Medical history (history of illness) is an important component in the diagnosis of multiple sclerosis (MS). Family history
- Is there a frequent history of neurologic disease in your family?
- Are there any severe eye diseases in your family?
Social history
- Is there any evidence of psychosocial stress or strain due to your family situation?
Current medical history/systemic history (somatic and psychological complaints).
- Do you have or have you had eye movement pain* ? If yes, how long ago?
- Have or had you noticed a deterioration in visual acuity* ? If yes, what was your visual impression during this process:
- Blurred vision to complete visual loss (loss of vision)?
- Disturbed color perception* (colors are perceived as dirty and pale)?
- Have you noticed a temporary deterioration of vision after physical exertion (for example, sports, hot showers and baths)?
- Have you ever experienced such discomfort?
- Have you noticed any other symptoms:
- Bladder weakness?
- Gait disturbance/gait unsteadiness?
- Sensory disturbances?
- Taste disturbances?
- Concentration disorders?
- Fatigue?
- Sexual dysfunction?
- Speech disorders?
- Word-finding disorders?
- Do you feel depressed out of tune?
- Are you experiencing any pain? If so, where is this pain localized and when does it occur?
Vegetative anamnesis incl. nutritional anamnesis.
- Do you eat a balanced diet? Do you eat a lot of meat and animal fats?
- Have you noticed any changes in bladder and/or rectal function?
- Do you take long walks? (maximum walking distance)
Self history including medication history.
- Previous diseases (neurological diseases, rheumatological diseases, infections, tumor diseases).
- Operations
- Allergies
Medication history (medications that may have an ototoxic (hearing damaging) effect).
- Analgesics
- Nonsteroidal anti-inflammatory drugs (NSAID): acetylsalicylic acid (ASA) [hearing impairment: > 1.95 g, dose-dependent and reversible after a short period of time; hearing impairment: > 10 g/d; ringing in the ears: from 6-8 g]; salicylates (sensorineural hearing loss)
- Antibiotics
- Aminoglycoside antibiotics (aminoglycosides; disorders especially in the higher frequencies) – amikacin, gentamycin (gentamicin), kanamycin, neomycin, netilmicin, paromomycin, streptomycin, tobramycin.
- Glycopeptide antibiotics (vancomycin, teicoplanin).
- Gyrase inhibitors (ciprofloxacin, ofloxacin).
- Macrolides (interference in the range of the complete frequency spectrum) – azithromycin, erythromycin, clarithromycin.
- Anti-malarial drugs such as chloroquine or quinine (quinine alkaloids).
- Anticonvulsants such as carbamazepine, phenytoin, streptomycin.
- Diuretics
- Carboanhydrase inhibitors (acetazolamide)
- Loop diuretics (bumetanide; etacrylic acid; furosemide – here, the side effect occurs mainly with rapid intravenous injection in the presence of coexisting renal insufficiency)
- 4-Hydroxybutanoic acid (obsolete also gamma-hydroxy-butanoic acid or gamma-hydroxy-butyric acid, GHB for short).
- Phosphodiesterase-5 inhibitors/PDE5 inhibitors (avanafil, sildenafil, tadalafil, vardenafil).
- Proton pump inhibitors (proton pump inhibitors, PPI) – omeprazole.
- Thalidomide damage caused by taking the drug thalidomide in the 1960s.
- Cytostatic drugs such as cisplatin, carboplatin, bleomycin, vincristine.
Diagnostic criteria indicative of multiple sclerosis:
- There must be clinically objectifiable neurological disorders.
- There must be predominantly white matter involvement of the central nervous system.
- Anamnestically or clinically, at least two areas of the central nervous system must be affected.
- The clinical course must consist of either two or more relapses involving different lesion sites, with relapses lasting at least 24 hours and spaced not less than one month apart; or continuous or gradual progression of the disease over at least six months, if there are concomitant specific laboratory changes.Magnetic resonance imaging is considered conclusive if a new lesion is detectable at least three months after a clinically isolated syndrome.
- Neurologic symptoms cannot be associated with another disease.
Multiple sclerosis is classified according to the above criteria into.
- Certain MS – all five criteria are met.
- Probable MS – all five criteria are met except for (a) only one objective neurologic disorder despite two symptomatic episodes or (b) only one symptomatic episode despite two objective neurologic findings.
- At-risk individual – criteria 1, 2, and 5 are met; the individual has only one symptomatic episode and one objective disorder.
* If this question has been answered with “Yes”, an immediate visit to the doctor is required! (Data without guarantee)
