Diagnosing Multiple Sclerosis: What are the tests & procedures used today ?Diagnosing multiple sclerosis can be a very difficult, long and scarry process. You are probably asking yourself why is that? I will tell you why. Simply put, multiple sclerosis (MS) can mimic the symptoms of more than 50 other illnesses or problems that occur with other diseases. Let me show you
When I had my first “problem” back in 1996, my doctor at the time diagnosed me with having an Ischemic attack. All the symptoms were there:
After the doctor saw the results of a CT scan of my brain the next day, he must have felt pretty confident about his original diagnosis since he came back with the Ischemic attack story. That wasn’t it, as I later found out. But that’s multiple sclerosis (MS) for you! It’s easily mistaken with a number of conditions including strokes and brain infarcts. This is why diagnosing multiple sclerosis is never easy. Many MS symptoms are hazy and quite hard to quantify. There are other symptoms like chronic fatigue syndrome, depression and cognitive problems that are frequently blame on to much stress by other doctors and patients may never be referred to a neurologist trained in diagnosing multiple sclerosis. You see now why diagnosing multiple sclerosis is so tough. Today, doctors in medical organizations have come up with diagnostic criteria to ease and standardize the process for diagnosing multiple sclerosis. Historically, the Schumacher criteria and the Poser criteria were most popular. Now days, the McDonald criteria focus on a demonstration, in a certain time frame, of the spreading of multiple sclerosis (MS) lesions by looking at:
Even if your symptoms meet the McDonald criteria, a definite diagnosis cannot be made until other possible conditions have been ruled out and there is evidence of more demyelinating taking place in other parts of the central nervous system (CNS).
THE BASIC GUIDELINE FOR DIAGNOSING MULTIPLE SCLEROSIS (MS) RELIES ON TWO CRITERIA:
The damage to the myelin must have occurred at more than one point in time and not have been caused by any other disease that can cause demyelination or similar neurologic symptoms. I clearly remember that after my first “attack” the neurologist told me that I could just wait and see what happens. If nothing happen in five years, I had nothing to worry about. Exactly one year after my first “attack” I had a second one which for the first time the doctors called a relapse. Stronger and more damaging than the first one. The most well known Diagnostic Tests and Procedures for diagnosing multiple sclerosis are:
MRI's use magnetic waves to produce images of the brain and spinal cord. A special contrast material (gadolinium) is usually injected for the scan when multiple sclerosis (MS) is suspected. The gadolinium reacts to areas of inflammation and lights up when a lesion is active, indicating demyelination taking place
The MRI does not hurt at all, but can be a strange and noisy experience. The MRI is considered the best test for diagnosing multiple sclerosis. In over 95% of the cases suspected with multiple sclerosis (MS), the multiple sclerosis lesions show up on MRIs. Around 5% of all the folks with multiple sclerosis do not have abnormalities that can be seen on an MRI. Also, some damage related more to aging than anything else, can easily look like multiple sclerosis (MS) lesions. The doctor will ask you questions about the symptoms that you are currently experiencing and any “unusual” sensation that you have experienced in the past. It is a good idea to write down any and all weird sensations, problems and things you experienced in the past. Take the list with you when seeing the doctor. Include any symptom that you have had in the past, no matter how long ago. Bring with you all other medical information, including any prescriptions you are currently on, any medical test results and any other doctor’s findings. The doctor will probably ask about any other health issues that you may have had in the past. All of this information will help a specialist like a neurologist piece together a better image to help determine whether multiple sclerosis (MS) is a possible diagnosis or not. This is that strange exam we all have seen doctors do. The “follow my finger” deal. Before multiple sclerosis (MS), I didn’t have an idea of what was it for, now I can tell you that the doctor is testing for: Functioning of the cranial nerves (these are the nerves that control the senses, as well as how you talk and swallow) He/She does this by having you do certain tasks - like touching your nose, then his finger in succession - touching you with various instruments and having you describe any sensation or looking for a response himself. These tests can last a few minutes or may be as long as a couple of hours depending on your doctor. There are 3 main types of evoked potential tests used in diagnosing MS. Each of these tests requires that electrodes are attached to your scalp and connected to an electroencephalograph (EEG) to record brainwaves in response to different stimuli. The tests are: The doctor is looking for both the size of the response and the speed in which the brain receives the signal. Weaker or slow signals may indicate that demyelination has occurred and that multiple sclerosis (MS) is a possibility. This test is also not specific to multiple sclerosis (MS) and abnormalities could indicate another problem. A series of all three tests could take up to two hours to complete. I took this test when I had my first attack but the results were inconclusive. Also called a spinal tap is done by inserting a needle between your vertebrae and extracting a little bit of cerebrospinal fluid (CSF) from the spinal column. There are certain antibodies, detected in oligoclonal bands, which doctors’ look for in cases of suspected multiple sclerosis (MS). This is not a 100% guarantee test for multiple sclerosis (MS) but oligoclonal bands can be found in 79%-90% of all MSers. My test result came back negative, which put me in the 10%-21% group of patients that have the illness without a positive spinal tap result. Once again, that is why diagnosing MS is no simple task. Although there is no blood test for diagnosing MS yet, scientists are working hard to develop one. Most of the blood work currently prescribed is used to rule out other illnesses like lupus, rheumatoid arthritis, scleroderma, Lyme disease and even HIV. Great progress towards developing better and more reliable diagnostic mechanisms has been done in the recent years. Now there is even talk of developing a test to check the propensity of a person to acquire MS later in life. These are incredibly fast changing times we’re living in right now. Here is a link to download a guide produced by the National MS Society that will help you choose the doctor that will treat your MS. Click here to find out what to look for in your Neurologist Go to top of the page Go back from Diagnosing Multiple Sclerosis to What is Multiple Sclerosis Go back from Diagnosing Multiple Sclerosis to ms-multiple-sclerosis- symptoms Home page Go to the MS'ers Place About Me | Privacy Policy | Disclaimer | Contact Me New! CommentsHave your say about what you just read! Leave me a comment in the box below. |
I do remember complaining about a strong headache after the procedure finished, so be prepared and take a couple of aspirins with you.