicines for chorea and mood plus physical, occupational, and speech therapy can preserve function, and early neurology care, genetic counseling, safety planning, and guidance on when to seek urgent help are crucial; full, medically approved next steps and trial options are outlined below.
References:
* Bates, G. P., Dorsey, R., & Hayden, M. R. (2023). Huntington Disease. In M. P. Adam et al. (Eds.), GeneReviews® [Internet]. University of Washington, Seattle. PMID: 20301616.
* André, S., Sampaio-Marques, B., & Silva, A. C. (2020). Synaptic Dysfunction in Huntington's Disease: From Alterations in Neuronal Connectivity to Impaired Neurotransmission. Frontiers in Neuroscience, 14, 574719. doi:10.3389/fnins.2020.574719. PMID: 33177995.
* Frank, S., & Boudreau, J. (2023). Huntington's Disease: A Clinical Update. Current Treatment Options in Neurology, 25(7), 437-451. doi:10.1007/s11940-023-00806-3. PMID: 37410292.
* Gil, J. M., Rego, N., Rego, A. C., & Oliveira, C. R. (2021). The Many Faces of Huntington's Disease: Current Perspectives on Pathophysiology and Therapeutic Strategies. Cells, 10(12), 3244. doi:10.3390/cells10123244. PMID: 34884639.
* Coates, A. O., Reardon, R., & Wild, E. J. (2023). Emerging therapeutic approaches in Huntington's disease. Journal of Neurology, Neurosurgery & Psychiatry. doi:10.1136/jnnp-2023-331256. PMID: 37579998.
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Numbness or "Static"? Why Your Nerves Short-Circuit & Medical MS Next Steps
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Tingling, numbness, or a "static" sensation happen when nerve signals are disrupted; while often harmless, persistent or one-sided symptoms, episodes with vision changes, weakness, balance problems, or bladder issues can suggest multiple sclerosis, where immune damage to myelin makes nerves short-circuit. There are several factors to consider. See below to understand more about red flags, urgent warning signs, and MS next steps including tracking symptoms, seeing a clinician, and tests like MRI, blood work, and lumbar puncture, plus treatment outlook.
References:
* Lublin, F. D., & Miller, A. (2023). Multiple Sclerosis: Diagnosis and Clinical Course. *Handbook of Clinical Neurology*, 197, 1-17. pubmed.ncbi.nlm.nih.gov/36737088/
* Huang, S. T. H., Chen, C. M., & Chen, C. L. (2023). Multiple Sclerosis: A Clinical and Pathophysiological Review. *Brain Sciences*, 13(10), 1438. pubmed.ncbi.nlm.nih.gov/37892182/
* Ziemssen, T., & Ziemssen, F. (2021). Treatment of multiple sclerosis: an update. *Journal of Neurology*, 268(7), 2617-2632. pubmed.ncbi.nlm.nih.gov/33822295/
* Truffert, A., Piguet, C., Fame, F., von Wyl, L., & Zehnder, T. (2017). Sensory symptoms in multiple sclerosis. *Revue Neurologique (Paris)*, 173(9), 565-573. pubmed.ncbi.nlm.nih.gov/28527878/
* Waxman, S. G. (2006). Axonal conduction and demyelination: what have we learned from multiple sclerosis?. *Annals of Neurology*, 59(1), 1-5. pubmed.ncbi.nlm.nih.gov/16385496/
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Living Longer with Multiple Sclerosis (MS): Understanding Today's Life Expectancy.
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While life expectancy has been increasing for people with multiple sclerosis (MS), recent evidence suggests life expectancy is lower (about 7 years) than the general population. However, there is considerable variation in disease progression on an individual basis.
References:
Lunde HMB, Assmus J, Myhr KM, BL, Grytten N. Survival and cause of death in multiple sclerosis: a 60-year longitudinal population study. J Neurol Neurosurg Psychiatry. 2017 Aug;88(8):621-625. doi: 10.1136/jnnp-2016-315238. Epub 2017 Apr 1. PMID: 28365589; PMCID: PMC5537547.
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Link to full study:
https://www.medrxiv.org/content/10.1101/2024.08.29.24312810v1McGinley MP, Goldschmidt CH, Rae-Grant AD. Diagnosis and Treatment of Multiple Sclerosis: A Review. JAMA. 2021;325(8):765–779. doi:10.1001/jama.2020.26858
https://jamanetwork.com/journals/jama/article-abstract/2776694?casa_token=7gSU0m74lwoAAAAA:i0Mg1HziIGHT23muifKVtyc23MYu5YHqSm0tvuWhos5tIhfhHKyoavVwFAJsHfds_MCG4Kswo0eZDobson R, Giovannoni G. Multiple sclerosis–a review. European journal of neurology. 2019 Jan;26(1):27-40.
https://onlinelibrary.wiley.com/doi/10.1111/ene.13819Hauser SL, Cree BA. Treatment of multiple sclerosis: a review. The American journal of medicine. 2020 Dec 1;133(12):1380-90.