Diagnosis of Multiple Sclerosis - MS

The diagnosis multiple sclerosis (MS) may be difficult to make because the symptoms can be subtle and vary widely from person to person. To make the diagnosis requires that there have been at least 2 attacks (see Symptoms of multiple sclerosis), and the discovery of at least 2 different areas of damage to the myelin (white matter) in the central nervous system (see Multiple Sclerosis).

Persons with the symptoms of multiple sclerosis must undergo a thorough neurological examination. If this, together with medical history, confirms the suspicion of multiple sclerosis, there are 3 further examinations, which, with almost full certainty, can confirm the diagnosis. They are:

• MRI scanning of the brain and spinal cord: In multiple sclerosis there will be white areas, so called Plague, indicating damage to the brain (see Multiple Sclerosis). When combining the scan with injected contrast it is possible to see if there are areas with current disease activity.
• Examination of the spinal cord fluid: A lumbar puncture is performed to draw spinal cord fluid for examination if there are anti bodies in the brain. The presence of antibodies further indicates sclerosis. However, there might be multiple sclerosis without the presence of anti bodies.
• Examination of visual pathways: The nerves that connect the eyes with the visual cortex traverse the brain from the retina to the back of the brain where the visual cortex is located. Due to the long distance these nerve fibers traverse through the brain they are very likely to be passing through areas of the brain that are affected by the disease. In multiple sclerosis is one often seen reduced speed in the transmission of nerve impulses from the eyes to the visual cortex

Outlook for Multiple Sclerosis

Someone having been diagnosed with multiple sclerosis is obviously interested in finding out how the disease will progress. However, it is unfortunately not yet possible to predict the outlook at the time the diagnosis is confirmed. Only after following the disease activity for a minimum of 5 years is it possible to say something further about the most likely progression of the disease. (see Symptoms of multiple sclerosis).

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