Your doctor will refer you to a neurologist. They will examine you to check how different parts of your nervous system are working. A combination of tests is used to diagnose MS. The best test is an MRI of your brain and spinal cord to detect areas of damage.
Neurological examination
Your neurologist will look for abnormalities, changes or weakness in your vision, eye movements, hand or leg strength, balance and co-ordination, speech and reflexes. These may show whether your nerves are damaged in a way that might suggest MS.
The process of diagnosis can take months, in some cases years, and is often referred to as 'limboland'. In this factsheet we look at the early symptoms of MS and hope to answer some of the common questions that you might have at this time. The contents include: Why does a diagnosis take so long?
There is no one single test to diagnose MS. If the results of your neurological exam point to an MS diagnosis, your neurologist will likely order other tests to confirm it.
Magnetic resonance imaging (MRI) is a diagnostic tool that offers the most sensitive, noninvasive way to examine the brain, spinal cord or other areas of the body. It is a valuable tool for diagnosing MS and tracking the progression of the disease.
These include fibromyalgia and vitamin B12 deficiency, muscular dystrophy (MD), amyotrophic lateral sclerosis (ALS or Lou Gehrig's disease), migraine, hypo-thyroidism, hypertension, Beçhets, Arnold-Chiari deformity, and mitochondrial disorders, although your neurologist can usually rule them out quite easily.
Here's where MS (typically) starts
You may experience eye pain, blurred vision and headache. It often occurs on one side and can eventually lead to partial or total vision loss. Spinal cord inflammation, or what's called partial transverse myelitis, is the second most common symptom Shoemaker typically sees.
The early signs and symptoms of MS can be the same for women and men. One of the more obvious first signs of MS is a problem with vision, known as optic neuritis. This is often because it's a more concrete symptom as opposed to vaguer neurological symptoms like numbness and tingling.
Although MRI is a very useful diagnostic tool, a normal MRI of the brain does not rule out the possibility of MS. About 5 percent of people who are confirmed to have MS do not initially have brain lesions evidenced by MRI.
Multiple sclerosis (MS).
When your optometrist detects optic nerve inflammation, that can indicate a diagnosis of MS. Patients with MS often also have double vision, blurred vision, or report pain when moving their eyes.
How long can MS go undiagnosed? MS is usually diagnosed between the ages of 20 and 50, but it can go undetected for years. In fact, a 2021 study suggested that many people with MS experience disease symptoms several years before being officially diagnosed with the disease.
Sarcoidosis is another inflammatory autoimmune disease that shares some symptoms with MS, including fatigue and decreased vision. But sarcoidosis most commonly affects the lungs, lymph nodes, and skin, causing a cough or wheezing, swollen lymph nodes, and lumps, sores, or areas of discoloration on the skin.
Over time, this leads to a decrease in brain volume, known as brain atrophy. Healthy adults have a small amount of brain atrophy due to natural ageing, but in many people with untreated MS, brain atrophy occurs at a much faster rate.
Blood tests: They can't diagnose MS, but the doctor will use them to look for substances in your blood that point to it.
My brain goes fuzzy, I can't think clearly, my speech slurs and my eyesight goes. Swallowing becomes more difficult, my balance gets worse and my legs feel heavy and clumsy. Unlike the limits of normal, everyday tiredness, which may give a little when pushed against, MS fatigue can feel like a barrier.
There is no single test that can be used to definitively diagnose a person with MS. Diagnosis involves both clinical evidence (something that a doctor observes during a neurological examination, or learns from a patient's history) and the results of certain tests, such as MRI, spinal tap, or evoked potentials.
MRI plays a vital role in how we diagnose and monitor MS. In fact, over 90% of people have their MS diagnosis confirmed by MRI.
Spinal tap (lumbar puncture), in which a small sample of cerebrospinal fluid is removed from your spinal canal for laboratory analysis. This sample can show abnormalities in antibodies that are associated with MS . A spinal tap can also help rule out infections and other conditions with symptoms like MS .
Widespread use of MRI (magnetic resonance imaging) has revolutionized the ability to diagnose multiple sclerosis. Disease-related changes in the brain or spinal cord are detected by MRI in more than 90% of people suspected of having MS.
MS can appear at any age but most commonly manifests between the ages of 20 and 40. It affects women two to three times as often as men. Almost one million people in the United States have MS, making it one of the most common causes of neurological disability among young adults in North America.
MS itself is rarely fatal, but complications may arise from severe MS, such as chest or bladder infections, or swallowing difficulties. The average life expectancy for people with MS is around 5 to 10 years lower than average, and this gap appears to be getting smaller all the time.
Neuromyelitis optica (NMO) is a rare chronic disease that happens when your immune system attacks specific parts of your central nervous system. Experts previously thought this was a rare type of multiple sclerosis (MS) but now recognize it's a separate condition.