Diagnosing Multiple Sclerosis
Everyone’s experience with Multiple Sclerosis (MS) diagnosis is different. A sudden, severe attack that demands medical attention may prompt a diagnosis of MS. However, neurologists sometimes find it challenging to diagnose MS properly, and it may take time to reach a definite diagnosis.
Most MS symptoms are also common in other health conditions, prompting your doctor to perform multiple tests to rule out other possibilities. Afterwards, you’ll need additional tests to determine if you have MS.
Diagnosis can sometimes be a matter of waiting and monitoring how the symptoms develop to distinguish MS from other health conditions. Diagnosing MS can be very frustrating and worrying even to professional neurologists, but it is also a common experience.
How is MS Diagnosed?
To date, no single laboratory test or individual symptom is used to make an MS diagnosis. Instead, physicians and neurologists must rely on several medical strategies to determine if the condition meets enough criteria to confidently make a diagnosis while ruling out other possible causes of the patient’s symptoms.
To make a proper diagnosis, neurologists must:
- Find evidence of damaged cells or nerves in at least two separate areas of the patient’s central nervous system, including the brain, optic nerves, and spinal cord
- Find evidence of damage resulting at least one month apart
- Rule out other possible diagnoses
The steps below should provide more insight into how to analyze and speed up MS diagnosis.
Tests to Diagnose Multiple Sclerosis (MS)
In addition to checking your medical history and performing neurological examinations, you may undergo multiple specialized procedures (although not always necessary) to diagnose MS accurately. Our medical team at Brooks Rehabilitation asks the right questions to uncover critical information that helps us properly evaluate the signs and symptoms of malfunctioning nervous systems.
Magnetic Resonance Imaging (MRI)
The MRI is a very accurate process for diagnosing MS that can pinpoint the exact location and size of the damage, scarring, or inflammation of the myelin sheath in the brain and spinal cord. Finding these health issues can help physicians confirm a diagnosis in patients with MS.
However, senior adults or patients with diabetes and high blood pressure can have similar kinds of spots on a brain MRI scan. Your medical provider will therefore consider other information (including your symptoms) and compare them with the scan before making a diagnosis.
Consequently, a “normal” MRI result does not necessarily rule out MS. You may be one of the few patients with lesions in places the MRI scan cannot show.
Ensure you remove all jewelry before going for an MRI scan. You will be asked to lie inside the MRI machine for the duration of the procedure. We also recommend letting your doctor know ahead of time if you have:
- A metallic implant
- Tattoos
- A pacemaker
- A history of diabetes
- Implanted drug infusions
- Artificial heart valves
- Any other conditions that may be relevant
The process can take between 45 minutes to 1 hour and offers detailed, sensitive images of the patient’s brain and spinal cord. It is also much less invasive than CT scans and X-rays, which both use radiation.
Neurological Examination
Your neurologist will ask you several questions about your medical history and current health problems and symptoms. These details will help the neurologist to get a better picture of you as a patient and identify other problems that may explain certain symptoms.
You will also receive a physical examination to check for any changes or weaknesses in eye movements, hand or leg coordination, speech, balance, reflexes, or sensation. While the neurologist may strongly suspect MS if all the diagnostic criteria are met, they may not give a definitive diagnosis until other test results confirm the condition.
Evoked Potential Tests
Neurologists use this painless test to measure the time it takes for the patient’s brain to receive messages from the eyes, ears, and skin. Evoked potential (EP) tests effectively check the patient’s nerve function if they have unusual symptoms.
The EP test uses electrodes to measure electrical activity in different areas of the brain triggered by touch, light, or sound. The most common test requires viewing light patterns while brainwaves are monitored using sticky patches, called electrodes, attached to the patient’s head.
The test measures messages to and from the patient’s brain, which will be slower if the disease has damaged the myelin sheath around critical nerves. The EP test does not require any preparation. The patient taking the test may listen to clicking sounds, look at patterns on a screen, or get electrical pulses to the body. The test requires active concentration but is safe and noninvasive.
Lumbar Puncture
The lumbar puncture, also known as a spinal tap, removes a sample of the patient’s spinal fluid by inserting a needle into their lower back. Patients with MS often have proteins (antibodies) in the spinal fluid. This means their immune system is active in their brain and spinal cord. Patients who don’t have MS normally don’t have these antibodies.
The lumbar puncture procedure is done under a local anesthetic, meaning you can be awake, but the area the needle goes into will be numb. The sample collected will then be tested for antibodies and immune cells (a sign your immune system is fighting a disease in the brain or spinal cord). The procedure is very safe but can sometimes be uncomfortable and cause headaches that occasionally last a few weeks.
The lumbar puncture helps provide extra information if the initial MS tests or symptoms are unusual.
Blood Tests
While there’s currently no definitive blood test for MS, this diagnostic procedure can help rule out other health conditions with symptoms similar to those of MS. But the patient must undergo extensive blood work to rule out other conditions that mimic MS.
Diseases that may resemble MS and be ruled out through specific blood tests and thorough history examination include:
- Lyme disease
- Lupus
- Antiphospholipid syndrome
- Sarcoidosis
- HIV
- B12 or copper deficiency
To correctly diagnose MS, your physician must rule out other possible diagnoses. For this reason, blood testing is critical in guaranteeing the proper diagnosis of multiple sclerosis.
Rehabilitation for Multiple Sclerosis
Brooks Rehabilitation’s holistic and innovative technology aids in improving patient health through their recovery journey. But we know tech alone is not enough, as patients with multiple sclerosis require emotional support and personal connection with their loved ones and caregivers.
That’s why our multiple sclerosis services include a peer-mentoring program to help patients with rehabilitation as they transition back into daily living. We are also leaders in Mobile Therapy and Neurorehabilitation.
Brooks Rehabilitation aims to provide high-quality treatment to all patients, facilitate ongoing growth, and improve their rehabilitation processes. We will be there with you every step of the way. Get in touch to learn more about the services we provide.