How multiple sclerosis is diagnosed: everything you need to know

Multiple Sclerosis is a progressive autoimmune condition that disrupts communication in the central nervous system and leads to nerve damage over time. Getting to a diagnosis of Multiple Sclerosis can be difficult, as there are no known causes or definitive risk factors. Typically, a doctor will run a variety of tests to detect Multiple Sclerosis, and to identify any other underlying disease that may be causing the symptoms. Here, we provide a brief overview of what to expect through the diagnosis process for Multiple Sclerosis.

Understanding Multiple Sclerosis

Multiple Sclerosis (MS) is a chronic inflammatory condition of the central nervous system. It is an autoimmune demyelinating disease, which means the immune system mistakenly attacks normal tissues — in this case, the myelin or protective covering around nerve fibers. This causes scarred tissues or lesions in multiple areas, disrupting electrical impulses throughout the body. When the myelin sheath is damaged, nerve impulses slow or even stop, causing neurological problems. Multiple Sclerosis has no cure, but early detection and treatment can slow the progression of the disease and maximize functionality for the patient.

Early signs of Multiple Sclerosis

An MS diagnosis is generally made between the ages of 20 and 40. The early signs and symptoms are often vague and unnoticeable. It is advisable to get a check-up if you experience two or more of the following symptoms:

1. Muscle weakness/spasms
2. Tingling or numbness in the limbs
3. Fatigue
4. Dizziness
5. Loss of balance
6. Blurry vision
7. Slurred speech
8. Eye pain that exacerbates with movement

Ways to diagnose Multiple Sclerosis

There is no distinct test that can confirm or rule out Multiple Sclerosis. If you have been demonstrating signs of Multiple Sclerosis, your doctor will conduct a full physical examination and then run blood tests to eliminate other conditions that could be causing the symptoms. If these blood tests are inconclusive, the doctor may refer you to a neurologist, who will call for some or all of the following tests:

MRI

Magnetic resonance imaging (MRI) employs magnetic fields and radio waves to present detailed images of the central nervous system. They identify irregularities by assessing the water content in the body’s tissues. Demyelination is one of the classic indicators of Multiple Sclerosis. Damaged myelin sheaths do not repel water as they should under normal conditions. An MRI can also detect other abnormalities that may not have been detected through the blood test.

Evoked Potential (EP) tests

EP tests evaluate the brain activity in response to sensory stimuli like sight or sound. The neurologist will place electrodes on the patient’s scalp and monitor the response to minute electrical signals. Most patients with early-stage Multiple Sclerosis demonstrate reduced transmission across the body’s neural pathways This can lead to ocular disorders such as blurry or double vision. Thus, an EP test helps make a conclusive diagnosis while also detecting other problems that may account for impaired vision.

Lumbar puncture

Also known as a spinal tap, lumbar puncture involves collecting a sample of the patient’s cerebrospinal fluid (CSF) for testing. Neurologists will test the sample for indicators of Multiple Sclerosis, such as an elevated WBC count, an elevated IgG antibody count, or the presence of proteins that are known as oligoclonal bands. These indicators can also be used to identify other diseases that may be the culprit.

In conclusion, diagnosing Multiple Sclerosis can be a time-consuming and mentally taxing process, especially when there is much at stake. Knowing what to expect can make things easier, as can reaching out to friends or a support group. It is important to commence the diagnosis process as soon as possible so that you can gain the benefit of early treatment.

A highly regarded neurologist and stem cell specialist, Dr Na’eem Sadiq studied neurology and clinical neurophysiology in London before working with some of England’s and the Middle East’s most prestigious medical institutions. He completed his MBBS