Diagnosing MS

Multiple sclerosis (MS) is diagnosed by conducting a thorough medical interview during which differential diagnoses are excluded. A neurological examination is also performed to determine the occurrence of potential lesions.

Assessment and examination

During an in-depth interview, doctors ask patients for any previous signs which might indicate MS. A physical examination and neurological tests such as checking reflexes, tests of sensitivity, coordination and balance are performed. This allows doctors to assess the degree of progression of MS through a standardised tool such as the Expanded Disability Status Scale (EDSS). To confirm the diagnosis, additional tests are done.

Medical imaging

Magnetic resonance imaging (MRI) makes it possible to accurately visualise and evaluate healthy and pathological structures of the brain and spinal cord and to highlight lesions typical of MS. The administration of a contrast medium increases the sensitivity of MRI images and allows for visualisation of smaller, more recent foci of inflammation.

Laboratory analysis

Laboratory analysis are usually conducted and include:

• A blood test. There is no biological test to specifically diagnose MS. However, these tests are necessary to rule out other conditions.
• A lumbar puncture to analyse the cerebrospinal fluid. Markers of inflammation of the central nervous system, such as special antibodies, also known as oligoclonal bands, can be detected.

Supplementary exams

Further tests may be performed depending on the symptoms.

For example, disturbances in the electrical transmission of stimuli that occur in MS patients can be demonstrated by examining 'evoked potentials' (PEs). This is the measurement of electrical brain waves caused by targeted stimulation.

Numerous tests, and the exclusion of differential diagnoses are necessary to establish a diagnosis of MS.