Diagnosing multiple sclerosis (MS) is not straightforward. No single test can quickly or clearly pinpoint MS. Instead, a series of tests and procedures are needed to identify the central nervous system disease. Only then can doctors rule out other possible causes and truly begin to treat MS and the symptoms it causes.
Learn how MS is discovered and the tests that are used to reach a diagnosis.
Multiple sclerosis is a chronic, debilitating disease that damages the central nervous system. MS attacks and destroys myelin, a protective coating that shields nerve fibers in the central nervous system. As myelin is destroyed, your brain, spinal cord, nerves, and other parts of the central nervous system suffer from the damage.
More than 2.3 million Americans have MS. The severity of the disease is different for each person. Thanks to recent treatments and advances in diagnosis procedures, patients with MS can lead better, more fulfilling lives.
Despite many advances, doctors still do not have a single test that can diagnose MS definitively. Instead, they must rely on several tests and procedures to first rule out other possible causes. Only then, can they declare a diagnosis. If your doctor suspects you have MS, he or she may use some or all of the following tests to help understand the symptoms you’re experiencing. These tests are outlined in the 2010 Revised McDonald Criteria, a plan that helps doctors diagnose MS more easily.
Magnetic resonance imaging (MRI) is a powerful tool for diagnosing MS. Currently, it is the most advanced form of imaging that can detect plaques on the brain. These plaques, or lesions, typically serve as a clear indicator of MS. However, according to the National Multiple Sclerosis Society, a small minority of MS patients don’t show these scars initially.
Because MRI is a non-invasive procedure, it is preferred over more invasive procedures like the Spinal Fluid Analysis. An MRI exam can also help doctors see how advanced the disease is and how it responds to treatment.
A visual evoked potential (VEP) test records your nervous system’s electrical response when it is stimulated. Before this test, a healthcare provider will connect you to sensors. The doctor will then give you visual, auditory, or sensory stimuli. The sensors record your nervous symptom’s response to the stimuli. Subsequent tests can tell doctors if myelin has been damaged. Longer response times typically indicate myelin damage. The delay in response may be so minor you can’t tell a difference, but the VEP test can detect such delays.
In order to analyze your spinal fluid, your doctor may conduct a spinal tap or lumbar puncture. This procedure removes a small amount of fluid from around your spine for analysis. The fluid is then tested for the presence of proteins that may suggest you have MS. In particular, doctors are looking for oligoclonal bands. According to the National Multiple Sclerosis Society, these bands are present in the spinal fluid of between 90 and 95 percent of people with MS.
Understanding a patient’s health history is very important to doctors. Your past affects your present health. To better understand what might be causing your symptoms, your doctor will want to conduct a thorough physical exam, as well as a verbal health history.
Important things to share with your doctor include:
- a family history of diseases or illnesses
- a personal history of disease or illness
- a personal history of illegal drug or alcohol abuse
- a personal history of mental or emotional problems
- any major life events that affect health
If your doctor believes you have MS, he or she might order a variety of blood tests. These blood tests can help rule out other possible causes for your symptoms. These blood tests can check for a multitude of diseases, illnesses, and conditions that might affect your immune system. Your results may show another explanation for symptoms you’ve been experiencing—or they may show nothing, which could point your doctor back towards a MS diagnosis.
Many conditions mimic MS, and no single test can diagnose it. To reach a diagnosis, your doctor will likely conduct several tests over a period of weeks and months. Reaching a diagnosis can be difficult. It will require patience and understanding, which may feel confusing and frustrating. It’s important to maintain an open dialogue with your doctor. Don’t be afraid to ask questions. This relationship will help you reach a diagnosis more quickly and may serve you well as you begin planning your treatment options.