Diagnosing Multiple Sclerosis (MS): The Misconceptions
- Early diagnosis of Multiple Sclerosis varies widely—from rapid recognition in clear cases like optic neuritis to long delays when symptoms are mild, fluctuate, or are misattributed, says Dr. Nancy Sicotte, Chair of Neurology and Director of Multiple Sclerosis and Neuroimmunology at Cedars-Sinai in Los Angeles.
- Dr. Sicotte suggest that early awareness and specialist evaluation are key to better outcomes.
- She says that MS diagnoses are often delayed in atypical patients, including men and African Americans, partly due to outdated misconceptions that the disease primarily affects white women.
- Symptoms such as fatigue, depression, brain fog, sensory changes, or even what feels like a “pinched nerve” are often dismissed, which can lead people to overlook MS as a possibility.
- Get trusted answers about your health when you need them. SurvivorNet’s AI-powered My Health Questions tool allows patients and caregivers to get personalized, doctor-backed answers in real time.
Reaching a diagnosis of multiple sclerosis (MS), an autoimmune condition, can take as little as days in some patients—or be overlooked for months or even years in others, explains Dr. Nancy Sicotte, Chair of Neurology and Director of Multiple Sclerosis and Neuroimmunology at Cedars-Sinai in Los Angeles, who says the difference often comes down to how and when symptoms first appear and are recognized.
“One of the things that we’ve worked really hard on in the MS community is to try and get an early diagnosis, because once people are diagnosed, we now have effective therapies, and the sooner people get on effective therapies, the better their outcomes are,” Dr. Sicotte tells SurvivorNet, “We definitely know that to be the case.”Quick vs. Delayed MS Diagnosis: Why Ophthalmologists Often Spot It First
Read More“If we see [that] the MRI shows those telltale signs, then the patient can be referred very quickly to a neurologist who can have the information they need in order to make a diagnosis,” Dr. Sicotte says.
She notes that patients who present with optic neuritis often have a better outlook, likely because their symptoms are recognized quickly, allowing them to see the right specialists sooner, receive a diagnosis, and start treatment earlier.
Why MS Is Often Diagnosed Later in Men & Black Populations
“I would say the patients that take the longest would be maybe an atypical patient. Previously, there was a notion that only white women were affected by MS. We know this is absolutely not the case and that Black or African-American populations are very commonly impacted, and men can also be diagnosed,” Dr. Sicotte says.
Although MS is less common in men, they still make up roughly one-third of those living with the disease.
In some cases, men may downplay or overlook symptoms—particularly when they are intermittent—which can lead them to delay seeking care and ultimately postpone diagnosis, Dr. Sicotte further explains.
Meanwhile, symptoms that are non-specific and can occur briefly in anyone—such as numbness or tingling—Dr. Sicotte says some people may attribute that to a pinched nerve.
Overlooked Symptoms Delay Diagnoses
What can make it challenging for patients to recognize is that MS symptoms often fluctuate—they may appear suddenly, last for days or weeks, then fade away before returning again later.
Dr. Sicotte adds, “So someone might think, ‘Oh, I just had some weird, you know, pinched nerve and now it’s gone.’ And so those kinds of symptoms can sometimes be ignored.”
Other symptoms that may be ignored because most are so common:
- Fatigue
- Depression
- Brain Fog
- Sensory Issues
MS: Understanding Symptoms
Dr. Lauren Krupp, a neurologist at NYU Langone in New York City, describes MS as an “immune mediated condition,” which causes the immune system to work against itself.
“We’re not exactly sure why that happens, but it probably has to do with an exposure to a virus at some point in time. And in the effort to fight off that virus, the immune system turns against itself and specifically, a coating of the nerves called myelin,” Dr. Krupp tells SurvivorNet. “The myelin that it affects involves the central nervous system, and that’s the brain and the spinal cord.”
Because it can involve different areas in the brain or spinal cord, Dr. Krupp explains, “the symptoms can vary in location.”
Symptoms might include:
- Numbness and tingling in the face
- Numbness or weakness in the arms and legs
- A sensation of vertigo or rooms spinning
- Vision loss or blurred vision
- Lack of coordination
Symptoms may affect one side of the body or, when the spinal cord is involved, both sides. In some cases, the numbness can spread and may also come with muscle weakness.
“Usually we see people who have had some neurological symptoms and they often get worked up with an MRI of the brain … the brain MRI is a really important tool,” Dr. Krupp adds.
Contributing: SurvivorNet Staff
Learn more about SurvivorNet's rigorous medical review process.
