Diagnosis

Diagnosing Multiple Sclerosis

Although multiple sclerosis (MS) has many characteristic symptoms, researchers have not yet created a single, conclusive test that can diagnose MS. Instead, doctors rely on a battery of tests to rule out other conditions that can have similar symptoms. To diagnose a patient with MS, a neurologist must find:

• Damage to a minimum of two separate sections of the central nervous system (brain, spinal cord, and optic nerves).
• Demonstrate that the two areas of damage occurred at least one month apart.
• Rule out any other condition that could be causing the symptoms.

Because there are so many tests involved, it can take a significant amount of time for a doctor to ultimately arrive at a diagnosis of MS. Some of the tests that might be necessary include:

• Magnetic Resonance Imaging (MRI) to look for lesions on your brain or spinal cord that are characteristic of MS.
• Evoked Potential Tests to measure the electrical signals your nervous system produces when stimulated.
• Lumbar Puncture or spinal tap to look for antibody abnormalities associated with MS.
• Medical history and neurological exam to evaluate language functions, emotional and mental status, coordination and movement, balance, vision, and more.
• Blood tests to rule out other conditions.

Relapsing/Remitting MS, where symptoms come and go with time, is easier to diagnose, as the pattern of symptoms is consistent and more obvious. Those with atypical symptoms or progressive forms of the disease may take longer to diagnose.

In previous decades, doctors were unable to diagnose MS after a single episode; they advised patients to wait and see if an additional attack would occur. New guidelines released in 2010, however, made it possible for MS to be diagnosed after a single episode if more significant lesions were present during an MRI. This has been important for patients as more and more evidence demonstrates that early intervention is key to changing the overall course of the disease.

Sources:

1. National MS Society - 'Diagnosing MS'
2. Mayo Clinic -'Multiple Sclerosis - Diagnosis'
3. Medscape - 'Multiple Sclerosis Workup'