How is Multiple Sclerosis diagnosed?
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The physician, usually a neurologist, requires two signs to confirm Multiple Sclerosis:
1) Signs of disease in more than one area of the CNS
2) Signs of at least two attacks at least one month apart
There is no one test that is specific for Multiple Sclerosis. The diagnosis is clinical, based on the following helpful tests and procedures:
| The Diagnostic Process
Complete medical history
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For an overall health picture, the physician will ask you your current and previous symptoms and when they began, previous illness, medication use, family history of neurological disease, and may explore your social situation.
| Nervous system examinationThe physician will test your eye movements and vision, face movements, limb coordination and strength, balance, weakness, sensation, speech and reflexes.
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Confirmatory Diagnostic Tests
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Magnetic resonance imaging (MRI)
| The MRI scan provides detailed structural pictures of the brain and spinal cord. An MRI will show abnormalities in the brain and spinal cord, particularly in areas rich in myelin in about 80% of new cases of Multiple Sclerosis. Abnormalities on MRI are not specific for Multiple Sclerosis as they may occur in several other processes. Therefore the MRI is a useful tool only if used in conjunction with all the other diagnostic information.
|  | MRI in Multiple Sclerosis frequently shows abnormalities in the brain matter (red arrow). Plaques may also be seen in the optic nerve and spinal cord (not shown).
| Evoked potentialsEvoked potential tests measure how quickly and accurately the nervous system carries impulses to the brain in response to stimulation. If there is demyelination, there will be a delay and weakening of nerve conduction.
Lumbar punctureCerebrospinal fluid (which flows around the brain and spinal cord) is tested for the presence of antibodies signaling the presence of Multiple Sclerosis.
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