Distinguishing Fluctuations from True Progression in MS

In this episode, panelists discuss practical ways to tell apart temporary symptom changes from actual progression in multiple sclerosis. They recommend asking patients to compare their current daily functioning to how they were six months or a year ago. Gathering input from family members or caregivers is encouraged, as this can provide important insights into subtle changes. The conversation highlights tracking individual symptoms over time, such as how far a person can walk before experiencing foot drop or whether fatigue occurs with common activities. Clinicians are reminded to rule out reversible causes, including infections, vitamin deficiencies, and poor lifestyle habits, before determining if symptoms represent true disease progression. Monitoring cognitive function is also considered essential, with the Symbol Digit Modalities Test (SDMT) presented as a quick and effective tool for regular bedside assessment. These combined approaches support more accurate and patient-centered identification of genuine MS progression.