Use of Spinal Tap in MS Diagnosis

What is cerebrospinal fluid?

The central nervous system (CNS) is bathed in a clear, colorless liquid, called cerebrospinal fluid (CSF), that cushions and protects the brain and spinal cord. CSF is produced in the ventricles and helps to transfer waste products from the brain to the vascular system. It can also deliver nutrients and hormones to the brain. CSF is composed of cells, water, proteins, sugars, and other vital substances. Examining the fluid can help doctors to identify diseases affecting the central nervous system, including MS.

How is CSF collected?

Cerebrospinal fluid is obtained through a needle that is inserted into the spine during a procedure called lumbar puncture or spinal tap. For this procedure, the patient will usually lay on their side with their back arched (chin and knees tucked toward the chest). An area of skin on the lower back is cleaned before the procedure.

After the area is anesthetized (numbed), a thin and hollow needle is carefully inserted between two lumbar bones into the spinal canal, the space where the CSF circulates.

You may feel slight pressure as the needle is inserted. It’s very important to stay perfectly still during the procedure.

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Do I Need A Spinal Tap To Diagnose MS?

Evoked Potential Testing in MS

Multiple sclerosis (MS) is a complex demyelinating disease of the central nervous system for which there is no single diagnostic test. Common tools used to diagnose MS include the neurological exam, complete medical history, magnetic resonance imaging (MRI), and evoked potential (EP) studies.

What are evoked potentials?

As the brain “talks” to various parts of the body, messages are sent as electrical signals that travel along nerves. Demyelination and neurodegeneration caused by MS can disrupt these electrical signals. Evoked potential studies, also called evoked potentials (EPs), measure signals that travel through specific sensory nerve pathways in response to external stimuli. Those electrical signals are measured through sensors placed on the skin in combination with sophisticated computer programs.

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Evoked Potential Tests: How Are They Used In MS?

Improving End-of-Life Care With MS

Discussions about end-of-life issues are often taboo in our culture — until we are "suddenly" faced with unpleasant realities and challenging decisions. Although many deaths occur unexpectedly, a large number of deaths follow a prolonged period of decline in health due to a progressive disease. This path of decline has been termed "progressive dwindling."

Four broad trajectories of dying in an aging population were identified in a study of Medicare beneficiaries:

• Twenty percent of deaths followed illnesses, such as cancer, characterized by a clear clinical transition from treatable to untreatable progression.
• Twenty percent of deaths were related to progressive long-term conditions, such as COPD, complicated by acute attacks that increase the likelihood of death.
• Twenty percent of deaths were classified as sudden deaths, such as those following a fatal heart attack or accident.
• Forty percent of deaths followed a prolonged period of progressive dwindling associated with conditions such as Alzheimer’s disease or other degenerative conditions.

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Living with Advanced MS: Improving End-of-Life Care

The Process of Being Diagnosed with Multiple Sclerosis

Being diagnosed with multiple sclerosis (MS) is a multi-step process that can take anywhere from days to years. Unfortunately, MS is not a condition where you walk into your primary care doctor’s office because of unusual symptoms, and you walk out of the office with a definitive diagnosis. Reporting your symptoms to your doctor is only the first step.

Step one: Early symptoms and preliminary tests

The neurological exam is the first step in trying to solve th

e mystery as to whether MS might be the cause of your symptoms. The doctor will look for signs to indicate that something may not be functioning as expected within the central nervous system (CNS) that includes the brain, spinal cord, and optic nerves.

To help eliminate potential causes of symptoms, your doctor may order some preliminary blood tests to rule out conditions such as vitamin B12 deficiency, lupus, autoimmune disease, Lyme disease, syphilis, or HIV. If the results come back normal, your doctor may then order an MRI of the brain and/or spinal cord.


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How Long Does It Take To Be Diagnosed With MS?

Surviving the Holidays with MS

The holiday season offers many opportunities to relax, party, shop, spend time with family and friends, travel, eat lots of goodies, and have fun. However, for people living with chronic diseases like multiple sclerosis (MS), the change in routine can take its toll, especially if you go-go-go until you drop.

How can you protect yourself against the consequences of holiday fun?

Remember that MS is a constant companion. Just because there are so many cool things to do during the limited number of days of the holiday season doesn’t mean that you should neglect your own health. Continue to eat nutritious food and respect your body’s need for exercise and rest.

Stay hydrated. Holiday parties frequently offer special drinks, particularly alcoholic beverages. This is not the time to substitute your eight glasses of water each day with eight glasses of wine, beer, or eggnog. To compensate for the dehydrating effects of alcohol, increase your water intake. Alternate a glass of wine with a glass of water to keep those brain cells plumped up and hydrated.

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MS Doesn't Take a Holiday

Urinary Problems and Multiple Sclerosis

Many people with multiple sclerosis (MS) experience urinary problems at some point. Common problems associated with MS, often caused by neurogenic bladder, include frequent urination, urinary urgency and/or hesitancy, urinary incontinence, difficulty urinating, incomplete urination, and recurrent bladder infections. Conservative treatments include adjusting fluid intake, pelvic floor exercises, oral anticholinergic medications, avoidance of certain foods/alcohol, and self-catheterization.

How common are urinary problems in MS?

In a survey of 1,047 people with MS conducted by the North American Research Committee on Multiple Sclerosis (NARCOMS), 966 participants (92 percent) reported experiencing at least one lower urinary tract symptom, the most common being post-void dribbling (64.9 percent), urinary urgency (61.7 percent), and a feeling of incomplete emptying (60.7 percent). Eight hundred twenty-six participants (79 percent) reported having some type of urinary incontinence.

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Do I Need To See A Urologist For MS?