There is no straightforward test for MS. None of the tests available to help doctors with a diagnosis of MS is conclusive on its own.

Early MS may present itself as a history of vague symptoms, which may occur sporadically over a prolonged period of time and could often also be attributed to a number of other medical conditions. Invisible or subjective symptoms are often difficult to communicate to doctors and health professionals and sadly it has not been uncommon for people with MS to be treated unsympathetically in the very early stages of diagnosis.

Even when a person shows a ‘classic’ pattern of MS-type symptoms, the symptoms must conform to agreed criteria before a doctor or neurologist can diagnose clinically ‘definite’ MS.  The McDonald Criteria are most commonly used to diagnose MS. The most commonly used diagnostic criteria (called the revised McDonald Criteria) are:

  • that two different areas of the central nervous system are affected
  • that these effects have been experienced on at least two separate occasions of at least one month apart, supported by a magnetic resonance image (MRI) scan of the person’s brain showing lesions (areas of demyelination in the central nervous system)
  • all other possible diagnoses can be ruled out.

In 2001, the International Panel on the Diagnosis of Multiple Sclerosis updated the criteria to include specific guidelines for using magnetic resonance imaging (MRI), cerebrospinal fluid (CSF) analysis, and visual evoked potentials (EP) to speed the diagnostic process. Using these it is now more and more possible to be diagnosed as having ‘definite’ MS on a first visit to a neurologist, but it is also quite likely that the diagnosis will be uncertain, and that the person will be referred for further tests.

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A man operates an MRI machine from a computer

MRI machine with operator. Photo: Robert van Willigenburg

A set of images from a Magnetic Resonance Imaging scan

A set of images from a Magnetic Resonance Imaging scan

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