Multiple Sclerosis

Diagnosing MS can be challenging because it affects everyone differently. You might experience symptoms like blurred vision, dizziness, tingling or fatigue, and these can change over time. Symptoms may also vary depending on the type of MS you have.

Types of multiple sclerosis

There are three main types of MS:

• Relapsing-remitting MS (RRMS): This is the most common type of MS. It involves distinct episodes of new or worsening symptoms — often referred to as relapses, attacks or flares — followed by periods of complete or partial recovery. This is called remission.
• Primary progressive MS (PPMS): With primary progressive MS, relapses are uncommon or may not happen at all. Instead, your primary (initial) symptoms will steadily worsen over time.
• Secondary progressive MS (SPMS): This type begins as relapsing-remitting but typically progresses over time without further relapses.

What to expect at your first appointment

When you come to see us for the first time, a neurologist specialising in MS will take a detailed medical history and ask you about your symptoms. Then they may order some tests and do a neurological exam.  

It’s important to understand that there isn’t one single symptom or test that confirms an MS diagnosis, and many conditions have similar symptoms. So, diagnosing MS isn’t always straightforward. Testing, along with learning as much as we can about your symptoms, can help us move closer to confirming a diagnosis.

Tests you may have include:

• Magnetic resonance imaging (MRI)
• Lumbar puncture (spinal tap)
• Evoked potentials study
• Optical coherence tomography (OCT)
• Blood tests

We’ll use what we learn from your medical history, symptoms and tests to help us make a diagnosis, but a firm diagnosis can only happen when:

• We find lesions (damage) in different areas of your central nervous system.
• The lesions happened at different times, or the lumbar puncture shows oligoclonal bands (proteins in your cerebrospinal fluid indicating inflammation in your brain or spinal cord).
• We’ve ruled out all other possible diagnoses.

Multiple sclerosis is a chronic condition, but with the appropriate, personalised treatment, our experts can keep the condition well managed.

Disease-modifying therapies

These medications are available as pills, injections or infusions. They help reduce the frequency of relapses, slow down MS progression and prevent new lesions from forming. They’re mainly used for relapsing-remitting MS but can also be helpful in some people with progressive MS.

Relapse management medications

Your consultant may prescribe corticosteroids, like methylprednisolone (Solu-Medrol^®) as an injection or infusion (IV) to help reduce inflammation if you have a relapse.

Rehabilitation therapy

Rehabilitation therapy plays a key role in helping you manage MS symptoms.

• Physiotherapy can help with walking, muscle strength and balance. A physiotherapist can also teach you how to safely use a cane, scooter or wheelchair if you need one.
• Occupational therapy can help you learn new, easier ways to do daily tasks, at home or at work. Occupational therapists can also help you make your home or work environment safer to navigate.
• Speech therapy can help with changes in your voice and speech. Speech therapists can also help with swallowing difficulties that MS causes.

Cognitive therapy

MS can affect cognition, too. A neuropsychologist can help with thinking, attention and memory problems. A psychologist or psychiatrist can help you cope if you’re feeling depressed, anxious, overwhelmed or are having mood swings.

Lifestyle changes

Eating well, staying active, managing stress, not smoking and limiting alcohol can sometimes ease MS symptoms and boost your overall well-being.

Paying for Multiple Sclerosis Care at Cleveland Clinic London

Our self-pay option is a convenient way to pay for MS care at Cleveland Clinic London.  If you would like to use private health insurance, we advise contacting your provider to determine what aspects of MS care your plan may support. Have questions? We’re happy to connect you with a payment specialist who’ll guide you through the financial process.

What’s Next?

Multiple sclerosis is life-changing, but there’s always hope. Cleveland Clinic London’s expert MS specialists have helped many people with this chronic condition, and they want to help you, too. With the right support and treatment options, you can take control of your life and move forward with confidence and hope for the future.