Multiple Sclerosis (MS)
What Is It?
Chronic autoimmune demyelinating disease of the CNS causing episodic neurological deficits (relapsing-remitting) or gradual progression. Symptoms: vision loss, numbness, weakness, ataxia, bladder dysfunction, and cognitive impairment.
How Is It Diagnosed?
McDonald criteria: clinical episodes + MRI evidence of CNS lesions disseminated in space and time. CSF oligoclonal bands. VEPs (visual evoked potentials). Neurology referral essential.
How Is It Treated?
Disease-modifying therapies (DMTs): interferons, glatiramer, natalizumab, ocrelizumab, siponimod. Acute relapse: IV methylprednisolone. Symptomatic management for spasticity, pain, bladder, fatigue.
Tests and Imaging Typically Needed
MRI brain and spine with contrast, CSF analysis, VEPs, CBC, BMP, TSH, Lyme, ANA, NMO-IgG (to exclude NMOSD).
Approximate Self-Pay Costs
Office visit: $95-$150. MRI: $500-$1,200. DMTs: $50,000+/year (insurance and manufacturer assistance). Neurology required.