How Is Multiple Sclerosis Diagnosed?
Multiple sclerosis (MS) is a disease of the central nervous system, including the brain and spinal cord. It occurs when your immune system attacks the protective myelin sheath around your nerves. Because MS affects the entire nervous system, symptoms can be unpredictable and varied. Although most cases of MS are mild, you may experience loss of vision, movement, memory, and more.12
This disorder usually occurs in people aged 20-40. 1
The most common type of MS is relapsing-remitting MS (RRMS): Your symptoms get worse during relapsing periods, followed by periods of recovery when your symptoms are reduced or gone.3
There is no single test to diagnose MS. But your health care provider, such as your primary care provider or a neurologist (who specializes in neurological disorders), can diagnose MS from your symptoms. They'll ask about your medical history and test your brain-related functions, such as motor skills and eyesight. Brain imaging, blood tests, and other procedures are then used to confirm the diagnosis.3
How long your diagnosis will take depends on the number of tests you need.4 Here's what you can expect during the process.
Health record
Discussing symptoms and medical history with a healthcare provider is the first step in diagnosing MS.3 Common symptoms include:53
Diplopia (double vision), eye pain, blurred vision, swelling of the optic nerve (which connects your brain to your eyes)
Loss of balance or vertigo when walking (a feeling that you and your surroundings are spinning)
Weakness, tremors, fatigue
Numbness, a "pins and needles" sensation, or abnormal burning or stinging of the skin
Constipation, diarrhea, urinary incontinence
Memory problems or trouble concentrating
Depression or anxiety
Difficulty speaking and swallowing
You don't have to have all the symptoms at once to have MS. If you are in remission, you may not have any symptoms at all. 5
Although the cause of MS is unknown, experts suspect that the disease is caused by genetic risk, environmental factors, and factors in the immune system.5 When discussing your medical history, your doctor may consider your family history, living environment, and other health conditions. status and places you have traveled.4 It is important to share your personal stories as much as possible.
Physical and neurological examination
After taking a medical history, your healthcare provider will perform a neurological exam to check how well your brain and spinal cord are working. They can use different tools to check:567
Vision: This may involve using a flashlight or other eye device to check for uncontrolled movements, double vision, or eye pain.
Hearing: This can use a hearing aid to check for hearing loss.
Muscles and nerves: Your provider may use a reflex hammer to test your muscle response and body coordination. They may check your ability to swallow or if you have signs of tremors, weakness, muscle spasms, or overactive reflexes.
Kidneys and urinary tract: Laboratory tests based on blood and urine samples can check kidney function. Your provider may use an ultrasound or a catheter (a thin tube inserted into the urethra) to determine if you have urinary retention (remaining urine in the bladder after you urinate).
Genitalia: If you have genitalia, your provider may instruct you to perform a nighttime penile exam that can determine if you have erectile dysfunction.
Mental health: Your provider can ask about your mood and behavior to determine if you have depression or anxiety.
Types of MS
Your health care provider can determine which type of MS you have based on how often you have symptoms. There are four main types:
Clinically isolated syndrome (CIS): This is the first attack of MS and occurs when you have no previous symptoms of MS and no fever or infection. Symptoms may appear suddenly and burn for at least 24 hours and may last for days or weeks.8
Relapsing-remitting MS (RRMS): This is the most common type of MS. During a relapse, your symptoms may worsen within 24 to 48 hours and last for days to weeks. You can usually recover from symptoms with or without medication after a few weeks or months. After that, you go into remission, or mildly symptom-free.5
Secondary-progressive MS (SPMS): This type occurs 1 to 20 years after the initial onset of MS, with relapsing-remitting MS cases after worsening. You may experience more frequent or different types of symptoms than relapses at the same time.85
Elementary stage
