Multiple Sclerosis: Why Getting a Second Opinion Counts

Medically reviewed by Peggy Pletcher, MS, RD, LD, CDE on April 13, 2016Written by Anna Schaefer on April 13, 2016
Doug Ankerman

Multiple sclerosis, or MS, affects 2.3 million people around the world, according to the National Multiple Sclerosis Society. It is a disease of the central nervous system, characterized by degradation of the myelin sheath — a protective covering around nerves.

This damage can lead to varying degrees of symptoms, depending on the nerves involved. It becomes completely debilitating for some.

Two people who have MS can have very different symptoms, which progress along very different paths. For these reasons, and more, getting a second opinion can be crucial.

The initial symptoms of MS may include numbness and weakness, fatigue, dizziness, slurred speech, tremors, and problems with bladder and bowel control. How, and whether or not, these symptoms arise depends on the nerves affected.

“I always advise obtaining a second opinion from an academic center’s MS neurologist if there is any uncertainty in the diagnosis or for reassurance that a correct diagnosis has been made,” says Dr. Clifford Segil, a neurologist at Providence Saint John’s Health Center in Santa Monica, California.

How is MS diagnosed?

Officially, there are three criteria needed in the diagnosis of MS:

  1. Evidence of myelin sheath damage in at least two separate areas.
  2. Evidence that this damage occurred at least one month apart.
  3. Other diagnoses ruled out.

The 5 best second opinion telemedicine options »

“Sometimes, patients’ symptoms are pronounced enough at presentation to make an accurate diagnosis quickly,” says Dr. Segil. Other times, “the symptoms are nonspecific, and even an MRI can produce inconclusive results.”

In addition to MRI scans, which are used to produce images of the brain, a neurologist may use electrical testing and evaluation of spinal fluid to arrive at an MS diagnosis.

When you should think about getting a second opinion

An MS diagnosis can be difficult to make, which is why getting a second opinion is often worthwhile. In fact, says Dr. Segil, the condition is probably underdiagnosed, because “symptoms can be as nonspecific as intermittent leg tingling, dizziness, and other benign neurological complaints that are transient.”

Misdiagnosis is possible, too. A 2012 study found that nearly 75 percent of surveyed MS specialists had seen at least three patients over the past 12 months who had been misdiagnosed with MS.

People who definitely have MS might find that getting another doctor’s opinion is also useful when looking at viable treatment options.

“There are multiple medications now available that are approved to treat multiple sclerosis,” according to Dr. Segil. These include pills, injectables, and intravenous medications. “I have my preferences and other neurologists will have their preferences in medication choice.”

“I switched neurologists because I felt I was missing out on more up-to-date treatment programs,” recalls Doug Ankerman. “My assumptions were correct, as now I’m a patient at a proper MS clinic and have been introduced to a wealth of new treatment options.”

“If anyone is even slightly frustrated by their current MS treatment program, I would encourage them to seek out different options of treatments,” says Ankerman.

Where to go for an MS second opinion

Doctors usually encourage their patients to seek a second opinion, to ensure the best medical attention and course of treatment.

Where you go for a second opinion will depend on a number of factors, including your insurance coverage. You may ask your diagnosing doctor what they recommend. There are also several telemedicine options, which you can schedule at your leisure.

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