Emmy Award-winning actress Christina Applegate, known for her roles in Married... with Children, Anchorman and Netflix's Dead to Me, recently revealed a surprising development in her health journey.

After publicly announcing her multiple sclerosis (MS) diagnosis in 2021 and becoming a prominent advocate for people living with the disease, Applegate revealed on her MeSsy podcast that her doctor recently told her she does not have MS, reversing a diagnosis she received more than five years ago.

The 54-year-old actress continues to experience debilitating symptoms, leaving her medical team searching for answers.

Her experience highlights the challenges of diagnosing MS, a disease that can resemble several other neurological conditions.

Douglas Juvinall, MD, is a fellowship-trained neurologist who specializes in multiple sclerosis at OSF HealthCare Illinois Neurological Institute, a National Multiple Sclerosis Society-designated center recognized for providing comprehensive MS care.

"There is not a single blood test or MRI finding that definitively tells you this is MS," Dr. Juvinall says. "The criteria requires a constellation of MRI findings. Some other diseases can sometimes show you similar findings, and it takes someone with expertise in those other conditions to help exclude other conditions that aren't MS."

Why is MS difficult to diagnose?

Multiple sclerosis is an autoimmune disease that causes inflammation and damage to nerves throughout the central nervous system, which includes the brain and spinal cord.

Symptoms can include vision loss, double vision, numbness, weakness, severe fatigue and bladder dysfunction. However, these symptoms can also occur with other conditions, making an accurate diagnosis more challenging.

"The symptoms of MS are not unique to MS, they can occur in many other conditions," Dr. Juvinall says. "The MRI findings in MS can be unique to MS if interpreted correctly by a neurologist who specializes in MS, or a neuroradiologist. But sometimes those findings can be very subtle and can lead to a misdiagnosis."

According to the Multiple Sclerosis International Federation, early symptoms can be vague and occur sporadically over time. Reaching a diagnosis can take months or longer, even when symptoms appear consistent with MS.

In some cases, rarer diseases can mimic MS and produce similar findings on an MRI scan. Dr. Juvinall emphasizes the importance of working with a neurologist who specializes in MS, along with a multidisciplinary team experienced in identifying other conditions.

Part of that process involves reviewing medical history, imaging and other diagnostic tests to rule out diseases that could be responsible for the symptoms.

Why an accurate diagnosis matters

Someone incorrectly diagnosed with MS may undergo treatments that aren't addressing the actual cause of their symptoms. Learning that a diagnosis was incorrect can also bring frustration and uncertainty, particularly when symptoms remain unexplained.

Applegate expressed similar feelings on her podcast, saying she is back at square one in trying to understand her health.

Dr. Juvinall says there are more than 20 treatments approved by the U.S. Food and Drug Administration (FDA) for MS. While these medications can be highly effective, some can increase the risk of infections and other complications.

That makes confirming the diagnosis essential to developing an appropriate treatment plan.

"I believe it's very important (to see an MS specialist) because neurologists who have training or expertise in dealing with multiple sclerosis, will have had more cases of seeing the disease," Dr. Juvinall says. "As well as more expertise in finding those diseases that can mimic MS."

For people experiencing symptoms that could be related to MS, seeking an evaluation from a neurologist with expertise in the disease can be an important step toward finding answers and receiving appropriate care.

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This comes roughly five years after he announced he had been diagnosed with Parkinson's disease (PD).

Within 25 years, the world can expect to see a 112% increase in the number of people living with Parkinson’s since 2021.

A new report in the British Medical Journal (BMJ) links population growth and longer predicted lifespans as two main causes for an expected 25 million patients with Parkinson’s across the globe by 2050.

What is Parkinson's disease? 

“Parkinson’s disease is a movement disorder which causes a person to move less. It happens because the brain is not making enough dopamine, which is the neurotransmitter required for movement,” says Kavya Moravineni, a movement disorders neurologist with OSF HealthCare Illinois Neurological Institute (INI). “Our movement circuits in the brain use dopamine and cause voluntary movement.”

Dr. Moravineni wasn’t shocked to see the estimate in the BMJ. Parkinson's is a neurodegenerative disease, which coincides with natural aging. So, as life expectancy increases, the incidence naturally increases. Additionally, Dr. Moravineni believes there has been increased awareness, and in turn, increased diagnoses of Parkinson's. People are seeking out medical attention earlier as they recognize the symptoms, especially if they have a family history of PD.

Symptoms of Parkinson’s

“Tremor is the most common one. That’s what brings attention to see that something is wrong here,” Dr. Moravineni says. “Patients can have stiffness in their limbs, primarily in their muscles, and they can have problems walking. The typical dragging feet or not moving their arms as much when they’re walking. Stooped posture is another one.”

However, patients can have other symptoms which they don’t initially attribute to something like Parkinson’s disease. This can be the loss of sense of smell, dizziness upon standing or longstanding history of constipation. Sometimes anxiety or acting out your dreams at night can be longstanding symptoms.

The first step, Dr. Moravineni says, is to get a diagnosis. Next would be to decide how to manage the disease. The medical team at OSF INI offers different medication options, as well as discussing different surgical options. One example is deep brain stimulation (DBS).

What is deep brain stimulation? 

"It's an implant that's going into your brain. The idea is that we're using electricity to help with symptoms," Dr. Moravineni says. "To put it simply, the leads that go into the brain will pass electricity into the tissue and neurons. This negates abnormal signaling causing symptoms, so it improves symptoms."

Why deep brain stimulation can replace medication:

"As the disease progresses, the need for medication dosage increases. With that comes side effects. In those situations where the patients are still responding to medications, but experiencing a lot of side effects, deep brain stimulation can help. It's replacing medication while still providing the same benefit," Dr. Moravineni says. 

It can be increased or decreased based on what the symptoms are doing. Younger patients are often "better" candidates for deep brain stimulation. Patients cannot be candidates if they have severe dementia or underlying psychiatric illness that has not been managed. Of if they don't have solid family support. Dr. Moravineni calls deep brain stimulation one of the "next steps" in the process. It is recommended patients have proof of responding well to medication. 

Supportive therapies (speech and/or physical therapy) are beneficial parts of the care journey. 

The Michael J. Fox Foundation says while the BMJ article does not fully articulate the growth of PD, it does shine a light on the need for a cure.

There's no great list of health tips out there that can prevent Parkinson's. However, Dr. Moravineni says a well-rounded exercise regimen can help slow down progression in Parkinson's patients.

Dr. Moravineni adds that there have been increasing amounts of evidence indicating a connection between neurologic diseases and gut microbiome. The Mediterranean diet focuses on healthy habits like drinking less alcohol, eating more plant-based foods and fewer red meats, encouraging a strong and diverse microbiome. In turn, this may help in prevention and/or reduce the severity of certain neurologic conditions.

OSF INI has two physicians, one nurse practitioner and therapists caring for patients in the Peoria area. This multi-disciplinary approach to care helps INI be the go-to destination for patients in the community. 

For more information, visit the OSF INI website.

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"It can present in a variety of ways like vision loss, double vision, weakness, or numbness on one side or both sides of the body,” says Tiffani Franada, DO, a neurologist with the OSF HealthCare Illinois Neurological Institute (INI) who specializes in the autoimmune disease.

"Typically (multiple sclerosis) presents in young patients between 20 and 50 years of age. It's more common in women than men," Dr. Franada says. These events are called attacks or relapses, and they last a few weeks and then they get better. Patients can go awhile without anything, and then they can get other attacks down the line."

The OSF HealthCare Illinois Neurological Institute has launched a clinical trial for patients with nonrelapsing secondary progressive MS (nrSPMS). Dr. Franada and her team are looking for further preventive treatments. The trial, sponsored by Sanofi, uses an antibody called frexalimab, to see if it delays the progression in those enrolled.

"It's a disease state with no current treatment options available,” Dr. Franada adds. "We are actively enrolling right now. The age range is between 18-60 years of age for patients with secondary progressive MS that's not active. This is different than the relapsing remitting phase, which is the most common. This comes after that phase.”

While some patients currently in the OSF INI clinic are candidates for the clinical trial, Dr. Franada and her team are looking to include patients outside the clinic as well.

People interested in the clinical trial can call OSF INI at (309) 624-4000 to learn more information.

Multiple Sclerosis treatment options

There are 20 disease-modifying therapies to prevent disease activity in MS, Dr. Franada says. “Some treatments are given by IV, some are given by mouth, and some are given as at-home injections. It just depends on what is right for that individual."

Dr. Franada says if someone has an MS attack, the team wants to know about it right away. Adding that treatment of MS is more effective when it’s started early.

"There are some acute treatments that can be given, typically in the hospital. But prevention is a mainstay of our treatment course for patients.”  

Prevention tips

"Getting good sleep at night (is important), about eight hours. Getting regular exercise, about 30 minutes 5 days per week. In fact, exercise helps increase levels of BDNF, which is one of the hormones in our body that helps with neurological repair, called remyelination," Dr. Franada says. "The problem in MS is stripping away the covering of the nerve, demyelination, so exercise helps the reparative process. We don't know what the best diet for MS is, but I usually encourage my patients to focus on a Mediterranean diet, which is heart healthy." 

Knowing family history is also important to assess your risk factor of getting the disease.

"The risk for developing MS is a combination of genetics and environment, it's not just one. If you have a family member who lives with an autoimmune disease, or MS, it does slightly increase your risk for developing the disease,” Dr. Franada says.

Hydration is paramount, as is stress reduction. “Exercise is a great way to manage stress.”

"Your brain sits in a pool of fluid, so we want to hydrate as much as possible," Dr. Franada says. 

If you know a family member has MS, there are things you can do to lessen your risk.

"That includes Vitamin D supplementation. If you're low in Vitamin D, it’s critical to supplement that to a normal level. Also, smoking cessation. If you're a smoker, we advise you to quit. But this is incredibly important for patients with MS, because smokers are more likely to develop the disease,” Dr. Franada says.

National recognition of the disease has gone up, Dr. Franada says, which drives more patients to the OSF Illinois Neurological Institute. 

While there is no cure for MS, there are treatment options available to help with day-to-day symptoms (fatigue, pain and cognitive issues).

For more information on OSF HealthCare Illinois Neurological Institute, visit the OSF HealthCare website.

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Actor Michael J. Fox might be the most well-known person with Parkinson’s disease but he’s far from alone. In fact, the Parkinson’s Foundation says 90,000 people are diagnosed with Parkinson’s disease each year in the U.S. with diagnosed cases increasing 50% between 2012 and 2022.

The Foundation estimates 1 million people in the United States are living with the neurodegenerative disease, with men 1.5 times more likely to have Parkinson’s than women.

April is Parkinson’s Awareness Month, a time to bring added attention to the disorder which impacts balance and coordination, while also causing shaking and stiffness.

The Michael J. Fox Foundation recently announced a biomarker breakthrough from an international group of scientists which will help diagnose. The tool, called the α-synuclein seeding amplification assay (αSyn-SAA), can detect the disease in spinal fluid not only of people diagnosed with Parkinson’s, but also in individuals who have not yet been diagnosed or shown clinical symptoms of the disease, but are at a high risk of developing it.

Marc Katchen, MD is a neurologist with OSF HealthCare. He breaks down the signs to look out for when it comes to Parkinson’s.

“For people who are concerned that they have a shake in the hands, they really have to say ‘Am I moving slower? Am I having trouble getting up out of chairs? Can I not get out of my car very easily?’ It’s that slowness of movement to look out for,” Dr. Katchen says. “Usually the family will notice the person is walking slower or not swinging their hands as much. Another sign is if someone’s facial expressions have slowed down and they’re a little more poker faced than normal.”

Dr. Katchen says sometimes patients assume they have Parkinson’s because of hand tremors, but that’s not always the case. He adds symptoms of Parkinson’s disease can appear up to 10 years before you have tremors.

“Some of the non-specific findings we see are constipation, depression and anxiety which can precede the tremor and slowness of movement. The essential tremor is a tremor people have when they’re using their hands,” Dr. Katchen says. “It can be when they’re holding a cup of coffee, when they’re trying to screw in a small bolt and their hand won’t let them do that. That’s not Parkinson’s. With Parkinson’s disease, their tremor is at rest. You can almost hear it, and it goes away with activity.”

While there is no cure for Parkinson’s, Dr. Katchen says that shouldn’t make those diagnosed give up hope. He says exercise is a great way to increase overall quality of life.

“Get a program at home. Remember, therapy begins at home and it continues at home. There are programs like Rock Steady, which is a boxing program. There are also bicycling programs recently developed,” Dr. Katchen says. “All exercise works. It improves almost 30%, it’s almost like an added medication. It’s something we can give patients and their families that they can control. So you don’t have to rely on a physician to give you a pill.”

While the average age of diagnosis for Parkinson’s is 60 years old, Dr. Katchen says younger people can get it too.

“Michael J. Fox is probably the best known example. Many young people will go to many different providers before they get a diagnosis, because no one is thinking about it and they think they’re too young. You can certainly be in your twenties and thirties with a new onset.”

In 1997, the U.S. Food & Drug Administration (FDA) approved Deep Brain Simulation (DBS) surgery to treat Parkinson’s tremor. Dr. Katchen says this was groundbreaking for that time. Since then, the FDA approved the DBS surgery to treat advanced Parkinson’s symptoms.

Learn more about the Parkinson’s services offered at OSF HealthCare.

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