THE MULTIPLE SCLEROSIS SOCIETY OF WESTERN AUSTRALIA (INC.)

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MS is not easily diagnosed as there is no single laboratory test, symptoms or physical findings that determine whether a person has MS.

A clinical diagnosis is made based on a person’s medical history, assessment of their reported symptoms and the presence of abnormalities identified by the neurologist (but not always noticeable to the person) during a thorough neurological examination.

At this time, a neurologist can only make a clinically definite MS diagnosis if the following criteria are met:

  • There must be objective evidence of two attacks, that is, two episodes of demyelination in the central nervous system;
  • The two attacks must be separated in time (at least one month apart) and space (indicated by evidence of inflammation and/or plaques in different areas of the central nervous system); and
  • There must be no other reasonable explanation for the attacks or the symptoms the person is experiencing.

The type and number of symptoms vary depending on where demyelination occurs in the CNS. It is not known why this process occurs or why some people experience more or different symptoms from others. As far as we know the person who develops MS has done nothing to cause the disease or its symptoms and could not have prevented it from occurring.

A definite diagnosis of MS will be made only when all other explanations of the signs and symptoms can be excluded. This helps explain why it may take a long time for some people to get a definitive explanation for their puzzling and uncomfortable symptoms. While for many people their medical history and neurological examination will provide sufficient information to support a clinically definite diagnosis of MS, for others, further tests may be needed to confirm it.

The most common test used is the Magnetic Resonance Imaging (MRI) scan, which produces pictures of the brain and spinal cord without the use of x-rays. These pictures identify lesions in the CNS; however an MRI may not always be conclusive of a diagnosis of MS. MS Trust - MRI

Other tests used to confirm a diagnosis of MS may include evoked potentials which measure the speed and efficiency of nerve conduction along different pathways in the CNS. These are non-invasive and well tolerated by most people. MS Trust - MRI

In some cases a lumbar puncture (spinal tap) may be recommended. The cerebrospinal fluid (surrounding the brain and spinal cord) is analysed. The neurologist is looking for indications of abnormality in the immune system. While the results are not specific to MS, they can help distinguish MS from other neurological conditions resembling MS. This test is done less frequently than MRI or evoked potentials. MS Trust - Lumbar Puncture

There is no one test that will tell whether a person has MS or not. Your medical history and the symptoms and signs of CNS demyelination that you and your doctor piece together provide the clearest evidence for the MS diagnosis. Read more at: MS Trust - Diagnosis

There has been much discussion about a possible relationship between stress and the onset or worsening of MS. Although a variety of research studies have been conducted in an effort to identify a possible link between stress and MS, no conclusive evidence has been demonstrated. Trying to remove stress from your life could prove to be impossible, but might also remove much of what is most interesting and fulfilling. Learning to manage life’s stresses  effectively may be a more realistic goal.

1.McDonald, W. et al. Annals of Neurology 2001; 50:121-127.