Diagnosing Multiple Sclerosis

Some people with MS say that handling the uncertainty during and following diagnosis is harder than coping with any of the symptoms they ever experience. Knowing what to expect can help to make the challenges of living with MS easier to deal with.
Getting a diagnosis of MS can be a difficult process, not least because the symptoms of MS are common to many other conditions. Often, doctors need to rule out other possible causes of symptoms before they can confirm a diagnosis of MS. Also, if an individual experiences symptoms for the first time, which then improve or disappear, neurologists may wait for a second relapse, or for symptoms to become more severe, before giving a definite diagnosis.
There is no one test or procedure that can be used to accurately diagnose MS on its own. Diagnosis is usually based on a history of symptoms (perhaps an unexplained episode of blurred vision years before, or pins and needles in the hands or feet) and on the results from a series of tests.

Medical (clinical) history

The doctor will ask about medical history and symptoms and may perform some simple physical examinations.

MRI scanning

Magnetic resonance imaging (MRI) scans are frequently performed to identify any areas of scarring in the brain or spinal cord.
The first MRI image on a human took place in 1977. Although very slow and crude by today’s standards (it took five hours to produce just one image of a finger), it was quickly recognised that this technology was a major step on from other scanning methods and when applied to images of the head and spine would be of great use in identifying MS.
Having an MRI scan:

An MRI scanner consists of a larger tubular magnet with a bed that slides out from the hole in the middle on which the person being scanned lies.
There are no risks associated with MRI scans, which are painless and generally lasts from half an hour to an hour, during which time the individual will be asked to lie as still as possible. Some people can find this claustrophobic. Whilst scanning, the machine makes loud banging and buzzing noises. Often people are given headphones to make this more tolerable.
As the scanner is a very powerful magnet, all metallic objects must be left outside the scanning room. It is advisable not to wear clothes with metal poppers, zips or metal buckles.

How MRI works

Unlike CT scanning, which uses x-rays, MRI creates images by using magnetic fields and radio waves to monitor the behaviour of hydrogen atoms in the body.
The nucleus at the centre of a hydrogen atom spins like a top. The strong magnetic field in an MRI machine (more than 10,000 times stronger than gravity) makes the atoms line up in the direction of the magnetic field.
The machine then fires a pulse of radio waves that causes the atoms to spin in a different direction (causing ‘resonance’). When the pulse is turned off, the atoms return to their natural alignment within the magnetic field and release energy. The machine picks up this signal and sends it to a computer, which converts it into an image.
The chemical make up of the scars caused by MS means that they show up as white patches on MRI images, giving a very clear picture of the effects of MS on the brain and spinal cord. By using a contrast enhancing agent called gadolinium, which is injected before read more