Multiple Sclerosis Tests & Diagnosis

Conditions & Diseases: Brain & Nervous System

Multiple Sclerosis

Medical Tests & Diagnosis Methods

Diagnosis of MS is very difficult since no single test can confirm the disease. However, diagnosis involves the following steps:

Evidence from patient history
Clinical examination
Laboratory tests

A physician generally requires all the above tests to rule out other possible causes for symptoms and to pool in the facts consistent with diagnosis of MS (6).

A diagnosis is carried out by carefully noting the medical history, symptoms, signs and rules out other ailments before assessment is finally done. Diagnosis depends heavily on the accuracy of the patient’s medical history and physician’s skill in eliciting and evaluating the information. The physician takes note of various aspects such as past surgeries, illnesses, allergies, hereditary neurological disorders including MS, place of residence (geographic location), adverse affect of heat, medications taken in the past and history of substance abuse such as alcohol, drugs or tobacco.

The physician checks for exaggerated reflexes such as Babinski’s reflex, upward movement of big toe when sole of the foot is stimulated and eye examination reveals determines optic nerve damage.

Most physicians also carry out the following tests to diagnose and confirm the disease:

Magnetic Resonance Imaging (MRI): An MRI helps in detecting possible plaques or scarring caused due to MS by using magnetic and radio waves. Presently, an MRI scan is considered as the most sensitive, non-invasive imaging tool. The absence of radiation in an MRI is an asset when compared to Computerized Tomography (CT), but the powerful magnetic field in MRI can be hindered in patients who have cardiac pacemakers and metal implants such as aneurysm clips in their bodies. Dental fillings are not an obstruction.

Oligoclonal Bands: Cerebrospinal fluid sampled through a lumbar puncture (spinal tap) is tested for the presence of staining pattern of antibodies called Oligoclonal bands and certain immune system proteins. Oligoclonal bands are noticed in the spinal fluid sample collected from 90-95% people suffering from MS. It is important to note that Oligoclonal bands can be detected in the spinal fluid of other diseases. Therefore, the presence of these bands cannot be deemed as a positive proof for MS.

Evoked Potential (EP) Tests: Evoked potential tests are electrical diagnostic studies that show the slowing of messages in various parts of the brain. They provide evidence of scarring along nerve pathways. The most accepted EP test for aiding the diagnosis of MS is Visual Evoked Potential (VEP) test, in which a person is asked to look at a screen consisting of an alternating checkerboard pattern and a neurologist or neurophysiologist interprets the results (6).

Brainstem Auditory Evoked Potentials (BAEP): This test is used to detect abnormalities related to demyelinating lesions in the brainstem which causes a delay in the transmission of sounds.

Somato-Sensory Evoked Potentials (SSEP): In this test, SSEP delivers electrical stimulus to the wrist or ankle and permits detection of disruptions in the pathways from arms and legs to the brain at some specific points in the Central Nervous System (CNS) (8).

Article by Kona Vishnu, MS
Medical Writer,
OmniMedicalSearch.com