Multiple sclerosis (MS)

Amy Sandberg's Diagnosis

Amy Sandberg, 42, was diagnosed with MS after experiencing urine incontinence, exhaustion, unsteadiness, and blurred vision, among other symptoms. Researchers have long noted the significant prevalence of comorbidity (CC) in MS patients (Marrie, 2016). The CC in this case is a chronic fatigue syndrome characterized by periods of exhaustion that the patient has had for six months.<\/p>

Comprehensive Medical History

A comprehensive medical history is also required for the diagnosis of MS. When constructing an MS history, it is critical to evaluate when the symptoms first appeared and how they manifested. In this regard, the patient started showing signs of MS six months ago with fatigue, but the symptoms have progressed into body weakness, unsteadiness, blurred vision and now urinary incontinence. In the physical exam, the doctor should review changes in reflex and visual acuity. Patients with MS may exhibit various physical findings which changes over time depending on the disease pattern and whether the patient is experiencing relapse or exacerbation. These results include localized weakness, hyperreactive reflexes and loss of visual acuity.<\/p>

Challenges in MS Diagnosis

In some cases, the diagnosis of MS presents a few challenges. For instance, when a patient has the symptoms presented in the case, the doctor should not be quick to diagnose MS because the differential diagnosis includes many diseases such as factitious disorder, UTI, anemia, lupus and ALS (Luzzio & Dangond, 2017). However, clinical evidence of T2 lesions backed up by oligoclonal bands and intrathecal IgG synthesis can help in identifying the condition. Lastly, although the evidence suggests that the patient has MS, it is noteworthy that it can take years to make an accurate diagnosis of MS, as the disease usually worsens slowly.<\/p>


Luzzio, C., & Dangond, F. (2017). Multiple Sclerosis Differential Diagnoses. Retrieved 16 September 2017, from

Marrie, R. A. (2016). Comorbidity in multiple sclerosis: some answers, more questions. International Journal of MS care, 18(6), 271-272.

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