Multiple Sclerosis Diagnosis and Treatment

At the OHSU Multiple Sclerosis Center, we use the latest advances to treat MS and related conditions.

You’ll find:

  • Internationally recognized MS experts working as a team.
  • Neurologists who meet weekly to discuss challenging cases and to apply the latest research breakthroughs.
  • Experts who can give you a quick and precise diagnosis.
  • Care tailored to your specific needs.
  • Researchers forging paths to better understanding and treatments.
  • A full range of treatment options, including wellness and complementary therapies.
Dr. Vijayshree Yadav, a neurologist who specializes in MS, is part of our large team of expert providers and researchers.
Dr. Vijayshree Yadav, a neurologist who specializes in MS, is part of our large team of expert providers and researchers.

Team-based care

Our providers work together. They understand the full range of treatment options, so they can tailor a care plan to your exact needs.

Your care team may include specialists such as:

  • Neurologists
  • Nurses and nurse practitioners
  • Radiologists (imaging specialists)
  • Infusion experts (hematologists-oncologists)
  • Physical, occupational and speech therapists
  • Psychologists
  • Pain specialists (experts in managing pain)
  • Pharmacists
  • Urologists

Diagnosing multiple sclerosis

There is no single test for multiple sclerosis. Experts diagnose MS by assessing your symptoms, taking detailed scans and ruling out other conditions.

For an MS diagnosis, your doctor must:

  • Rule out other conditions.
  • Find damage in at least two areas of the brain or spinal cord.
  • Find signs that the damage occurred at different times.

Why an early, accurate diagnoses is important

Our providers have the expertise to identify or rule out MS. This is important because, without treatment, your brain and nerves are at risk of permanent damage even in early stages.

In addition, MS is complex. Providers with less experience sometimes misdiagnose it. When that happens, patients don’t get proper care or end up with expensive treatments they don’t need.

Diagnosing MS includes a complete neurologic exam.
Diagnosing MS includes a complete neurologic exam.

Tests for MS

If you show signs of MS, your doctor will review your medical history and do a neurologic exam to measure your:

  • Muscle strength
  • Reflexes
  • Nerve function
  • Other physical and mental processes

Other tests may include:

MRI: A magnetic resonance imaging scan of your brain or spinal cord can show areas called lesions. Lesions, which can be signs of MS, are areas where the myelin surrounding your nerve fibers is damaged.

Spinal tap (lumbar puncture): Your doctor uses a thin needle to withdraw some of the fluid (cerebrospinal fluid) that surrounds your brain and spinal cord. High levels of certain substances in the fluid can be a sign of MS.

Evoked potential study: This test can show possible nerve damage. It measures the time it takes for nerves to respond to stimulation.

Blood tests: We may do tests to check for other conditions that could be causing your symptoms.

Multiple sclerosis treatment

Medications can help slow or change the progress of MS. Medications and other treatments can also manage relapses and ease symptoms.

Disease-modifying treatments

Disease-modifying medications can help lessen damage and delay disability in early stages of MS. More than a dozen medications can slow or modify relapsing forms of MS. One medication, ocrelizumab (Ocrevus), treats relapsing forms and primary-progressive MS.

These treatments can:

  • Reduce the number and severity of relapses
  • Reduce the number of brain lesions
  • Slow disabling effects of the disease

They come in three forms:

  • Pills
  • Self-injectable medications (shots you give yourself)
  • Infusions (IV drips)

Treatment for relapses

Relapses happen when MS causes inflammation in the central nervous system. An attack is considered a relapse when it lasts at least 24 hours and occurs at least 30 days after a previous attack.

Relapses can last for a few days to a few months. Mild relapses usually need no treatment. For severe relapses, a medication called a corticosteroid can reduce inflammation and shorten the relapse.

High-dose corticosteroids such as methylprednisolone are usually given by IV. You may take a corticosteroid such as prednisone by mouth after that. The lower-dose pills help you taper off the medication.

Managing MS symptoms

Your team may suggest medications for MS symptoms. Common types include:

  • Muscle relaxants or sedatives for tremors, stiffness and spasms.
  • Bladder relaxants for incontinence or overactive bladder.
  • Stool softeners or fiber supplements for bowel issues.
  • Stimulants or antiviral medications to ease fatigue.
  • Antidepressants for depression.

Complementary therapies

The OHSU Multiple Sclerosis Center is an international leader in research on complementary therapies for MS. Therapies such as acupuncture, tai chi and diet can be used alongside medical treatments.

  • Oral cannabis extract: Cannabis in pill form can lessen muscle stiffness and pain.
  • Oromucosal cannabinoid spray: This form of cannabis comes as a mouth spray. It can reduce muscle pain caused by stiffness (spasticity) and reduce symptoms such as frequent urination.
  • Acupuncture, tai chi and yoga: These techniques can lower stress and increase your energy, flexibility and balance.
  • Vitamin D: Some studies have found that vitamin D supplements can lessen how often you have symptoms and make them less severe.
  • Nutrition: A healthy diet low in fats and high in whole grains seems to lower disability and ease symptoms.
  • Exercise: Routine exercise may improve your strength and mood. It can also help with fatigue, and improve bladder and bowel function. Stretching exercises may help with stiffness and improve mobility.
  • Relaxation exercises: Deep breathing, meditation and visualization techniques can reduce stress.
Our rehabilitation center offers a range of technologies, including weight-supported walking therapy with a device called a Lokomat.
Our rehabilitation center offers a range of technologies, including weight-supported walking therapy with a device called a Lokomat.

Rehabilitation

Rehabilitation therapy helps patients with multiple sclerosis strengthen muscles and improve coordination. These, in turn, can help you manage symptoms.

Your care team will work with physical therapists, occupational therapists and other experts at OHSU’s state-of-the-art rehabilitation center. Our therapists, with expertise in neurologic disorders such as MS, can help you maintain function.

  • Physical therapy: A therapist can help you with exercises to manage fatigue. Your therapist can also address strength or balance concerns.
  • Occupational therapy: We can help you continue to use computers and other technology. We can help you learn to use assistive devices such as canes, braces, walkers and wheelchairs. We can also help you improve your coordination, and your finger and hand strength.
  • Speech-language pathology: Our therapists can help with speech issues, memory and attention, along with accommodations for work or school.
  • Electrical stimulation devices: We use the latest technology to stimulate weakened muscles. Devices include the FES bike, which uses low-level electrical signals to help people pedal a stationary bike. We also have Bioness, a wearable device the delivers low-level electrical stimulation to help MS patients with foot drop (trouble lifting the front of the foot).
  • Body-weight-supported treadmill training: We provide robot-assisted walking therapy for patients who can’t use their legs. This training uses a device called a Lokomat to simulate a typical gait, to strengthen muscles and to improve circulation.

Managing pain

Many people with MS have chronic pain. OHSU’s Comprehensive Pain Center is one of the largest pain centers in the region. It provides expert treatment for patients with short-term and long-term pain.

Our team can also help you address the physical, mental and behavioral issues that can result from ongoing pain.

Learn more

For patients

  • Referral: To become a patient, please ask your doctor for a referral.
  • Questions: For questions or follow-up appointments, call 503-494-7772.

Location

Parking is free for patients and their visitors.

Center for Health & Healing Building 1, eighth floor
3303 S.W. Bond Ave.
Portland, OR 97239
Map and directions

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Research and clinical trials