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.
MS is best detected by a neurological examination and painless imaging studies of the brain and spinal cord using magnetic resonance testing (MRI). An ophthalmologist also can use a test called an optical coherence tomography (OCT) to determine if the optic nerve has been affected by MS.
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.
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.
Numbness of the face, body, or extremities (arms and legs) is often the first symptom experienced by those eventually diagnosed as having MS.
When this happens, your brain can't send electrical messages to your body as well as it should. That changes the way your body moves and operates. Most people start to get MS symptoms between 20 and 40 years old. But sometimes, you won't have any MS symptoms until you're 50 or older.
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.
MRI scans are an important way to help health care providers figure out if a person has MS or not, but MRI scans cannot diagnose MS by themselves. While it is true that almost all people with MS will have lesions on MRI, not all people with MRI lesions have MS.
There are also multiple infectious entities that mimic MS including; progressive multi-focal leukoencephalopathy (PML), Toxoplasmosis, Tuberculosis, Herpes Simplex Virus, Cytomegalovirus, Varicella zoster virus, Epstein Barr virus, Cryptococcus and Human immunodeficiency virus.
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.
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.
These include imaging techniques such as magnetic resonance imaging (MRI), spinal taps (examination of the cerebrospinal fluid that runs through the spinal column), evoked potentials (electrical tests to determine if MS affects nerve pathways), and laboratory analysis of blood samples.
There is no definite measure or laboratory marker for the diagnosis of MS, yet. Both the clinical features of the disease, and laboratory investigations such as magnetic resonance imaging (MRI), and cerebrospinal fluid (CSF) analyses are being used.
Floaters are a common ocular symptom for individuals with multiple sclerosis, but MS isn't a leading cause. On their own, floaters don't usually indicate serious conditions. Eye conditions like optic neuritis can be an early warning sign of oncoming multiple sclerosis.
Multiple sclerosis (MS).
This demyelinating disease can lead to severe dry eye. In MS, poor corneal sensory impulse conduction can result in insufficient tear production, and lagophthalmos-associated DED can occur due to poor motor control.
Causes of multiple sclerosis
your genes – MS isn't directly inherited, but people who are related to someone with the condition are more likely to develop it; the chance of a sibling or child of someone with MS also developing it is estimated to be around 2 to 3 in 100.
In people with MS, the immune system attacks cells in the myelin, the protective sheath that surrounds nerves in the brain and spinal cord. Damage to the myelin sheath interrupts nerve signals from your brain to other parts of your body. The damage can lead to symptoms affecting your brain, spinal cord and eyes.
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.
Most symptoms develop abruptly, within hours or days. These attacks or relapses of MS typically reach their peak within a few days at most and then resolve slowly over the next several days or weeks so that a typical relapse will be symptomatic for about eight weeks from onset to recovery. Resolution is often complete.
Neuropathic pain happens from “short circuiting” of the nerves that carry signals from the brain to the body because of damage from MS. These pain sensations feel like burning, stabbing, sharp and squeezing sensations. In MS you can experience acute neuropathic pain and chronic neuropathic pain.
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.
Multiple sclerosis is often difficult to diagnose because there is no single test or finding on an exam that makes the diagnosis and because the disorder varies from person to person. In most cases, there is a history of neurological symptoms that come and go over years.
A computed tomography (CT) scan is not used to diagnose MS; although it can be helpful in ruling out alternative diagnoses. Overall, MRIs are significantly more sensitive in detecting abnormalities within the brain and spinal cord tissue.