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Fearing a diagnosis of multiple sclerosis may prompt a visit to a physician, especially if the symptoms experienced have occurred more than once. The possibility of a patient learning that he suffers from a degenerating disease can add huge stress.

And that great deal of stress means it’s crucial to have a definitive answer regarding whether or not multiple sclerosis is the cause of the symptoms.

Doctors use a number of tools and criteria to determine if there is sufficient evidence of multiple sclerosis, including ways to rule out a great many other ailments that could present similar symptoms. Diagnosing multiple sclerosis is no small matter and takes time, and the more prepared a patient is, the easier it can be to get a resolute determination.

Why It’s important to diagnose multiple sclerosis 

Symptoms related to MS can be both frightening and uncomfortable, but some of them may mirror even more serious diseases, such as cancer. Getting a diagnosis in a timely fashion can both lead to relief and a change in lifestyle that will aid in adjusting to the symptoms and presence of the disease for proper management and reduced suffering.

It’s even more essential to follow procedures and get a clear result since two new factors about MS have become clear:

  1. There are almost twice as many people in the United States living with MS today as originally thought. In the last year, the projected number has more than doubled, from 400,000 to close to 1 million sufferers.
  2. It has been discovered that permanent neurological damage can take place even in the earliest stages of multiple sclerosis, making it essential to identify the disease as soon as possible to decrease degeneration.

How doctors diagnose multiple sclerosis

There are now some specific criteria doctors look for in order to diagnose MS. Prior to entering into testing, a physician will have a deep discussion with the worried patient about medical history and recent symptoms or events. Some of the information requested will include:

  • A history of any symptoms that could have occurred in the past or present that would have likely been caused by MS
  • Family history, including birthplace, exposure to certain environmental factors, other potential illnesses, or places the patient has traveled
  • Evaluation of mental, emotional, or speech functionality, as well as coordination and balance, strength and reflexes, vision, walking, and other sensory tests

Once this is done, the doctor will move on to other definitive tests that can be performed. The most common and qualifying are:

  • MRI – Magnetic Resonance Imaging is a noninvasive way to get a clear picture of what the nerves that could be affected look like. A doctor can see the inflammation, the damage to myelin and nerves, and other signs of multiple sclerosis.
  • Cerebrospinal Fluid – CSF resides in and around the brain as well as in the spinal cord. A spinal tap can be performed to get a sample of this fluid for analysis, showing if there is evidence of antibodies that have attacked the myelin coating the nerves.
  • Evoked Potentials Test – An EP test is used to measure the brain’s response to certain stimuli, which are applied to trace specific pathways. Slowed conduction of these electrical messages could be a sign of MS.
  • OCT – An optical coherence tomography allows for an image of the retinal structure to be studied non-invasively, which can help identify signs of optic neuritis, a condition common among people with MS. It’s also been discovered that the layer of retinal nerve fiber is different for those with MS, even if they haven’t had episodes of optic neuritis.

Criteria required to definitively diagnose multiple sclerosis 

Even when these tests have been run, a doctor has to meet certain guidelines with their findings before declaring the diagnosis to be multiple sclerosis. This is part of the reason for running multiple tests and digging deeply into other possibilities of diseases or conditions that could be causing the patient’s symptoms. In order for a diagnosis of MS, the physician has to:

  1. Assess the central nervous system (CNS), including the brain, the spinal cord, and the optic nerves, finding evidence in at least two places completely separate from each other that there is damage;
  2. Determine that the evidence found in multiple locations was incurred during at least two separate episodes or points in time (a single occurrence would be diagnosed as clinically isolated syndrome); and
  3. Rule out any other possible diagnosis that might lead to the same set of symptoms and damages as what has been found.

Because it’s such a grueling process, this is usually something not taken lightly and performed by a neurologist, or specialist of the nervous system. Beyond deciding if the diagnosis is multiple sclerosis, the doctor will also need to determine what type of MS is present, which is also best left to a specialist.

Types of multiple sclerosis

Typically, people are first diagnosed with relapsing-remitting multiple sclerosis, but this isn’t always the case. In addition, many people eventually advance to a more serious form of MS.

  • RRMS – Relapsing-remitting multiple sclerosis is defined by the fast that the individual sees symptoms for at least 24 hours before they fade away and stay away for at least thirty days but as much as several years, before they occur again. The relapse of symptoms isn’t worse than the original or previous onset, and the change to general health in between is unnoticed.
  • SPMS – Secondary progressive MS is usually the next stage of the disease. At some point, likely years down the road, someone with RRMS no longer sees symptoms in remission and, rather, sees them worsening over time. There are no more relapses because the symptoms never go away, and the damage steadily progresses.
  • PRMS – Progressive relapsing multiple sclerosis is highly uncommon but does occur in about one of every 25 patients. This is like a combination of RRMS and SPMS, with symptoms receding in a remission but, upon returning, they are worse than the prior relapse.
  • PPMS – Primary progressive MS is like SPMS, with no relapses and remissions. However, this is usually diagnosed in an older age group and was never preceded by RRMS, so there has never been any sign of remission capabilities. Instead, symptoms are constant and continually progress without letup.


While the prospect of a diagnosis may be frightening, it’s vital to overall health and stabilizing the progression of the disease to determine as soon as possible if multiple sclerosis is a possible cause of symptoms in patients. Doctors take time and care to assure that they have ruled out stroke, blood vessel diseases, and any other potential ailment that could mimic the symptoms to assure that patients are fully aware of their condition.

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