If you have had a "single attack" which presented with MS like symptoms, the neurologist would be looking at CIS (Clinical Isolated Syndrome) which is a term that has been used to describe a first neurologic episode that lasts at least 24 hours, and is caused by inflammation/demyelination in one or more sites in the central nervous system (CNS). The episode can be monofocal or multifocal. A monofocal episode is when the person experiences a single neurologic sign or symptom—for example, an attack of optic neuritis—that’s caused by a single lesion. A multifocal episode is when the person experiences more than one sign or symptom—for example, an attack of optic neuritis accompanied by weakness on one side—caused by lesions in more than one place.
To move into the "MS types" the neurologist will look for a second attack. The neurologist would also look for new lesions (or any lesions). The Revised McDonald Criteria uses two lesions in order to push a diagnosis of MS if the other tests concur.
Your life has been quite a stressful life and you have endured what many of us will never truly know. It is really difficult to look back and separate your traumatic life events into possible MS. An MS Specialist can sort this out to a degree.
When I was diagnosed, my neuro worked with me in looking back. I could only recall events when I was 14 yo and I still had shoes which provided evidence of foot drop. I may have had problems earlier, but there was no evidence. I would not have been able to separate events without my neuro's insight. Brain fog and cognitive difficulties can certainly plague you, but I would not worry about this. You just do the best you can and allow the doctors to do their work. If you cannot remember, no worries. When you can remember, write it down. It is like a puzzle; after a few pieces are joined, the whole picture becomes clearer!
Make sure you are looking at the 2010-2011 Revised McDonald Criteria which was updated from the 2005 version. In order to make a diagnosis of MS, the physician must:
1. Find evidence of damage in at least two separate areas of the central nervous system (CNS), which includes the brain, spinal cord and optic nerves AND
2. Find evidence that the damage occurred at least one month apart AND
3. Rule out all other possible diagnoses
If you have had attacks at least one month apart, you would satisfy this criteria. Writing in a journal will help you in knowing this which will aid the neuro in his review.
Have I confused you? I hope not. It is late and my brain fog is rolling in!
