If you have multiple sclerosis (MS) and have new or worsening symptomssymptomsyou need to know the underlying causes. And in some cases, the symptoms of a multiple sclerosis relapse and the symptoms of a stroke can overlap, making it difficult to tell them apart.
Knowing the difference is crucial, especially for people with multiple sclerosisgreater risk of stroke. Stroke treatment depends on time - the sooner you are treated, the better for you.
Read on for five ways to tell the difference between the symptoms of MS and a stroke.
1. Time is important
If you're worried you're having an MS relapse or having a stroke, the timing of your symptoms can provide a lot of information. Usually during a strokesymptoms appear suddenly. One minute you're functioning normally, the next you're not. Symptoms of a stroke usually appear within minutes to hours. However, during an MS relapse, symptoms often develop over a period of hours or days.
While time can be a good indicator of the difference between a stroke and a myocardial infarction, this is not always the case. For example, if someone is asleep when a stroke or relapse occurs, symptoms may not be recognized until the next day. At this point, you don't know when your symptoms started.
The same applies if you miss the first symptoms, such as weakness or very slight numbness. Also, if someone has a cognitive impairment (difficulty thinking or remembering), lives alone, has difficulty expressing themselves, or has new symptoms related to speaking or understanding, it may not be possible to know when symptoms started. However, time can serve as a good basis for assessing the likelihood of having a stroke.
2. Watch out for certain symptoms
Although many of the symptoms of multiple sclerosis relapse and stroke overlap to some extent - because they both affect the nervous system - there are some symptoms that are not as common.
Sometimes a stroke can cause people to lose the ability to speak, either through slurred speech or by stringing together words that don't make sense (known as word salad). Usually a family member notices this change. A stroke can also cause problems understanding speech. Sudden difficulty speaking and/or understanding are much more common symptoms of a stroke.speech symptomsseen during MS relapse.
Some symptoms are more common in a MS flare-up due to trauma (damage or inflammation of the central nervous system) than in a stroke. Problems with bowel and bladder control, pain and muscle spasms are rarely seen during a stroke. If you usually have these symptoms during an MS flare, you're more likely to have another flare than a stroke.
Sometimes it's hard to tell the difference based on symptoms alone. Symptoms seen in multiple sclerosis attacks and stroke may include:
- Weakness and/or numbness in the arms, legs or face
- Changes in vision, including loss of vision or blurred vision
- difficulty walking
- Problems with balance or coordination
- Headache
- Dizziness
- Confusion
3. Your background may be important
In general, multiple sclerosis and stroke affect different groups of people. Stroke is most common in men aged 65 and older, and MS is most commonly diagnosed in women between the ages of 20 and 50. Research from the National Institutes of Health shows that African Americans or Hispanics are twice as likely to have a stroke, but whites or Europeans are more likely to develop multiple sclerosis.
According to the Centers for Disease Control and Prevention, about 1 in 7 strokes occur in people under the age of 45, and stroke affects people of all races and ethnicities. This information is just an overview of trends so you can better understand the most common demographic differences (populations and characteristics) between the two groups.
4. Your medical history is important
A lotrisk factorsknown to significantly increase the risk of stroke. These include high blood pressure (also called hypertension), high cholesterol, heart disease, diabetes, and sickle cell anemia. Your family history is also important. A family history of stroke, especially when combined with an unhealthy lifestyle, increases the risk of stroke.
Drinking too much alcohol or using drugs also increases the risk of stroke. It's important to remember that if you've had a stroke or a transient ischemic attack (TIA, also called a "mini-stroke") in the past, your risk of having a second stroke is higher.
MS is differentrisk factorsthen stroke. Especially the history of some virusesEpstein-Barr infectionyou suffer from another autoimmune disease or afamily historyfrom multiple sclerosis puts you at higher risk of developing multiple sclerosis. Living in temperate regions and areas farther from the equator also increases the risk of being diagnosed with MS because there is less ultraviolet light in these areas.
Both smoking and obesity are risk factors for MS and stroke. And if you have MS, you're also more likely to have a stroke.
A balanced diet, an active lifestyle and quitting smoking are important to reduce the risk of stroke and the severity of MS symptoms.
In addition to multiple sclerosis, people with severe migraines, very high blood pressure, brain tumors, and seizures may have stroke-like symptoms.
5. When to seek urgent help
If you live with MS and are concerned about the symptoms, it's always best to talk to a neurologist. However, there are certain times and symptoms that should bring you to the nearest emergency room as soon as possible. These include the sudden onset of:
- Weakness, especially on one side of the body
- Numbness or tingling
- Vision problems, especially in one eye
- Confusion
- Slurred speech or gibberish
- difficulty walking
- severe headache
- Difficulty staying awake or unconscious
Multiple sclerosis can vary greatly from person to person, especially in terms of the types of symptoms and when they occur. Since a stroke is an emergency - and can be fatal - it's extremely important that it is evaluated by an emergency room physician immediately. Also, the treatment time window is very limited.ischemic stroke, a type of stroke usually caused by a blood clot. Therefore, the sooner you get to the emergency room, the better the chance of a good outcome.
If you think you're having a stroke or aren't sure if it's multiple sclerosis or a stroke, contact your neurologist or seek medical attention right away. Acting quickly can make a big difference and possibly even save a life. Don't wait for these symptoms to occur - get medical help right away.
Talk to other people who understand
My MSTeamis a social networking site for people with multiple sclerosis and their loved ones. At MyMSTeam, over 198,000 members come together to ask questions, give advice and share their stories with others who understand living with MS.
Are you living with multiple sclerosis and worried about knowing the difference between multiple sclerosis and a stroke? Share your experience in the comments below or start a conversation by posting on yoursClassesside.
Bibliography
- Stroke Risk in Multiple Sclerosis and Myelitis Optical Spectrum Disorder: South Korea National Cohort –– Journal of Neurology, Neurosurgery, & Psychiatry
- Beroertebehandeling –– National Heart, Lung and Blood Institute
- Stroke Signs and Symptoms -– Centers for Disease Control and Prevention
- Ischemic Stroke –– Cedars-Sinai
- Predictors of Multiple Sclerosis Relapse Severity and Outcome –– BMC Neurology
- Unknown onset of ischemic strokes in patients last seen >4.5 hours: differences between awake and unnoticed strokes during the day –– Acta Neurologica Belgica
- Klinika Afasia – Cleveland
- Spraakproblemen –– National Multiple Sclerosis Society
- INFO CMSC: Multiple Sclerosis and Stroke, Differences in Symptoms, Causes and Treatment –– Multiple Sclerosis Center Consortium
- How many people are affected/at risk of having a stroke? — Eunice Kennedy Shriver National Institute of Child Health and Human Development
- Who Has Multiple Sclerosis: The Epidemiology of MS - National Multiple Sclerosis Society
- Stroke before age 45 -– Sutter Health
- Know Your Stroke Risk –– Centers for Disease Control and Prevention
- The low incidence of multiple sclerosis in regions near the equator may be due to ultraviolet light-induced suppressor cells for melanocyte antigens.
- Obesity and vulnerability to multiple sclerosis: a review - Journal of Neurology and Neuromedicine
- AVC –– EmergencyPhysicians.Org
- Time is a key factor in treating a stroke - Adventist Health
- Ischemic Stroke - Cleveland Clinic
- Stroke simulators: incidence, etiology, clinical features and treatment - Annals of Medicine
FAQs
How to tell the difference between a stroke and multiple sclerosis? ›
Another key difference is that multiple sclerosis flares occur over several days, whereas stroke symptoms are sudden and severe and can occur within a few minutes. If your symptoms then appear with full force, it is very likely that you are having a stroke as opposed to a multiple sclerosis flare.
Can MS be confused with stroke? ›Multiple Sclerosis and Stroke are two very different diseases; however, they can be mistaken for each other, because they both affect the brain.
What are 5 signs and symptoms of multiple sclerosis? ›- fatigue.
- vision problems.
- numbness and tingling.
- muscle spasms, stiffness and weakness.
- mobility problems.
- pain.
- problems with thinking, learning and planning.
- Epstein-Barr Virus.
- Vitamin B12 Deficiency.
- Diabetes.
- Nerve Damage.
- Eye Problems.
- Stroke.
- Lupus and Other Autoimmune Diseases.
- Parkinson's Disease.
A CT scan of the head is usually one of the first tests used for a stroke. A CT scan can show bleeding in the brain or damage to brain cells. The CT scan also can find other problems that can cause stroke symptoms. Magnetic resonance imaging (MRI).
What do MS brain lesions feel like? ›MS brain lesions can cause coordination problems, dizziness, slurred speech, muscular weakness, and sensation loss. The location of these lesions dictates which symptoms a person experiences. There is no cure for MS, but several treatment modes can help people to manage the condition.
How do I know if my brain lesions are MS? ›Diagnosing MS
More than 90% of people with MS have scar tissue that shows up on an MRI scan. A spinal tap can check for abnormalities in the fluid that bathes the brain and spinal cord. Tests to look at electrical activity of nerves can also help with diagnosis.
A normal MRI with MS symptoms
There are rare cases where someone can have MS but their MRI will look clear. This happens. That doesn't mean they can't get a diagnosis of multiple sclerosis, but it does make it significantly more difficult.
The obvious symptoms can include difficulty walking, loss of coordination, muscle spasms, weakness and changes in speech. But, not all symptoms are easily visible. “Unfortunately, many invisible symptoms are subjective,” said Dr.
What is the number 1 symptom of MS? ›Numbness or Tingling
Numbness of the face, body, or extremities (arms and legs) is often the first symptom experienced by those eventually diagnosed as having MS.
What autoimmune disease mimics MS? ›
Sjogren's syndrome is an autoimmune disease that can mimic some of the symptoms of MS such as fatigue and joint pain.
When should you suspect multiple sclerosis? ›People should consider the diagnosis of MS if they have one or more of these symptoms: vision loss in one or both eyes. acute paralysis in the legs or along one side of the body. acute numbness and tingling in a limb.
What is commonly misdiagnosed as MS? ›Some conditions that doctors may commonly misdiagnose as MS include migraine, RIS, spondylopathy, and neuropathy. To accurately diagnose MS, doctors must rule out conditions with similar symptoms and look for signs and symptoms specific to MS. As such, the process of diagnosing MS may be lengthy and complex.
How do you rule out MS? ›An MRI scanner uses a strong magnetic field to create a detailed image of inside your brain and spinal cord. It's very accurate and can pinpoint the exact location and size of any inflammation, damage or scarring (lesions). MRI scans confirm a diagnosis in over 90 per cent of people with MS.
How can I test myself for MS? ›How to self-assess multiple sclerosis symptoms. A multiple sclerosis (MS) self-assessment cannot diagnose MS, but it may help a person understand their symptoms and know when to contact a doctor. An MS self-assessment may focus on energy levels, physical sensations, vision problems, and more.
How can doctors tell if you've had a mini stroke? ›An MRI scan is most often used. This type of scan uses a strong magnetic field and radio waves to create an image of your brain.
What causes stroke like symptoms but is not a stroke? ›One of the most common stroke mimics is a seizure, which researchers believe account for as many as 20% of all stroke mimics. Other common stroke mimics include migraines, syncope, sepsis, brain tumor and metabolic derangement (low sodium or low blood sugar).
Where is the MS hug lesion? ›The 'MS hug' is an MS symptom where you feel pain or tightness around the chest or stomach area. It's not dangerous, but it can be frightening, especially if you haven't come across it before.
Where do MS lesions appear? ›Characteristic lesions are located in the periventricular and juxtacortical regions, in addition to the brainstem, cerebellum, spinal cord, and optic nerve.
Can you tell if you have MS from a brain MRI? ›MRI plays a vital role in how we diagnose and monitor MS. In fact, over 90% of people have their MS diagnosis confirmed by MRI.
What else besides MS causes brain lesions? ›
- Concussions and other traumatic brain injuries.
- Medical procedures, such as surgery, radiation therapy or chemotherapy.
- Radiation exposure.
- Heavy metal poisoning or other toxins.
Multiple sclerosis is caused by your immune system mistakenly attacking the brain and nerves. It's not clear why this happens but it may be a combination of genetic and environmental factors.
What can white spots on brain MRI mean? ›White spots on a brain MRI are not always a reason to worry. There are many possible causes, including vitamin deficiencies, infections, migraines, and strokes. Other risk factors for white spots include getting older, race/ethnicity, genetics, obesity, diabetes, hypertension, and high cholesterol.
Can you still have MS if MRI is clear? ›MS can be present even with a normal MRI and spinal fluid test although it's uncommon to have a completely normal MRI. Sometimes the MRI of the brain may be normal, but the MRI of the spinal cord may be abnormal and consistent with MS, so this also needs to be considered.
What mimics MS on an MRI scan? ›Some of the most common mimics include migraine and chronic cerebrovascular disease, according to Dr Schiess. Vasculitic autoimmune diseases such as systemic lupus erythematosus (SLE) and Sjögren's syndrome can also result in white matter abnormalities on MRI.
Does MS show up in blood work? ›Blood Tests: Currently, there are no definitive blood tests for diagnosing MS, but they can be used to rule out other conditions that may mimic MS symptoms, including Lyme disease, collagen-vascular diseases, rare hereditary disorders and acquired immune deficiency syndrome (AIDS).
What is the MS hug in the neck? ›What is the MS hug? The MS hug, also known as banding or girdling, is a symptom of multiple sclerosis in which you feel chest pain, rib pain or a tight uncomfortable band around your chest. It can be felt anywhere between the neck and the waist and may feel so tight around the chest that it's painful to breathe.
What neurological disorders are similar to MS? ›These include fibromyalgia and vitamin B12 deficiency, muscular dystrophy (MD), amyotrophic lateral sclerosis (ALS or Lou Gehrig's disease), migraine, hypo-thyroidism, hypertension, Beçhets, Arnold-Chiari deformity, and mitochondrial disorders, although your neurologist can usually rule them out quite easily.
What is the most common pattern of MS attacks? ›Attacks strike approximately every 12 to 18 months. This pattern is common when patients first develop MS and through the early years of their disease, and is referred to as relapsing-remitting MS.
What is the most common pattern of MS? ›The most common type of MS is relapsing-remitting MS (RRMS). Approximately 85% of people with MS have RRMS at the time of diagnosis.
What does MS rash look like? ›
A skin lesion triggered by MS medications may present as hives and as red and swollen bumps, often on the face. The itching sensation that often accompanies MS also can cause someone to scratch their skin too much in looking for relief. Symptoms may then include raised, thickened areas of skin that can become cracked.
Can fibromyalgia be mistaken for MS? ›But despite some similarities, “for the most part, there is no mistaking symptoms of MS with fibromyalgia,” says Philip Cohen, MD, a rheumatologist, professor of medicine and professor of microbiology and immunology at the Lewis Katz School of Medicine at Temple University in Philadelphia.
Can anxiety be mistaken for MS? ›Never Self-Diagnose MS From Anxiety
Unfortunately, anxiety causes many of the same symptoms as the early stages of MS. MS is one of the health issues that comes up most when those with anxiety search for their symptoms online, and millions of those with anxiety convince themselves that they might have MS.
Neurological examination
Your neurologist will look for abnormalities, changes or weakness in your vision, eye movements, hand or leg strength, balance and co-ordination, speech and reflexes. These may show whether your nerves are damaged in a way that might suggest MS.
- Vision problems. For many people, a vision problem is the first noticeable symptom of MS. ...
- Numbness. Numbness in the face, body, arms, or legs is another common symptom of MS. ...
- Fatigue. ...
- Bladder problems. ...
- Bowel problems. ...
- Pain. ...
- Cognitive changes. ...
- Depression.
There is a new blood test that may monitor multiple sclerosis disease activity better in clinically stable patients. The test is called sNfL (serum neurofilament). It measures the breakdown of a certain part of neurons, which occurs when multiple sclerosis is attacking the nervous system.
Does MS affect your nails? ›Nail problems are common, and they are not usually serious. If a person has multiple sclerosis (MS), nail problems can cause pain or discomfort. While nail issues are not directly related to the disease, determining the cause may help prevent a person with MS from experiencing further discomfort.
What is the difference between a stroke and multiple sclerosis? ›When you have a stroke, a blocked or burst blood vessel cuts off the blood supply to part of your brain. With MS, you have a lifelong disease where your immune system, your body's defense against germs, attacks the nerves in your brain and spinal cord. Two very different conditions, but they can look and feel alike.
What is the average age to be diagnosed with MS? ›MS can occur at any age, but onset usually occurs around 20 and 40 years of age.
What is the first test for MS? ›There are no specific tests for MS . Instead, a diagnosis of multiple sclerosis often relies on ruling out other conditions that might produce similar signs and symptoms, known as a differential diagnosis. Your doctor is likely to start with a thorough medical history and examination.
Can an eye Dr detect MS? ›
Multiple sclerosis (MS).
When your optometrist detects optic nerve inflammation, that can indicate a diagnosis of MS. Patients with MS often also have double vision, blurred vision, or report pain when moving their eyes.
Magnetic resonance imaging (MRI)
It's very accurate and can pinpoint the exact location and size of any inflammation, damage or scarring (lesions). MRI scans confirm a diagnosis in over 90 per cent of people with MS.
MS activity appears on an MRI scan as either bright or dark spots. Typical MS lesions tend to be oval or frame shaped. MS lesions can appear in both the brain's white and gray matter. Healthcare professionals may use a chemical contrast dye called gadolinium to improve the brightness of MRI scan images.
When do the first symptoms of multiple sclerosis typically appear? ›We don't know what causes MS, but there are certain factors that may increase the risk or trigger its onset. So while MS can occur at any age, it mostly makes its first appearance in people between the ages of 20 and 40.
How does a neurologist rule out MS? ›Neurological examination
Your neurologist will look for abnormalities, changes or weakness in your vision, eye movements, hand or leg strength, balance and co-ordination, speech and reflexes. These may show whether your nerves are damaged in a way that might suggest MS.
Some of the most common mimics include migraine and chronic cerebrovascular disease, according to Dr Schiess. Vasculitic autoimmune diseases such as systemic lupus erythematosus (SLE) and Sjögren's syndrome can also result in white matter abnormalities on MRI.