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Tests and diagnosis
By Mayo Clinic staffThere are no specific tests for multiple sclerosis. Ultimately, the diagnosis relies on ruling out other conditions that might produce similar symptoms. Your doctor may base a multiple sclerosis diagnosis on the following:
Blood tests
Analysis of your blood can help rule out some infectious or inflammatory diseases that have symptoms similar to multiple sclerosis.
Spinal tap (lumbar puncture)
In this procedure, a doctor or nurse removes a small sample of cerebrospinal fluid from within your spinal canal for laboratory analysis. This sample can show abnormalities associated with multiple sclerosis, such as abnormal levels of white blood cells or proteins. This procedure can also help rule out viral infections and other conditions that can cause neurological symptoms similar to those of multiple sclerosis.
MRI
This test uses a powerful magnetic field and radio waves to produce detailed images of internal organs. MRI can reveal lesions, indicative of the myelin loss on your brain and spinal cord. However, these types of lesions can also be caused by other conditions, such as lupus or Lyme disease, so the presence of these lesions isn't definitive proof that you have multiple sclerosis.
During an MRI test, you lie on a movable table that slides into a large, tube-shaped machine, which makes loud tapping or banging noises during the scans. Most MRIs take at least an hour. While the test is painless, some people feel claustrophobic inside the machine. Your doctor can arrange for a sedative if necessary.
You may also receive an intravenous dye that may help highlight "active" lesions. This helps doctors know whether your disease is in an active phase, even if no symptoms are present. Newer MRI techniques can provide even greater detail about the degree of nerve fiber injury or permanent myelin loss and recovery.
Newer MRI techniques may help with diagnosing multiple sclerosis. They include:
- Magnetic resonance spectroscopy (MRS). This provides information about the brain's biochemistry.
- Magnetization transfer imaging (MTI). MTI can detect abnormalities before lesions are visible on standard MRI scans.
- Diffusion tensor imaging (DTI). This technology provides 3-D images of demyelinated areas of the brain, which are useful in determining disease progression.
- Functional MRI (fMRI). This is used during cognitive performance tests.
Evoked potential test
This test measures the electrical signals sent by your brain in response to stimuli. An evoked potential test may use visual stimuli or electrical stimuli, in which short electrical impulses are applied to your legs or arms.
- Olek MJ. Epidemiology, risk factors and clinical features of multiple sclerosis in adults. http://www.uptodate.com/home/index.html. Accessed Sept. 29, 2010.
- Olek MJ. Treatment of relapsing-remitting multiple sclerosis in adults. http://www.uptodate.com/home/index.html. Accessed Sept. 29, 2010.
- Multiple sclerosis: Hope through research. National Institute of Neurological Disorders and Stroke. http://www.ninds.nih.gov/disorders/multiple_sclerosis/detail_multiple_sclerosis.htm. Accessed Oct. 14, 2010.
- Neurological diagnostic tests and procedures. National Institute of Neurological Disorders and Stroke. http://www.ninds.nih.gov/disorders/misc/diagnostic_tests.htm. Accessed Oct. 14, 2010.
- Burt RK, et al. Autologous non-myeloablative haemopoietic stem cell transplantation in relapsing-remitting multiple sclerosis: a phase I/II study. Lancet Neurology. 2009;8:244.
- Foley F, et al. Taming stress in multiple sclerosis. National Multiple Sclerosis Society. http://www.nationalmssociety.org/search-results/index.aspx?q=stress&x=0&y=0&start=0&num=20. Accessed Oct. 15. 2010.
- Harmon M. Exercise as part of everyday life. National Multiple Sclerosis Society. http://www.nationalmssociety.org/search-results/index.aspx?q=exercise&sitesearch=&x=0&y=0&start=0&num=20. Accessed Oct. 14, 2010.
- Medication guide: Gilenya. U.S. Food and Drug Administration. http://www.accessdata.fda.gov/scripts/cder/drugsatfda/index.cfm?fuseaction=Search.Label_ApprovalHistory. Accessed Oct. 20, 2010.
- Lucchinetti CF (expert opinion). Mayo Clinic, Rochester, Minn. Oct. 18, 2010.
- Baclofen. Micromedex Healthcare Series. http://www.micromedex.com. Accessed Nov. 23, 2010.
- Tizanidine hydrochloride. Micromedex Healthcare Series. http://www.micromedex.com. Accessed Nov. 23, 2010.
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