Symptoms of MS and Diagnosing MS

MS is difficult to diagnose because it shares many symptoms with other conditions(Trojano and Paolicelli 2001). A person wth MS can suffer almost any neurological symptom or sign, including:

• changes in sensation (hypoesthesia and paraesthesia)
• muscle weakness, muscle spasms or difficulty in moving
• difficulties with coordination and balance (ataxia)
• problems in speech (dysarthria) or swallowing (dysphagia)
• visual problems (nystagmus, optical neuritis, or diplopia)
• fatigue, acute or chronic pain
• and bladder and bowel difficulties.

Cognitive impairment of varying degrees and emotional symptoms of depression or unstable mood are also common.

MS is characterised by lesions in the nervous system which can be pinpointed by MRI. We had thought that these lesions would be a difference between Vitamin B12 deficiency and MS, however Scalabrino identified similar lesions in the spinal cord of mice either fed a B12 deficient diet or with surgically induced B12 absorption problems (Scalabrino, Veber et al. 2008).

Visiting your GP

Typically if you visit your GP with unexplained neurological symptoms (all of the above fall into the general category of neurological symptoms), then if the symptoms are severe they may refer you to a neurologist. The neurologist will

• take a history (ask about past symptoms and problems),
• perform a physical examination (check reflexes, movement, sensation ie when they tap your knee does it jerk, can you move your hands and arms smoothly, how is your hand- eye coordination, where can you feel and where are you numb)
• if s/he thinks it may be MS, will send for further tests and await the results
• explain what happens next.

Diagnosis of MS is only confirmed after a series of tests.

Clinically Isolated Syndrome (CIS)

The most common presentation of MS is the clinically isolated syndrome (CIS). In CIS, a patient has an attack suggestive of demyelination, but does not fulfil the criteria for multiple sclerosis. Only 30-70% of people experiencing CIS later develop MS (Miller, Barkhof et al. 2005). Patients first seeking medical attention commonly present with multiple symptoms (sensorial, visual, cerebellar, and motor are the most common, with rarer aphasia, psychosis and epilepsy).

Is this similar to the symptoms of Vitamin B12?

So many of these symptoms are exactly the same as the symptoms of vitamin B12 deficiency that there may be a relationship. What is the difference?

• MS is a description of the symptoms (multiple ie appearing in different parts of the body, hardened nerve paths (scleroids) ie nervous tissue that is serverely damaged).
• Vitamin B12 deficiency is a cause(your body doesn’t have as much Vitamin B12 as it needs, whether this is because it can’t get it from the diet, can’t absorb, has the wrong transporter in the blood stream, or the cells themselves have become insensitive to Vitamin B12 and need more to function correctly)

Vitamin B12 deficiency may show Pernicious Anaemia in its final stages, or severe neurological symptoms (which match the description of MS), or both.