As a GP what would you do if somebody presents with symptoms that you think might be MS?

It’s very difficult. MS is not an easy diagnosis to reach. By its very nature MS is something that presents with different symptoms in different parts of the neurological system, in different parts of the brain or the nervous system at different times. So when someone has a symptom it’s always difficult to say, Is this MS?’ As time passes they collect different symptoms at different times some of which may have got better and then it becomes clearer that this could be MS. There are some very classic symptoms for example blurring of the vision in one eye which comes on and then gets better over a period of about 6 weeks which should really raise alarm bells, Could this be MS?’

The problem is really how much do you share with a patient because if you are very uncertain then it can be very distressing for a patient to have the worry of multiple sclerosis raised when actually that turns out not to be the case. The other extreme is nobody saying anything until several episodes of different things have happened and then the poor patient finding out in the end that over several years everybody else has been thinking MS but nobody has told the patient. And somehow as a doctor you need to navigate between these two paths and be as honest as you can about what you think might be going on without unduly or unnecessarily distressing your patient or making them worry when it’s only a faint possibility. So I think it’s a really difficult thing to know what to say. On the whole if someone comes to me with symptoms that I think may well be multiple sclerosis I will refer them to a neurologist and I will also explain the reason that I am referring to the patient and what’s likely to happen when they see the neurologist. Most patients will then have a scan of some sort, having been examined by the neurologist, just to see whether the current symptoms they have may be related to MS.

Caring is incredibly hard work both physically and emotionally and I think it’s sometimes very difficult for carers to say, Stop, look at me, I’ve got my own health needs. Because they are so aware that the person they are looking after has so many more health needs. And I think we need to sometimes as health professionals focus more on the carer and ask them how they are doing, how they are getting on, how they are coping and if there is anything they need to help them. And similarly I think carers maybe need to prioritise their needs sometimes which is difficult for them to do but it is very important that they stay healthy and well and as cheerful as they can be while they are looking after the person with MS.