MS Made Simple: Understanding My MS Diagnosis (VIDEO)

 

Dr. Mitzi Joi Williams is a top neurologist and Multiple Sclerosis (MS) Specialist in Atlanta, Georgia. She received her undergraduate degree in Neuroscience and Behavioral Biology from Emory University and her Doctor of Medicine degree from Morehouse School of Medicine. Dr. Williams completed her internship and residency in neurology as well as a Clinical Fellowship in Multiple Sclerosis at the Medical College of Georgia in Augusta, GA. Dr. Williams has a strong interest in understanding and furthering research in MS in ethnic minority populations. She is a sought-after speaker and presenter and has discussed her research both nationally and internationally at various scientific meetings. She has spearheaded and participated in multiple Steering Committees and Work Groups to further research in underserved population with MS. She also has recently increased involvement in efforts to increase diversity in clinical research and educate the community about the importance of research participation. Dr. Williams is the author of MS Made Simple: The Essential Guide to Understanding Your Multiple Sclerosis Diagnosis. Because of her passion for teaching and advocacy.

My name is Dr. Mitzi Joi Williams and I am a neurologist and Multiple Sclerosis specialist in Atlanta, Georgia. Multiple Sclerosis is an autoimmune disease and basically what that means is that the immune system, the part of the body that normally attacks viruses and bacteria gets confused and attacks a good part of the body.

Every autoimmune disease has a different target and the target with ms is the coding of the nerves, which is a substance called Myelin and when Myelin is attacked, it damages the nerves so that the signals don't run properly and results in the symptoms that we see from multiple sclerosis, some of which can be numbness and tingling. Sometimes people have weakness or sometimes they have vision loss. The symptoms depend on the areas that are damaged by the immune system.

There are multiple different people who are at risk for multiple sclerosis. There is no one test that we can do to determine if someone has ms or not, but there are several things that we know increase the risk. People who live in certain parts of the world have a higher risk for Ms. So, for instance, if we look at locations that are very close to the equator, we don't see a lot of ms in those areas.

So we don't see a lot of ms and for instance, Africa like South Africa, um, or temporary climates. But we certainly see a lot more in places like Europe or Scandinavia and even in the United States. Um, so we know that location plays a part. We also know that genetics plays a part, but ms is not a directly inherited disease. So if we think about a disease like sickle cell, we know that if the mom has a gene, the dad has a gene, we can predict that one in four of the children will have the disease.

But with multiple sclerosis, there are over 200 genes in different locations that are associated with risk. And so I have some families where multiple people have ms and I have some families where that person is the only person. So the genetics are not really predictable in terms of who would develop it. And then finally there are some environmental factors that we think may be related to Ms. Smoking is a risk factor.

We also have learned more recently that obesity is a risk factor and also ms is much more common in women than men. So there are a lot of theories around estrogen and hormones and if they may or may not be related to increased risk. Um, one of the interesting things is that we found over the past five years or so, there are some studies that suggest that African Americans are at the highest risk for Ms. And this is news because we used to think that black people did not get a mess.

And so there was a study published in 2013 that suggested that the risk was 47% higher in African American women than in Caucasian women in the US and this is diagnosed by a couple of different things. So it's a combination of the person's history, um, the symptoms that they report to their doctor, their physical exam, and also imaging such as MRI. So a person has to have a typical of symptoms that are like multiple sclerosis, which include let's say numbness or tingling that lasted for several weeks and improved.

Sometimes they'll have vision loss that came on and lasted for a while and improved. And then in combination with that, we usually do MRIs of the brain and of the spinal cord which show us lesions or white spots. Those white spots that we see on MRI are the areas where the immune system has damaged the nerves and so when that Myelin is removed it shows up white.

And so that's what your doctor's looking at or that's what the doctor looks at when they look at those MRI scans. So we have to have a combination of symptoms plus MRI abnormalities to diagnose Ms. So a person that only has symptoms we don't necessarily diagnose. And in that case, in a person who only has MRI changes and doesn't have symptoms, also doesn't necessarily have Ms.

There are some times other tests that we can do including a lumbar puncture or spinal tap and some blood tests that we have to do to rule out other diseases. Because there are vitamin deficiencies that can mimic Ms. And also there are other rheumatologic conditions that can mimic Ms. So we are not only looking at things to confirm the diagnosis, but we're also making sure that they're not other reasonable causes for those symptoms before we make a diagnosis of multiple sclerosis.

Be sure to check out the next video in the Brown Lens series featuring Dr. Mitzi Joi Williams -- MS Made Simple: Forms Of MS

Tuesday, August 6th, 2019

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