Diagnostic Tests

Multiple sclerosis can be difficult to diagnosis; there is no single test that can diagnose it. Instead, a diagnosis typically requires multiple tests to rule out other conditions with similar symptoms.

Medical History

A doctor will usually ask for a medical history of your symptoms. A description of their onset and pattern may be a diagnosis of MS. Physical examination and medical tests will be needed to support a suggestion of MS.

Neurological Examination

The nervous system can be systematically examined by testing reflex pathways (the knee jerk), and measuring sensation to stimulus (especially a pin prick). By carrying out a full neurological examination a doctor is able to establish any abnormalities in the nerve pathways. However, this examination cannot conclude what is causing the abnormality and so other possible causes of illness which produces similar symptoms to MS must also be eliminated.

Magnetic Resonance Imagery (MRI)

Magnetic Resonance Imagery (MRI) is a technique that produces detailed images of the inside of your body. These images produce a clear picture of your internal organs and soft tissues, from many different angles. Dozens of images may be produced during any one scan, depending on your doctor’s request.

Lumbar Puncture

Lumbar punctures are not carried out as often as they used to be. Nowadays, you’re likely to have one only if a diagnosis of MS has not been confirmed with the other tests. A lumbar puncture, also known as a spinal tap, is performed so the doctor can take a sample of the cerebrospinal fluid that surrounds the brain and spinal cord. People with MS are often seen to have antibodies (called oligoclonal bands) in this fluid, showing the immune system has been at work in the central nervous system.

Cerebro Spinal Fluid (CSF)

Cerebro Spinal Fluid examination requires you to have a lumbar puncture. There is a characteristic CSF abnormality in the proteins in 90 per cent of persons with MS. CSF examination means admission to hospital for a day or two and can cause a headache in about 20 per cent of patients which may last several days. Despite this problem it is a very useful and important test, which may be needed for diagnosis.

Myelogram

This is an x-ray examination of the spinal cord. An opaque dye is injected into the spinal column and its movement along the spinal cord can be seen on x-ray. Any obstructions along the nerves will show up on the x-ray and therefore will help to identify any other causes of the symptoms and support a possibility of MS. Like the lumbar puncture, a short hospital stay will probably be required but the test is more uncomfortable than painful.

VER (Visually Evoked Responses)

Visually Evoked Responses measure the time it takes for the brain to receive and interpret messages from the eyes. This test is carried out in the EEG Department and can tell whether there is any abnormality in the optic nerves. Electrodes are placed at specific points on your scalp. You are then asked to look at a changing check pattern on a TV screen. The electrical activity at the back of the brain is measured; it is not painful.