How is multiple sclerosis diagnosed? A range of tests can be used to diagnose MS, including an MRI to detect lesions in the central nervous system, a physical examination to check reflexes and responses, blood tests, lumbar punctures and other types of tests to measure nerve activity.
There are no specific tests for MS . Instead, a diagnosis of multiple sclerosis often relies on ruling out other conditions that might produce similar signs and symptoms, known as a differential diagnosis. Your doctor is likely to start with a thorough medical history and examination.
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.
MRI scan. An MRI scan is a painless scan that uses strong magnetic fields and radio waves to produce detailed images of the inside of the body. It can show whether there's any damage or scarring of the myelin sheath (the layer surrounding your nerves) in your brain and spinal cord.
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.
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.
The first step in diagnosing MS is taking a thorough medical history. Your doctor will ask you about your symptoms, including when they began and whether you've noticed any patterns or triggers. They may also ask you about: injuries, diseases, or other health conditions with which you've been diagnosed.
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.
Those symptoms include loss of vision in an eye, loss of power in an arm or leg or a rising sense of numbness in the legs. Other common symptoms associated with MS include spasms, fatigue, depression, incontinence issues, sexual dysfunction, and walking difficulties.
Diagnosis and early intervention
As optic neuritis is the presenting sign of MS in up to 30 percent of patients, the eye exam can lead to the initial systemic diagnosis.
Here's where MS (typically) starts
Optic neuritis, or inflammation of the optic nerve, is usually the most common, Shoemaker says. 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.
Magnetic resonance imaging, or MRI, is a wonderful tool to help diagnose and follow people with MS. MRI is safe and relatively non-invasive yet can provide very detailed images of the brain and spinal cord that can reveal MS lesions (also known as demyelination, spots, or plaques) and changes in MS activity over time.
MS can be among the most difficult of all diseases to diagnose because of the bewildering number of symptoms it causes and the multiple ways in which they can present.
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.
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.
Vision problems are an early sign of MS. Gait and mobility changes: MS can change the way people walk due to muscle weakness and problems with balance, dizziness, and fatigue. Emotional changes and depression: Demyelination and nerve fiber damage in the brain can trigger emotional changes.
Hypoxic-ischemic vasculopathy, specially small-vessel disease, inflammatory disorders, vasculitis, and non-MS idiopathic inflammatory disorders, as well as some toxic, metabolic, and infectious disorders, may present mimicking MS on MR examinations and should be included in the differential diagnosis of MS-like lesions ...
Common CSF findings in people with MS include a high level of oligoclonal bands. Oligoclonal bands indicate an increase in autoimmune activity.
The magnetic resonance imaging (MRI) may show areas of abnormality that suggest MS, though the MRI in and of itself does not make the diagnosis. Spinal fluid testing may show that the immune system is active in and around the brain and spinal cord, supporting the diagnosis. Evoked potentials may assist in diagnosis.
If you are worried that you have symptoms of MS, it is important to consult a health professional so that you can get the correct diagnosis. There is no definitive test for MS and diagnosis will involve considering the various symptoms and ruling out other explanations. This process can take some time.
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.
Magnetic resonance imaging (MRI) of the brain and spinal cord is a good method of diagnosing and monitoring MS.
Lesions may be observed anywhere in the CNS white matter, including the supratentorium, infratentorium, and spinal cord; however, more typical locations for MS lesions include the periventricular white matter, brainstem, cerebellum, and spinal cord.