How is Multiple Sclerosis Diagnosed?


There are several ways that Multiple Sclerosis can be diagnosed. I told you about how I was diagnosed through a brain biopsy. That is probably one of the least common ways that the disease can be diagnosed. A patient will be given a neurological exam to see if they show reduced nerve function a given area. This exam will show if a patient has abnormal nerve reflexes as well the decreased ability to move certain body parts and decreased sensation in the area. Patients who are having difficulty with vision would be given an eye exam to determine if they have abnormal pupil responses and to see if they have decreases in their visual field.

“In order to make a diagnosis of MS, the physician must:
1 Find evidence of damage in at least two separate areas of the central nervous system (CNS), which includes the brain, spinal cord and optic nerves AND
2 Find evidence that the damage occurred at least one month apart AND
3 Rule out all other possible diagnoses”
(National MS Society)

MRI : “MRI is the best imaging technology for detecting the presence of MS plaques or scarring (also called lesions) in different parts of the CNS. It can also differentiate old lesions from those that are new or active.” (National MS Society) Although an MRI is an important tool for diagnosing MS it cannot be taken alone. In my case the initial MRI showed only one lesion on my brain and that was initially though to be a tumor. So, it was not until the doctor was able to rule out the tumor through the brain biopsy and the sample of tissue he took to have tested for demylination that he was able to diagnose me with MS. My initial MS doctor, Dr. David Dawson, had me coming in once a year to have an MRI to see how the disease was progressing. Over the next 3 or so years they found two other lesions.
MRI of the Brain

Visual Evoked Potential (VEP):Evoked potential (EP) tests are recordings of the nervous system's electrical response to the stimulation of specific sensory pathways (e.g., visual, auditory, general sensory). Because damage to myelin (demyelination) results in a slowing of response time, EPs can sometimes provide evidence of scarring along nerve pathways that does not show up during the neurologic exam. Visual evoked potentials are considered the most useful for confirming the MS diagnosis.” (National MS Society)

Cerebrospinal Fluid Analysis: “Analysis of the cerebrospinal fluid, which is sampled by a spinal tap, detects the levels of certain immune system proteins and the presence of oligoclonal bands. These bands, which indicate an immune response within the CNS, are found in the spinal fluid of about 90-95% of people with MS. But because they are present in other diseases as well, oligoclonal bands cannot be relied on as positive proof of MS.”(National MS Society)

Blood Tests: “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 Lyme disease, a group of diseases known as collagen-vascular diseases, certain rare hereditary disorders, and AIDS.” (National MS Society)