Diagnosing MS
Often neurologists can make a diagnosis of multiple sclerosis (MS) based on symptoms and a physical examination. However, if the neurologist is unsure about the diagnosis, further tests should be carried out. The most common tests are:
Magnetic resonance imaging (MRI) scan of the brain and spine, this technique uses strong magnetic fields to produce an image which can reveal damage to the white matter of the brain, characteristic of MS. Demyelination can be detected even when the damage is not sufficient to cause symptoms.
In this image of an MRI scan of the brain, round-to-oval shaped MS lesions can be seen (circled in red) around the lighter butterfly shape.
Evoked potential tests, these measure the speed with which messages are transmitted from specific parts of the body to the brain. If the myelin sheaths that surround nerve fibres in the central nervous system have been damaged by MS, transmission of the electrical signals is slowed down.
Test of cerebrospinal fluid (CSF), this is used to determine whether antibodies are present in the CSF, the fluid which surrounds the brain and spinal cord. Antibodies are present in the CSF of 85–95% of patients with MS (although they can be detected in patients with other diseases). A needle is inserted into the lower back (lumbar puncture) under local anaesthetic to collect a sample of CSF to test for antibodies.
Stages in diagnosis
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