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.
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.
MS can be present even with a normal MRI and spinal fluid test although it's uncommon to have a completely normal MRI. Sometimes the MRI of the brain may be normal, but the MRI of the spinal cord may be abnormal and consistent with MS, so this also needs to be considered.
An MRI looks for evidence of lesions (areas of damage) in the brain or spinal cord that indicate multiple sclerosis. Lesions develop as a result of damage to the myelin sheath surrounding the nerves. A spinal tap (lumbar puncture) may also need to be done.
MS activity appears on an MRI scan as either bright or dark spots. Typical MS lesions tend to be oval or frame shaped. MS lesions can appear in both the brain's white and gray matter. Healthcare professionals may use a chemical contrast dye called gadolinium to improve the brightness of MRI scan images.
While it is true that almost all people with MS will have evidence of brain lesions on MRI, not all people with brain lesions have MS. Therefore, an MRI report lists many possibilities that could explain the MRI's particular appearance.
Blood Tests: Currently, there are no definitive blood tests for diagnosing MS, but they can be used to rule out other conditions that may mimic MS symptoms, including Lyme disease, collagen-vascular diseases, rare hereditary disorders and acquired immune deficiency syndrome (AIDS).
People should consider the diagnosis of MS if they have one or more of these symptoms: vision loss in one or both eyes. acute paralysis in the legs or along one side of the body. acute numbness and tingling in a limb.
Sjogren's syndrome is an autoimmune disease that can mimic some of the symptoms of MS such as fatigue and joint pain.
In primary progressive MS, symptoms would be expected to have a gradual and insidious onset over at least 12 months by the time of diagnosis. A common first presentation of RRMS is with unilateral optic neuritis characterised by gradual onset monocular visual loss, pain on moving the eye and altered colour vision.
What Does MS Feels Like? A lack of feeling or a pins-and-needles sensation can be the first sign of nerve damage from MS. It usually happens in your face, arms, or legs, and on one side of your body. It tends to go away on its own.
Magnetic resonance imaging (MRI)
It's very accurate and can pinpoint the exact location and size of any inflammation, damage or scarring (lesions). MRI scans confirm a diagnosis in over 90 per cent of people with MS.
MRI has greater than 90% sensitivity in the diagnosis of MS; however, other white matter diseases can sometimes have a similar appearance on medical imaging.
Migraine is commonly confused with MS, as are other medical conditions such as cerebral small vessel disease, systemic lupus erythematosus, or autoimmune conditions like neuromyelitis optica or myelin oligodendrocyte glycoprotein antibody-associated disease.
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. You might also need to have blood tests, a lumbar puncture and tests to measure nerve activity.
While there is no definitive blood test for MS, blood tests can rule out other conditions that cause symptoms similar to those of MS, including lupus erythematosis, Sjogren's, vitamin and mineral deficiencies, some infections, and rare hereditary diseases.
MS lesions developed preferentially in the supratentorial brain, particularly the frontal lobe and the sublobar region.
A common visual symptom of MS is optic neuritis — inflammation of the optic (vision) nerve. Optic neuritis usually occurs in one eye and may cause aching pain with eye movement, blurred vision, dim vision or loss of color vision. For example, the color red may appear washed out or gray.
In 5 percent of the people showing clinical MS disease activity, lesions were not visible on the MRI. However, if follow-up MRI studies continue to show no lesions, the MS diagnosis should be reconsidered.