Diagnosis of Multiple Sclerosis
The problem with diagnosing multiple sclerosis is that there is no straightforward test that will conclusively prove that a person has it.
There are many Multiple Sclerosis symptoms that can be caused by other conditions such as Lyme disease (an infectious tick-borne illness) or autoimmune conditions like Lupus. These need to be ruled out first, which can make diagnosis very laborious. It's important that every possible test is carried out so that patients are not misdiagnosed with the disease or diagnosed with another condition when the underlying cause pf their symptoms maybe MS.
Early MS can present a wide variety of seemingly unconnected symptoms which have all too frequently been dismissed "as all in the mind" by some unsympathetic medics.
Nowadays thanks to new criteria in diagnosing MS patients and the advent of new technology such as magnetic resonance scanning (MRI) misdiagnosis is less common than it used to be.
International Panel on the Diagnosis of Multiple Sclerosis
Before patients are diagnosed they must conform to the following agreed criteria laid down by the International Panel on the Diagnosis of Multiple Sclerosis:
- There is objective evidence of two attacks of the disease, each lasting 24 hours
- The attacks must be at least one month apart
- There is no other explanation for the symptoms
Sadly though for around 15% of people presenting MS symptoms a definite diagnosis is still not possible even after every available test has been carried out. But over time studying a person's symptoms and changes in their condition, an accurate is diagnosis is possible in the majority of cases.
Neurological tests: a neurologist will take a complete medical history including all the past and present symptoms and current health to help build up a picture and possibly identify any other problem which may be causing the symptoms.
Physical examination: involving tests of mobility, sensation and reflexes to identify any weaknesses or abnormalities.
MRI scanning: although this is the only test where scarring can be found on the brain and spinal cord, doctors don't regard it as conclusive. It does however show up the size and number of scarred areas and with supporting evidence from a person's medical history and other tests it can be a good indicator of the disease.
In 95% of people who go on to be diagnosed the MRI has shown up abnormalities. The other 5% may have been diagnosed through other tests when the MRI scan failed to identify any scarred tissue. However, the longer the MRI scans remain clear the more questionable the original diagnosis becomes and every effort should be made to find another cause of the symptoms. More on MRI Scans.
Evoked potential testing: These non invasive, painless, tests measure the time it takes a person's brain to receive messages. Small electrodes are placed on the head and will monitor the brainwaves reaction to what is seen or heard. If the messages are slower than expected this could show that some of the nerves have been damaged.
Lumbar puncture: A needle is inserted into the lower back into the space around the spinal cord. A small sample of cerebral spinal fluid - the fluid which flows round the brain and spinal cord - is taken and tested for abnormalities which mat indicate MS. In 90% of MS patients the proteins in the fluid form a specific pattern when an electrical current is passed through them.