CLEVELAND CLINIC: CLICK TO READ MORE"Multiple sclerosis is not a disease that is easily diagnosed. Unfortunately, there is no one symptom that indicates MS, nor is there a single test that diagnoses MS. A diagnosis of MS is made after a complete review of the patient’s medical history, a neurological examination (including function of the brain and spinal cord) and diagnostic tests such as a MRI, spinal tap and/or evoked potentials.


Criteria for Diagnosing MS

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There is evidence of plaques (lesions) in at least two separate areas of the CNS;


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A course following one of two patterns: two or more episodes lasting at least 24 hours and occurring at least one month apart, or a progressive course of signs and symptoms over at least six months;


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There must be no other reasonable explanation of the plaque formation and symptoms.



Magnetic Resonance Imagining (MRI)
a test that produces very clear pictures, or images, of the human body without the use of x-rays.

Spinal Tap (lumbar puncture)
a test done to remove a sample of spinal fluid from the spinal column.

Evoked Potentials
a test that measures your brain’s response to certain types of stimulation, such as watching a pattern on a video screen, hearing a series of clicks, or receiving electrical impulses in your arm or leg.



How Is MS Diagnosed?
An accurate diagnosis is based on your medical history and neurological examination. A variety of specialized procedures are helpful in accurately diagnosing MS. These procedures may include a MRI (magnetic resonance imaging), spinal tap, evoked potentials, or other laboratory analysis of blood samples.

What does a MRI Show?
The images produced by a MRI gives neurologists clear evidence of scar tissue in the deep parts of the brain and/or spinal cord that is characteristic of MS. However, abnormal spots on the brain MRI can be caused by other conditions. To ensure the proper diagnosis of MS, it is important that a qualified neurologist interpret these images.

Will I need a Spinal Tap?
Performing a spinal tap (lumbar puncture) is done to examine the cerebrospinal fluid. Cerebrospinal fluid is tested for levels of certain immune system proteins and the presence of oligoclonal bands. For some individuals a spinal tap is done in order to rule out other medical conditions and support the diagnosis of MS.

What other tests might be done?
Evoked potentials are helpful in confirming whether MS has affected the visual, auditory, or sensory pathways. Evoked potentials are used to measure the electrical activity in certain areas of the brain and spinal cord. Electrical activity is produced by stimulation of specific sensory nerve pathways. These tests are used in combination with other diagnostic tools to assist in the diagnosis of multiple sclerosis (MS) and other disorders. Evoked potentials are used because they can indicate dysfunction along nerve pathways that is too subtle to show up during a neurologic examination or noticed by the person. The disruption may not even be visible on MRI. Evoked potentials test and record how quickly and completely the nerve signals reach the brain.

Your doctor may order blood tests to help rule out conditions that imitate multiple sclerosis, but the presence of MS cannot be detected in the blood.

The Future
The diagnosis of multiple sclerosis can be a lengthy process. Upon hearing the diagnosis, you may feel a mixture of emotions such as denial, relief, fear, and optimism.
When a person develops MS, he or she wants to know what will happen in the future. One of the greatest challenges of MS is the unpredictability and uncertainty of what is to come. A good plan for coping with what may come is to:

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Educate yourself about the disease and any possible changes;


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Work with your doctor and other health care professionals to manage your symptoms and general health;


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Communicate openly with your family and others;


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Stay healthy by eating properly, getting plenty of rest, exercise (when you can) and find healthy coping techniques to manage stress."