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Neurology FAQs

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Neurology FAQs



What is multiple sclerosis and how is it diagnosed?


MS is a chronic disease in which the body’s own immune system attacks the central nervous system (the brain, the spinal cord and optic nerves).  Nerves carry messages (impulses) from throughout our bodies , through our spinal cords and finally to our brains where these “ messages”  are processed.  Our nerves are covered and protected by a fatty substance called myelin.  Myelin helps these impulses travel smoothly along the nerves.  With MS, the myelin sheath and sometimes the nerves themselves are damaged or sclerosed.  The impulses that try to travel along these paths are interrupted.   This interruption results in symptoms of MS which can be mild,  such as numbness, or severe, such as paralysis or blindness.    MS is believed to be an autoimmune disease. 


Symptoms of MS include numbness, visual disturbances, walking problems/ gait disturbances, fatigue, spasticity,  pain, tremors, speech disorders, and headache. 


There is no direct test or specific symptom that it used to diagnose MS.  Instead, a physician must do a thorough physical exam, a neurological exam, MRI, EP studies, spinal fluid analysis and other blood tests.  Utilizing the information gathered by these tests, the physician will then rule out any other cause for symptoms and finally diagnose MS when all other causes are ruled out.  The national MS society lists the following criteria for diagnosing MS-  1. The physician must find evidence of damage in two separate areas of the central nervous system, 2. The physician must find evidence that the damage occurred at least one month apart, and finally 3. The physician must rule out any other possible diagnosis. 


There is no cure for MS.  Treatments are aimed at slowing down the disease progression, treating flare ups or exacerbations,  and managing symptoms.  Treatments include medications and rehab therapy. 


People diagnosed with MS can live normal, healthy lives.  Most have a normal life expectancy and most are not severely disabled.



What causes my frequent headaches?


There are several different kinds of headaches.  These different kinds of headaches can be divided into two categories- primary and secondary.  Primary headaches are the most common.  They have no direct cause and are diagnosed after any secondary causes are ruled out.  Examples of primary headaches include migraines and cluster headaches.  Secondary headaches have a direct underlying cause meaning that they are due to an underlying problem.  These underlying problems could be a medication side effect, illness, nervous system infections, and tumors among others.  Examples of secondary headaches include head injuries, hemorrhage, and meningitis.   In general, if you have not experienced headaches in the past and are now having recurring frequent headaches, you should be seen by  your doctor and x-rays or scans of your head and neck may be necessary.  Most headaches are primary headaches and are relieved with the use of analgesics, however the onset and reoccurrence  of new headaches should be evaluated by a physician to rule out secondary causes. 




What is a herniated disc and what are the treatments of it?


A herniated disk, also sometimes called a “slipped disc” or a “ruptured disc”, occurs when the soft cushion, the disk, in between our vertebrae, is forced outside its normal space. The spinal column has  seven cervical vertebrae, 12 thoracic vertebrae and 5 lumbar vertebrae.  In between each of these vertebrae is a soft spongy disc that works as a cushion.  A good way to picture this is to think of each of the discs as a jelly donut.  The donut, disk, becomes compressed or squished and the jelly is forced to the outside of the donut.  Herniated disks are painful because they cause pressure on the spinal nerves and spinal cord.  Most commonly, herniated discs occur in the lumbar region. 


Herniated discs can be caused by a sudden trauma, such as a fall, or can occur gradually over time with continued stress and pressure on the spine.  The symptoms of a herniated disc include pain, described as “electric shock” pain in arms and legs, numbness and tingling in arms and legs, and muscle weakness.  Some people experience difficulty urinating or moving their bowels.  Difficulty with urinating or moving bowels can be a very serious symptom and should  be evaluated by a doctor immediately. 


Herniated discs are diagnosed usually by a physical examination by your doctor.  Your doctor may also order x-rays or an MRI to help with the diagnosis.


Treatments for herniated discs really depend on how severe the symptoms are.  Generally speaking, the pain associated with herniated discs subsides in 4- 8 weeks.  Also, often times, the outcomes of treatments are the same whether non surgical or surgical.  Treatments truly depend on the severity of the symptoms you are experiencing. 


Most doctors will recommend trying non-surgical treatments initially.  The exception to this would be if you are experiencing loss of bowel and/or bladder control or if you are having progressive muscle weakness.  Non-surgical treatments include pain medications, topical treatments such as heat and cold therapy, electric stimulation and physical therapy.  Surgical treatments include minimally invasive techniques as well as open decompression. 

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