A complete neurological exam and medical history are needed to diagnose MS.
There are no specific tests for MS. Instead, a diagnosis of multiple sclerosis often relies on ruling out other conditions that might produce similar signs and symptoms, known as a differential diagnosis.
Your doctor is likely to start with a thorough medical history and examination. Your doctor may then recommend:
- Blood tests, to help rule out other diseases with symptoms similar to MS. Tests to check for specific biomarkers associated with MS are currently under development and may also aid in diagnosing the disease.
- Lumbar puncture (spinal tap), in which a small sample of fluid is removed from your spinal canal for laboratory analysis. This sample can show abnormalities in antibodies that are associated with MS. Spinal tap can also help rule out infections and other conditions with symptoms similar to MS.
- MRI, which can reveal areas of MS (lesions) on your brain and spinal cord. You may receive an intravenous injection of a contrast material to highlight lesions that indicate your disease is in an active phase.
- Evoked potential tests, which record the electrical signals produced by your nervous system in response to stimuli. An evoked potential test may use visual stimuli or electrical stimuli, in which you watch a moving visual pattern, or short electrical impulses are applied to nerves in your legs or arms. Electrodes measure how quickly the information travels down your nerve pathways.
In most people with relapsing-remitting MS, the diagnosis is fairly straightforward and based on a pattern of symptoms consistent with the disease and confirmed by brain imaging scans, such as MRI.
Diagnosing MS can be more difficult in persons with unusual symptoms or progressive disease. In these cases, further testing with spinal fluid analysis, evoked potentials and additional imaging may be needed.
Brain MRI is often used to help diagnose multiple sclerosis
Dr. B. Mark Keegan explains the diagnosis and treatment of multiple sclerosis
Aug. 04, 2017
- AskMayoExpert. What is multiple sclerosis? Rochester, Minn.: Mayo Foundation for Medical Education and Research; 2014.
- Daroff RB, et al. Bradley's Neurology in Clinical Practice. 6th ed. Philadelphia, Pa.: Elsevier Saunders; 2012. https://www.clinicalkey.com. Accessed Dec. 16, 2014.
- Ferri FF. Ferri's Clinical Advisor 2014: 5 Books in 1. Philadelphia, Pa.: Mosby Elsevier; 2015. https://www.clinicalkey.com. Accessed April 4, 2014.
- Olek MJ. Epidemiology and clinical features of multiple sclerosis in adults. http://www.uptodate.com/home. Accessed April 4, 2014.
- Wingerchuk DM (expert opinion). Mayo Clinic, Phoenix/Scottsdale, Ariz. May 13, 2014.
- Kantarci O. Treatment of primary progressive multiple sclerosis. Seminars in Neurology. 2013;33:74.
- Keegan BM. Therapeutic decision making in a new drug era in multiple sclerosis. Seminars in Neurology. 2013;33:5.
- Goldman L, et al. Goldman's Cecil Medicine. 24th ed. Philadelphia, Pa.: Saunders Elsevier; 2012. http://www.clinicalkey.com. Accessed April 4, 2014.
- Lotze TE. Pathogenesis, clinical features, and diagnosis of pediatric multiple sclerosis. http://www.uptodate.com/home. Accessed April 5, 2014.
- Kantarci OH, et al. Novel immunomodulatory approaches for the management of multiple sclerosis. Clinical Pharmacology & Therapeutics. 2014;95:32.
- Olek MJ. Treatment of relapsing-remitting multiple sclerosis in adults. http://www.uptodate.com/home. Accessed Dec. 16, 2014.
- Olek MJ. Treatment of acute exacerbations of multiple sclerosis in adults. http://www.uptodate.com/home. Accessed April 4, 2014.
- Wingerchuk DM. Multiple sclerosis: Current and emerging disease-modifying therapies and treatment strategies. Mayo Clinic Proceedings. 2014;89:225.
- Pizzorno JE, et al. Textbook of Natural Medicine. 4th ed. St. Louis, Mo.: Churchill Livingstone Elsevier; 2013. https://www.clinicalkey.com. Accessed April 4, 2014.
- Olek MJ. Diagnosis of multiple sclerosis in adults. http://www.uptodate.com/home. Accessed Jan. 2, 2015.
- Polman, C, et al. Diagnostic Criteria for Multiple Sclerosis: 2010 Revisions to the McDonald Criteria. Annals of Neurology. 2011;69:292. http://onlinelibrary.wiley.com/doi/10.1002/ana.22366/pdf.
- Patient information: Multiple sclerosis. http://www.uptodate.com/home. Accessed Jan. 2, 2015.
- Olek MJ. Symptom management of multiple sclerosis in adults. http://www.uptodate.com/home. Accessed Jan. 2, 2015.
- Yadav Y, et al. Summary of evidence-based guideline: Complementary and alternative medicine in multiple sclerosis. Neurology. 2014;82:1083.
- Riggin EA. Decision Support System. Mayo Clinic, Rochester, Minn. Jan. 20, 2015.
- National MS Society. Network of Pediatric MS Centers. Accessed Feb. 10, 2015. http://www.nationalmssociety.org/What-is-MS/Who-Gets-MS/Pediatric-MS/Care-for-Pediatric-MS-%28Centers-of-Excellence%29.
- Rodriguez M. Plasmapheresis in acute episodes of fulminant CNS inflammatory demyelination. Neurology. 1993;43:1100.
- Deb C. CD8+ T cells cause disability and axon loss in a mouse model of multiple sclerosis. PLOS One. Aug. 30, 2010.
- FDA approves new drug to treat multiple sclerosis. FDA. Accessed March 29, 2017.