Multiple Sclerosis - Diagnosis

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How was your multiple sclerosis diagnosed?

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How is multiple sclerosis diagnosed?

As in all conditions, the history of the patient is important. Many patients with multiple sclerosis have experienced various symptoms which were ignored or attributed to other events or illnesses. Even if no prior symptoms are recalled by a patient, the remaining medical history is needed to exclude other conditions which might mimic multiple sclerosis.

Once the history is obtained, a complete physical examination is required. Physicians look for signs of injury to the central nervous system (either the brain or spinal cord); findings on the examination can help a doctor determine which area of the central nervous system (CNS) is involved.

Imaging studies help to confirm a diagnosis of multiple sclerosis. The most common test done is a magnetic resonance image, or MRI. CT scans, while helpful in finding some brain injuries, are unable to reveal the changes associated with multiple sclerosis with as much detail as an MRI. MRIs can be used to image the brain and the spinal cord.

A spinal tap, or lumbar puncture, is done to collect a small amount of cerebrospinal fluid. Testing can be done on this fluid to confirm the presence of protein, inflammatory markers, and other substances. With the routine use of MRI, performing a spinal tap is not considered mandatory, unless there are questionable findings on the MRI or other questions to answer.

Evoked potential testing (visual evoked potentials, brainstem auditory evoked potentials, and somatosensory evoked potentials) can show slowed response times in the optic nerve, the auditory nerve, the spinal cord, or the brainstem. While helpful, these tests are not specific for changes seen in multiple sclerosis.

When multiple sclerosis is suspected, blood work and testing to exclude other conditions, such as Lyme disease, vasculitis, lupus, human immunodeficiency virus (HIV), and processes which lead to multiple strokes, are often done as well.

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See what others are saying

Comment from: melissawesley, 45-54 Female (Caregiver) Published: January 10

Her multiple sclerosis was diagnosed with an MRI spinal tap and an optic eye exam.

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Comment from: policy, 55-64 Female (Patient) Published: December 30

I was diagnosed with MS (multiple sclerosis) when I lost total sight in one eye from optic neuritis. I had an MRI which confirmed what I had suspected for years - I had MS. If you think you have it, seek another opinion if the doctor you see doesn't believe you. I went back to original doctor who still didn't think I had MS; until he saw the MRI. A small victory, since I was the one with MS and not the doctor. Get a second opinion, your instincts just might be right. It started out with numb hands, the doctor thought it was crimped spinal cord.

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