MRIs offer detailed and sensitive images of the brain and spinal cord. If the myelin has been damaged, however, this fat content is reduced or stripped away entirely and no longer repels water. The area will hold more water as a result, which can be detected by MRIs. To diagnose MS, doctors must find evidence of demyelination.
In addition to ruling out other potential conditions, an MRI can provide solid evidence that demyelination has occurred. Before you go in for your MRI, you should remove all jewelry. Let your doctor and technician know ahead of time if you have:. Lumbar puncture , also called a spinal tap, is sometimes used in the process of diagnosing MS.
This procedure will remove a sample of your cerebrospinal fluid CSF for testing. During the procedure, a needle is inserted into your lower back, between vertebrae, and into the spinal canal. This hollow needle will collect the sample of CSF for testing. After the area has been cleaned and a local anesthetic has been administered, a doctor will insert the hollow needle into the spinal canal to withdraw one to two tablespoons of CSF.
Doctors who order lumbar punctures during the process of an MS diagnosis will use the test to rule out conditions with similar symptoms. However, these abnormal immune responses can also be caused by other conditions. Evoked potential EP tests measure the electrical activity in the brain that occurs in response to stimulation, such as sound, touch, or sight.
Each type of stimuli evokes minute electrical signals, which can be measured by the electrodes placed on the scalp to monitor activity in certain areas of the brain. There are three types of EP tests. This typically happens early in most MS patients. However, before concluding that abnormal VERs are due to MS, other ocular or retinal disorders must be excluded. No preparation is necessary to take an EP test. You may be asked to cover one eye at a time.
Medical knowledge is always advancing. As technology and our knowledge of MS moves forward, doctors may find new tests to make the MS diagnosis process a simpler one. A blood test is currently being developed that will be able to detect biomarkers that are associated with MS. Most people who receive an MS diagnosis are between the ages of 20 and However, an MS diagnosis can come at any age, ranging from childhood to ages above Diagnosing MS currently can be challenging and time consuming.
When MS is considered as a potential diagnosis, other causes must be excluded — through the tools and tests outlined below — before an MS diagnosis is considered definitive. While this process of exclusion may be quick for some, it can also take much longer , with repeat testing sometimes needed.
Making the diagnosis of MS as quickly and accurately as possible is important for several reasons: You are living with frightening and uncomfortable symptoms and need to know the reason for your discomfort. Getting the diagnosis allows you to begin the adjustment process and relieves worries about other diseases such as cancer.
Since we now know that permanent neurologic damage can occur even in the earliest stages of MS, it is important to confirm the diagnosis so that you can start the appropriate treatment s as early in the disease process as possible.
In order to make a diagnosis of MS, the physician must: Find evidence of damage in at least two separate areas of the central nervous system CNS , which includes the brain, spinal cord and optic nerves AND Find evidence that the damage occurred at different points in time AND Rule out all other possible diagnoses The Revised McDonald Criteria, published In by the International Panel on the Diagnosis of Multiple Sclerosis, include specific guidelines for using MRI and cerebrospinal fluid analysis to speed the diagnostic process.
Medical history and neurologic exam Your healthcare provider: Takes a careful history to identify any past or present symptoms that might be caused by MS. Gathers information about birthplace, family history, environmental exposures, history of other illnesses and places traveled that might provide further clues.
Performs a comprehensive neurologic exam, which includes tests of cranial nerves vision, hearing, facial sensation, strength, swallowing , sensation, reflexes, coordination, walking and balance.
All partners, whether they are a neurologist or social worker, have a strong relationship with the Society and connect their patients to the information, resources and support they need to live their best lives with MS. Find a Partner in MS Care. Here are a few related topics that may interest you. You'll need to have your heart rate and blood pressure monitored for six hours after the first dose because your heartbeat may be slowed.
Other side effects include rare serious infections, headaches, high blood pressure and blurred vision. Ocrelizumab Ocrevus. This humanized monoclonal antibody medication is the only DMT approved by the FDA to treat both the relapse-remitting and primary-progressive forms of MS.
Clinical trials showed that it reduced relapse rate in relapsing disease and slowed worsening of disability in both forms of the disease. Ocrelizumab is given via an intravenous infusion by a medical professional.
Infusion-related side effects may include irritation at the injection site, low blood pressure, a fever and nausea, among others. Some people may not be able to take ocrelizumab, including those with a hepatitis B infection. Ocrelizumab may also increase the risk of infections and some types of cancer, particularly breast cancer.
Natalizumab Tysabri. This medication is designed to block the movement of potentially damaging immune cells from your bloodstream to your brain and spinal cord. It may be considered a first line treatment for some people with severe MS or as a second line treatment in others. This medication increases the risk of a potentially serious viral infection of the brain called progressive multifocal leukoencephalopathy PML in people who are positive for antibodies to the causative agent of PML JC virus.
People who don't have the antibodies have extremely low risk of PML. Alemtuzumab Campath, Lemtrada. This drug helps reduce relapses of MS by targeting a protein on the surface of immune cells and depleting white blood cells.
This effect can limit potential nerve damage caused by the white blood cells. But it also increases the risk of infections and autoimmune disorders, including a high risk of thyroid autoimmune diseases and rare immune mediated kidney disease. Treatment with alemtuzumab involves five consecutive days of drug infusions followed by another three days of infusions a year later.
Infusion reactions are common with alemtuzumab. The drug is only available from registered providers, and people treated with the drug must be registered in a special drug safety monitoring program.
Alemtuzumab is usually recommended for those with aggressive MS or as second line treatment for patients who failed another MS medication. Physical therapy can build muscle strength and ease some of the symptoms of MS. Physical therapy. A physical or occupational therapist can teach you stretching and strengthening exercises and show you how to use devices to make it easier to perform daily tasks.
Physical therapy along with the use of a mobility aid when necessary can also help manage leg weakness and other gait problems often associated with MS.
Explore Mayo Clinic studies testing new treatments, interventions and tests as a means to prevent, detect, treat or manage this condition. Many people with MS use a variety of alternative or complementary treatments or both to help manage their symptoms, such as fatigue and muscle pain. Activities such as exercise, meditation, yoga, massage, eating a healthier diet, acupuncture and relaxation techniques may help boost overall mental and physical well-being, but there are few studies to back up their use in managing symptoms of MS.
According to guidelines from the American Academy of Neurology, research strongly indicates that oral cannabis extract OCE may improve symptoms of muscle spasticity and pain.
There is a lack of evidence that cannabis in any other form is effective in managing other MS symptoms. Daily intake of vitamin D3 of 2,, international units daily is recommended in those with MS.
The connection between vitamin D and MS is supported by the association with exposure to sunlight and the risk of MS. Living with any chronic illness can be difficult. To manage the stress of living with MS , consider these suggestions:. You may be referred to a doctor who specializes in disorders of the brain and nervous system neurologist.
Your doctor is likely to ask you a number of questions. Being ready to answer them may reserve time to go over points you want to spend more time on. You may be asked:. In addition to the questions that you've prepared to ask your doctor, don't hesitate to ask other questions during your appointment.
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This content does not have an English version. This content does not have an Arabic version. Diagnosis Neurological exam Open pop-up dialog box Close.
Neurological exam A complete neurological exam and medical history are needed to diagnose MS. Spinal tap lumbar puncture Open pop-up dialog box Close. Spinal tap lumbar puncture During a spinal tap lumbar puncture procedure, you typically lie on your side with your knees drawn up to your chest.
MRI multiple sclerosis lesions Open pop-up dialog box Close. Brain MRI is often used to help diagnose multiple sclerosis. Care at Mayo Clinic Our caring team of Mayo Clinic experts can help you with your multiple sclerosis-related health concerns Start Here. Multiple sclerosis research laboratory at Mayo Clinic. Physical therapy for multiple sclerosis Physical therapy can build muscle strength and ease some of the symptoms of MS.
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