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.
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?
Answer: You can certainly have a normal neurological exam and still have multiple sclerosis.
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).
Magnetic resonance imaging (MRI)
MRI scans confirm a diagnosis in over 90 per cent of people with MS. To get the image of your brain and spinal cord you'll be asked to lie down and enter a small tunnel in the centre of the MRI scanner.
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.
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.
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.
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.
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.
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.
Characteristics of the MS gait pattern
You may walk more slowly, with shorter steps. You may lack in confidence when you walk – leading to hesitation and stumbling. You might feel unsteady when turning or walking. You might find placing your foot on the ground difficult.
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.
Here's where MS (typically) starts
Although a number of MS symptoms can appear early on, two stand out as occurring more often than others: Optic neuritis, or inflammation of the optic nerve, is usually the most common, Shoemaker says. You may experience eye pain, blurred vision and headache.
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.
There is a new blood test that may monitor multiple sclerosis disease activity better in clinically stable patients. The test is called sNfL (serum neurofilament). It measures the breakdown of a certain part of neurons, which occurs when multiple sclerosis is attacking the nervous system.
MRI is considered the best test to help diagnose MS. However, 5% of people with MS do not have abnormalities detected on MRI; thus, a "negative" scan does not completely rule out MS. In addition, some common changes of aging may look like MS on a MRI.
The symptoms can be similar, but people with fibromyalgia are more likely to experience depression, irritable bowel syndrome, and widespread, persistent pain. Symptoms more common with MS include weakness, vision problems, muscle spasms, and bowel or bladder issues.
Devic's disease, also known as neuromyelitis optica (NMO) spectrum disorder, is a rare neuro-immune disorder that affects your eyes and your spinal cord. It may also attack the brain.
There are three different types of muscle spasms in MS: Flexor spasm — The limb bends up toward the body. Extensor spasm — The limb shoots out, away from the body. Adductor spasm, commonly in the legs and thighs — The limbs come in toward each other.