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Diagnosis of Multiple sclerosis

If MS is suspected, the doctor will ask you for a detailed medical history including your past record of signs and symptoms as well as the current status of your health.

 Diagnosis of MS is complex because there is no single laboratory test that can positively diagnose MS. Several other conditions look similar to MS. MRI (magnetic resonance imaging) now gives neurologists better understanding of MS and helps with diagnosis.

MSIF’s International Medical and Scientific Board have drawn up new MS diagnostic criteria to help medical professionals distinguish between MS and other conditions that may present similar symptoms.

Criteria for diagnosis:

  • Evidence of two separate episodes of MS symptoms, each lasting at least 24 hrs and separated by 30 days - but symptoms alone are not enough
  • Evidence of lesions on two separate occasions in different parts of the central nervous system - the guidelines describe what MRI techniques should be used, and the size and expected general location of lesions
  • Primary progressive MS is particularly difficult to diagnose. The criteria are: evidence of inflammation, evidence of new lesions in repeated MRI scans and continued progression of disability for one year.

Possible tests for MS. These tests provide different types of information- each has limitations

  • Most commonly you will be offered an MRI scan, in which the lesions of Multiple Sclerosis can be seen, however it cannot always be regarded as conclusive
  • Lumbar puncture- Evidence of inflammation from analysis of fluid from around your spinal cord (lumbar puncture) However, in people with early or mild MS this test may not always be conclusive. It is often used when MRI results have been inconclusive.
  • Testing of Visual, evoked potentials- This test measures the speed at which messages from the brain pass along the nerves in response to visual stimuli , measured by placing electrodes on the scalp. It helps to determine whether demyelination has occurred.

After assessment, you will be given one of the following diagnoses:

  • MS
  • Possible MS - if tests are not clear, for example symptoms and cerebrospinal fluid test suggest MS, but there are no lesions visible by MRI
  • Not MS