Multiple Sclerosis Pathway - Provider Information: Suspicion of MS
While diagnosis of MS is made by a neurologist, most patients consult with their primary care physician at the time when the first clinical manifestations of MS emerge. Neurologists suggest that primary care providers maintain a high index of suspicion of MS, especially in the presence of:
- Characteristic presentation of relapsing-remitting MS—a gradual increase in symptom number and intensity over several days, followed by a stable period with partial or full resolution.
- Characteristic presentation of progressive MS—decline in physical neurological functioning for at least 6 months, with evidence of upper motor neuron signs on exam.
- Neurological manifestations such as optic neuritis, transverse myelitis, signs of brainstem inflammation (vertigo, double vision, dysarthria, ataxia) that precede or accompany physical symptoms.
- Do not routinely suspect MS if the main symptoms are fatigue, depression, dizziness, or non-specific sensory symptoms without history or evidence of focal neurological symptoms or signs. Such referrals may be directed to general neurology.
- Patients presenting to their GP/PCP with symptoms suggestive of MS should be referred promptly to a neurologist or to the MS Clinic.