Multiple sclerosis (MS) is an autoimmune disease of the central nervous system that damages the myelin which is the covering layer of the white matter of neurons. Multiple sclerosis can affect parts of the brain, optic nerves and spinal cord. The result is disruption of the flow of information within the brain, and between the brain and body. When specific neurological pathways are affected, patients may develop weakness, stiffness, sensory loss, pain, incontinence, and visual problems. Many patients also complain of refractory fatigue and mood disturbances. A majority of MS patients experience “attacks” that mark the onset of new neurological deficits. MRI studies of the brain and/or spinal cord during these attacks will show new “spots” which are indicative of active damage to the central nervous system. Some of the new symptoms improve over time. However, if patients continue to accumulate new injuries, they will become progressively impaired over time and may become disabled. This can impact their ability to maintain employment and remain independent.
Doctors taking care of MS patients often use MRI studies to help determine if the disease is active or stable and how it is evolving over time. For example, the appearance of the visible spots may change over time and brain tissue can even diminish in volume over time. Patients are often prescribed medications that have been shown to decrease the number of new attacks. There is a subset of patients that do not get any new attacks over a long period of time and their disease is considered stable. These patients would not be expected to develop new symptoms related to their MS.
Multiple Sclerosis medical expert witness specialties include neurology and radiology.