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Diagnosing MS
A careful
process of physical findings, diagnostic test results, symptoms, and
history makes the diagnosis of MS. There are certain criteria that
physicians utilize when diagnosing Multiple Sclerosis:
Two separate and identifiable exacerbations at least one month
apart. An exacerbation is a worsening of symptoms for at least a
48-hour period.
More than one area of damage to the Central Nervous System. This
damage is as a result of demyelination.
Diagnostic Tests
MRI (magnetic resonance imaging) is the preferred method of
imaging the brain to determine the presence of lesions and/or
scarring. An MRI better detects lesions/scarring than a CT
scan.
An MRI is a non-invasive diagnostic technique that
utilizes split magnets and rapid real-time imaging so that the
structure of the central nervous system is revealed. The patient
lies in an enclosed tube, and the duration of the test lasts from 15
to 30 minutes. It is also important to note that the test is
moderately noisy.
A Lumbar Puncture tests the cerebrospinal fluid for the presence
of oligoclonal bands (elevated protein levels) within the spinal
column. The presence oligoclonal bands indicate an immune response
within the Central Nervous System.
During this test, the
physician inserts a long needle into the base of the spine to obtain
spinal fluid. This test does involve some discomfort, and sometimes
patients have headaches for a few days afterwards.
An Evoked Potential Test is an electrical study that determines
if there is a slowing of messages in various parts of the brain.
Normally, the Evoked Potential Test includes a hearing and vision
portion.
During this test, wires are attached to the scalp,
neck and limbs.
This test records how quickly and completely
the nerve signals provoked by the stimulation reach the brain. In
MS, signal transmission slows down somewhat.
The use of
diagnostic testing is not "full proof", and there are times when
physicians will not base their determination solely on these tests.
It is important to mention that there are other illnesses/conditions
that mimic MS and need to be ruled out prior to a doctor confirming
his diagnosis.
During the diagnosis process, physicians will
schedule a battery of blood work to rule out other illnesses. There
is no blood test that can determine MS, however, it is necessary to
have this testing done in order to rule out other
conditions.
Finally, neurological examination and history
evaluations will be conducted. During this process, an extensive
review of your medical history and symptoms will be discussed. The
physician will perform a variety of testing that includes movement,
coordination, vision, balance, and other functions of the five
senses.
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MS Central Support
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