Multiple Sclerosis
Primary Care Management
See additional information for relapse and spasticity management.
MS typically presents with:
- A specific focal symptom evolving over hours to days, persisting for days to weeks, then gradually resolving.
- Typical symptoms include:
- Optic neuritis – typically painful loss of vision (including colour vision) in one eye – please direct patient to optician in 1st instance
- Brain stem/cerebellar syndromes – double vision, unsteadiness/ataxia, facial numbness
- Spinal cord syndromes – evolving weakness/numbness of legs (with or without arm or sphincter involvement)
- Cerebral hemisphere syndromes – hemiparesis/hemisensory symptoms
- Relapses are not characterised by numerous, non-focal symptoms waxing and waning over long periods of time.
- See National MS Factsheet for more information
Who to Refer
Who to refer via SCI Gateway:
- Patients with new focal neurology where MS is the considered diagnosis
Who to refer via on-call registrar:
- Patients with known MS who are experiencing a relapse and
- Their level of function is severely impaired +/-
- No response to steroids is seen.
Who not to Refer
- Headache, isolated fatigue/tiredness, and intermittent sensory symptoms are unlikely to be due to MS (please see National Benign Sensory Symptoms Factsheet).
- Patients currently under review by the MS team (Please make contact directly with the MS Specialist Nurse team in the 1st instance).
How to Refer
New patients via SCI Gateway/Neurology
Existing patients through MS Specialist Nurse Service:
Existing patients through MS Specialist Nurse Service:
- For Perth and Kinross Christine Whatley on ext 34028,
- Dundee, Angus and NE Fife Laura McEwan and Rose Perera on ext 35252
- MS Champion for Tayside and NE Fife Rachel Morrison (advanced MS) on ext 36033.
- E-mail: tay.msspecialistnurses@nhs.scot