Diagnosis of Multiple Sclerosis
Even today with the advances of science, is not easy to diagnose MS, whose symptoms associated, are various and, common to many other diseases. Is essential to consult neurology for a thorough analysis of the clinical history and the diagnosis was based on clinical and para-clinical:
- Clinical data: history of the disease, and results of clinical and neurological examination
- Para-clinical data: MRI results, evoked potentials and cerebrospinal fluid analysis
Neurological examinations are performed, Examination of cranial nerves, The test of reflexes, the test of motor function, the test of gait and balance and test of sensory function.
Techniques for diagnosis of multiple sclerosis
- Lumbar Punsão;
- Test of Event-related potentials.
The symptoms associated with MS are fickle in terms of both frequency, as gravity, varying according to the injured site in the central nervous system. How can we identify symptoms:
- Parestesias (sensory changes);
- Visual Changes;
- Changes in Balance and Motor Coordination;
- Disartria (changes of speech and verbal articulation);
- Motor and Spasticity changes;
- Urinary Changes;
- Psychological and Cognitive Changes.
The impact of the diagnosis of MS can be devastating on an emotional level: "Incurable disease, chronicle, progressive that attacks the body's own ".
The onset of MS, abnormal event in the life of man implies profound and permanent changes in their day-to-day. It's overwhelming to hear these words of the health professional. Feelings of anger, frustration, shock, sadness emerge in sick, usually a young woman in the productive phase of his life. Live with this diagnosis does not oblige deny these feelings but, undertake a rehabilitation meet the new requirements that the disease imposes. We know that the reactions that each will depend not only reflect your personality as well as the support they receive and feel of the most significant people.
At first we observe in the carrier refusing to accept the diagnosis, denying it to himself "Can not ... is a mistake ...".
Sometimes people become hostile, aggressive, antipathetic, unpleasant to live, being the main targets of this behavior change to family and friends living with him. Patience from all family and friends is essential to overcome this phase of your life.
Overcome this first phase, with variable time, patient demand on health professionals, of family and friends, clarify how you come to be treated. Often we observe behavior of accommodation to illness, giving up the fight against it may emerge here in a depressive phase, isolating yourself from everyone and everything: "I can not ... I do not know how to do ... this is not for me ...".
In the course of time and, in some cases with therapeutic support the patient enters a new phase that we can identify as an acceptance phase of the disease. Shall better understand their diagnosis, are more engaged in treatment and verbalizes / dialogues about the disease without anger, the shock, or distress initially observed at the time of diagnosis. The talk about the same, the share emotions, knowledge, experiences helps you to understand more about the pathology. Becomes aware that it can live daily facing and dealing with MS.
Not only is it challenging to accept the diagnosis, as also is learning to deal with the symptoms associated with it. MS is psychologically challenging the way manifests. Her symptoms, common to many other diseases appear, disappear, and reappear, in some cases ultimately remain.
The patient is aware that MS is still an incurable disease, but with treatments that reduce the frequency, intensity and number of outbreaks. Notwithstanding, times of exacerbation of the disease in which the patient becomes dependent on others to perform their activities remain difficult to accept.
Long time that depression and anxiety are described in MS patients.
Anxiety is a symptom of this disease permanent. Manifests itself early from the time that the research diagnosis when they are still made an array of tests to confirm the diagnosis and remains throughout life with greater or less intensity, before the knowledge about the evolutionary course of the disease.
Depression, often confused with other emotional states, is common in MS as fast response and manifestation of the need to seek help to achieve again the existential balance.
This symptom often arises by loss of physical and / or cognitive abilities, fear for the future, the loss of autonomy. Sometimes depression is hidden symptoms of MS own: disturbance of sleep, sexual dysfunction, concentration difficulties, insónia.
The euphoria although rarely may arise in particular the exaggerated euphoria of well-being in the face of emotional instability that the patient is experiencing. Although rare as cited this symptomatology is associated with demyelinating lesions or genetic predisposition to the existence of a psychotic disorder.
The cognitive impairment of MS patients is quite significant affecting functions such as memory, Speed of information processing, capacity to solve problems, verbal fluency. Although these commitments are not regular when they have their own particularities associated with MS, since the involvement of certain specific cognitive functions may occur, while others remain intact. A cognitive deficit impairs the quality of life of patients with MS given the slight probability of having a stable job, the lowest social commitment and performing household tasks by increasing their level of dependence.
A neuropsychological assessment and the use of cognitive rehabilitation techniques which allows to evaluate the injured and those functions are intact promoting better structure and organization of living patients by reducing the adverse effects of this deficit, assisting the patient and family to determine real goals in life and a better understanding of the disease.
Another factor to consider is the family. A diagnosis of MS affects all household members testing the dynamics and relationship. This diagnosis has an impact not only on a personal level, as well as the professional level, financial, family relationships and the relationship between the family and the society in which it operates.
We can not forget that in the progressive course of MS family members and / or caregivers are relevant to patients, valuable to health professionals and to processes of decision making and problem solving.
Also children are members of this household. All families are unique! Regardless of the innate sense of protection of parents towards their children, Also they feel fears, anxieties, fears. Are sensitive to changes in the behavior of their family and hides them only exacerbates these feelings as something bad which one can not speak. The adults will be surprised at the capacity that children have to deal with painful realities. Open dialogues, direct and honest with children about MS will make this feel like an important member of the family. Share problems and help each other certainly make the family more united.
The approach and monitoring of MS patients tends to be undertaken by a multidisciplinary team, aspetos focused on physical and psycho-cognitive, valuing diagnosis and treatment idiosyncratic according to the needs and characteristics of each patient.
It is essential an empathetic relationship, cordial, support and accuracy between the therapist and patient, defining treatment goals and real goals to be achieved that will not to create overly optimistic expectations that may hinder therapy.