Multiple Sclerosis (MS) is a disease affecting the nerves of the brain and spinal cord. Damage to the covering of the nerve endings (myelin) occurs. The loss or disappearance of this white insulating material is called demyelination. Electrical impulses can no longer travel at a normal rate along the nerves, which can cause damage to the nerves themselves. The patient then experiences disruptions to certain functions controlled by the central nervous system. Memory, vision, speech, writing, walking and other bodily functions may be affected.
Diagnosing MS is not an easy task because there are more than 50 symptoms (which sometimes come and go) attributed to Multiple Sclerosis. Many of the symptoms are vague and are attributed to other illnesses like - visual disturbances, muscle spasms, fatigue, loss of sensations, tremors and many, many more. Every individual is different and no blood test for this disease has been developed.
Diagnosing Multiple Sclerosis
Medical History. Every diagnosis starts with getting a patient’s medical history. It is important for patients to keep a journal or a list of the symptoms that they are feeling whatever the illness may be. This will make it easier to give the doctor a medical history with specific dates, symptoms, diagnostic tests, treatments given and medications taken. Knowing the family’s medical history is also important.
MRI or Magnetic Resonance Imaging Scan. An MRI Scan is still considered one of the best ways to diagnose MS. Images of the brain and the spinal cord are produced through the use of magnetic waves. If MS is suspected, gadolinium, a special contrast material or dye is injected. This liquid reacts to inflamed areas and pinpoints where an active MS lesion is located. An active lesion usually indicates that there is demyelination happening.
Neurologic Exam. During a neurologic exam, the neurologist tests the functions of the patient’s cranial nerves. These nerves control how one talks, swallows as well as the different senses of the body. He will test the patient’s coordination, reflexes, sensations, and strength by asking the patient to perform certain tasks. He can do an examination of the patient’s eyes as well as touch the patient with an instrument to check for a sensation or reaction.
Evoked Potential Testing. Under this type of diagnostic procedure, EEG or electroencephalograph electrodes are attached to the scalp to study the responses of the brainwaves to different stimuli. The doctor looks at both the speed in which the brain and the response size receive the signal. The three types of evoked potential testing are:
- SEP or Sensory Evoked Potentials
- BAEP or Brainstem Auditory Evoked Potentials
- VEP or Visual Evoked Potentials
Lumbar Puncture. Spinal tap or Lumbar Puncture is a procedure done wherein a needle is inserted in between the patient’s vertebrae and a small amount CSF or cerebrospinal fluid is extracted. The presence of specific antibodies called oligoclonal bands can indicate an increase of immune activity in the CSF. A positive result does not necessarily indicate MS. The result is evaluated together with the results of the other diagnostic procedures.
There is no one specific, foolproof test for Multiple Sclerosis. It usually requires several diagnostic methods to definitely say that a person is suffering from MS. The collective results of the diagnostic tests are used to affirm or negate MS in a patient.