Diagnosis of Multiple Sclerosis
The diagnosis of multiple sclerosis (MS) is complex. The symptoms and clinical signs of MS often come and go. Symptoms are not the same for every person. A diagnosis of MS is not based on one specific physical finding, lab test, or symptom. It is based on the right combination of findings, tests, and symptoms with the right time course. The diagnosis of MS in some people is quite quick, taking a few weeks when the person has a very typical presentation. It may take months or even years when a person's presentation is less typical.
To make a diagnosis of MS, a doctor will complete a thorough review of the person's history and perform a physical exam. A magnetic resonance image (MRI) of the brain is almost always also required. More testing may also be needed, including MRI of the spinal cord, spinal fluid analysis, and visual evoked potential tests. Repeated brain exams and imaging over time may also be needed to make a clear diagnosis of MS.
Although many of the symptoms cannot be seen on exam, there are specific guidelines that have been developed to help a doctor (usually a neurologist) make the diagnosis of MS. For a person to be diagnosed with MS, the doctor must:
- Find evidence of damage in at least two separate areas of the central nervous system (CNS). This includes the brain, spinal cord, and optic nerves. AND
- Find evidence that the damage occurred at least one month apart. Sometimes, spinal fluid problems consistent with MS can be used to make this finding. AND
- ALSO, all other possible diagnoses must be ruled out.
Symptoms of MS often look like those of other diseases. Ruling out any other condition is an important part of the diagnostic process. Although this may take time, it's important that the proper diagnosis is given. This way, the best treatment options can be selected for the disease. The VA is committed to giving Veterans the specialized services and testing needed to establish an accurate diagnosis of MS.
