I understand that almost all of the symptoms that can occur with MS can also occur with other diseases. It is often difficult to be sure if a first episode of symptoms (a first relapse) is due to MS. For example, you may have an episode of numbness in a leg, or blurring of vision for a few weeks, which then goes. It may have been the first relapse of MS, or just a 'one-off' illness that was nothing to do with MS.

Because of this a firm diagnosis of MS is often not made until two or more episodes or relapses have occurred. So, it may be months, or years, of uncertainty if you have an episode of symptoms, and the diagnosis is not clear.

Added to this uncertainty is the fact that in most cases, no test can definitely prove MS after a first episode of symptoms or in the very early stages of the disease. Some tests are helpful, however and may indicate that MS is a possible, or probable, cause of the symptoms.

An MRI scan (Magnetic Resonance Imaging) of the brain is the most useful test. This type of scan can detect small areas of inflammation and scarring in the brain which occur in MS. Although very useful in helping to make a diagnosis of MS, MRI scans are not always conclusive.

A scan result is always looked at together with symptoms and physical examination. Since MRI scans became available, other tests are now done less often. However, they are sometimes done and include:

·Lumbar puncture. In this test a needle is inserted, under local anaesthetic, into the back to extract CSF (the fluid surrounding the spinal cord) and protein levels are measured. Some proteins are altered in MS, although they can be altered in other conditions too.

·Evoked potential test. In this test, electrodes measure if there is slowing or abnormal patterns in the electrical impulses in certain nerves.

The important question is always how is multiple sclerosis diagnosed?
The first thing to know is that sadly there is no cure for MS, but treatments can often help a lot.

Treatments generally can be put into four categories.
Drugs that aim to modify the disease process.
Steroid medication to treat relapses.
Drugs to help ease symptoms.
Therapies and general support to minimise disability.
Drugs that aim to modify the disease process.

These drugs do not cure MS. However, studies have shown that they reduce the number of relapses in some cases. They may also have a small effect on slowing the progression of the disease. The exact way in which these drugs work is not clear, but they interfere with the immune system in some way.

As there is still some uncertainty as to the role of these drugs and how effective they are, guidelines were drawn up in 2001 by the Association of British Neurologists as to when they may be prescribed on the NHS. A specialist (neurologist) will advise on whether one of these drugs is recommended in each individual case. People who are prescribed one of these drugs are monitored. With the help of this monitoring, over time, it should become clear how effective these drugs are.

Each of the different disease modifying drugs have pros and cons. The Department of Health website [url]www.msdecisions.org.uk[/url] is designed to help patients decide which is the best drug for them.

Newer drugs and combinations of drugs are being studied. For example, one recent small research trial of a drug called mitoxantrone (a chemotherapy drug) in combination with glatiramer showed great promise. This led to the setting up of a larger scale clinical trial in 2005 in 10 centres across the UK to study this combination further.

Steroid is often prescribed if there is a relapse which causes the MS sufferer disability. A high dose is usually given for a few days. This is often by injection into a vein each day for several days. Sometimes steroid tablets are used. Steroids work by reducing inflammation. A course of steroids will usually shorten the duration of a relapse and any symptoms will improve more quickly than they would otherwise have done. However, steroids do not affect the ongoing progression of the disease.
Other medicines to treat symptoms
Depending on the symptoms that develop, other treatments may be advised to combat the symptoms. For example:
Anti-spasm drugs to ease muscle spasms.
Painkillers are sometimes needed.
Medicines can help with some urinary problems that may develop.
Antidepressant drugs are sometimes advised if you develop depression.
Drugs can often help with erectile problems which may develop.

There is debate as to the benefits of cannabis for people with MS.
Other treatments, therapies and support but a range of therapies are out there and may be advised, depending on what problems or disabilities develop. They include Physiotherapy, Occupational therapy, Speech therapy
Specialist nurse advice and support, Psychological therapies and counselling. I know that a lot of people turn their nose up at counselling but it really can be very useful, so do give it a try!

I know that the diagnosis of MS can be devastating to people, it is a lot to come to terms with and to know that you have a disease that progresses by degrees is horrible. Obviously anyone faced with this diagnosis wants to know - what is the prognosis?
It is difficult to predict at the outset how badly MS will affect any particular individual. Some very general statistics though are that :
After 10 years from the first episode of symptoms, about half of people with MS have developed some form of permanent disability. But, about half will not have done.
After 15 years, about half are unable to walk without assistance. But, about half are still walking independently.
After 25 years, about half are confined to a wheelchair. But, about half are not. So, the common belief that all people with MS will quickly become wheelchair bound is a myth.

The life expectancy of someone with MS is reduced on average by 6-11 years compared to the general population. Death only rarely occurs directly as a result of MS. However, as with other disabling conditions, if you become immobile due to MS then you have more risk of developing life threatening infections such as pneumonia.

In actual fact the facts are not as bad as I for one had thought, I hope that this gives some hope to anyone suffering from this condition.