How is MS diagnosed?

As of yet, there are no specific tests that MS-diagnosis. A diagnosis is arrived at through a series of examinations. There are also no tests that will determine whether a person will develop MS in the future.

MS diagnosis

It is very important to rule out other ailments. Many diseases mimic the symptoms of MS.

MS-diagnosis will be dependent on two types of evidence:

  1. Clinical information - a careful medical history and a neurological exam

  2. Paraclinical information - Spinal Tap, MRI, Evoked Potentials, blood tests

Clinical Information

The physician will need your complete medical history for an MS-diagnosis. This will include questions about your past surgeries and illnesses, sensitivity to heat, family history of any neurological disorders (including MS), your symptoms, medications prescribed to you, and any substance abuse issues.

The neurological exam will evaluate your:

  1. Mental, emotional and language functions

  2. Movement, reflexes and coordination

  3. Vision and balance

  4. Areas of numbness

  5. Fitness of the five senses

Also taken into consideration is your sex, birthplace and your age when the symptoms first began.

Paraclinical Information

The long-established standards for MS-diagnosis are:

  1. Objective evidence of two separate attacks at least one month apart

    An attack or flare-up is the sudden worsening of an MS symptom that lasts at least 24 hours. The details of your neurological exam and the diagnostic tests (MRI, Spinal tap) will make the evidence 'objective.'

  2. Signs of the disease in different parts of your Central Nervous System

    There must be inflammation, scarring or damage in at least two different areas of the brain and/or spinal cord.

  3. Absolutely no other explanation for the symptoms you are experiencing

There are many neurological disorders, which is why so much of the MS-diagnosis is about ruling out all the other possibilities. Many of the symptoms experienced in MS are very similar to other illnesses.

Not all tests are required for all patients. The following diagnostic tests will show results that are not always evident in your neurological exams.

Spinal Tap

A sample of the fluid in your spine is taken. It is tested for certain levels of immune system proteins. The physician is also looking for particular 'bands' in the cerebrospinal fluid. These are called oligoclonal bands. These bands confirm an immune response within your Central Nervous System.

90 - 95% of people with MS have oligoclonal bands in their spinal fluid. The presence of these bands is not definite proof of MS. They also appear in other diseases.

MRI (Magnetic Resonance Imaging)

The MRI is the favored way of taking a detailed picture of the brain. This scan shows the scarring caused by MS. It can also reveal whether your scars are old, or new and active. This is very important in MS-diagnosis.

Many other diseases also cause these lesions or scars on the brain.

As well, a person with MS may only have scarring on the spinal cord, or the lesions may be very small. Neither can be seen in the brain scan. Consequently, the results of the MRI are not conclusive.

Evoked Potentials

In MS, the protective myelin in the brain is scarred and the messages passed along the nerves become slower. That is what the Evoked Potentials are testing - the speed of your messages. The Evoked Potentials evaluate your brain waves. They measure the time it takes your brain to receive and process the messages from your nerves.

These diagnostic tests can also confirm lesions that are not seen on the MRI. They can also identify 'unsuspected lesions' which are lesions that have not produced any symptoms.

Blood Tests

There is no definitive blood test for MS. The blood sample is mainly used to rule out other diseases.

However, there is new research about two kinds of antibodies found in the blood. If a person has both these antibodies present, they are 76 times more likely to develop MS than a person with neither antibody. This test could help patients receive early treatment to slow the progression of MS or reduce flare-ups.

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