Identifying Early Signs of Progression in MS

In this episode, the panel focuses on the practical challenges of detecting early changes that may signal disease progression. Clinicians emphasize the value of a comprehensive patient history, explaining that patients usually report subtle changes in functional abilities before these are apparent on examination. Intermittent symptoms, such as occasional foot drop or symptoms brought on by heat or fatigue, often precede more persistent difficulties. The panel discusses using functional assessments, such as home-based or supervised six-minute walk tests, to objectively track changes in walking distance over time. They highlight how early signs may not always be captured by standard neurological exams and can require more nuanced questioning, sometimes involving input from family members. The group also addresses the challenge of distinguishing genuine disease progression from reversible conditions, such as pseudo-exacerbations due to infection or external stressors, recommending intensified monitoring and deeper clinical assessment when early warning signs emerge.