Typical Tests For Multiple Sclerosis

All the main symptoms of multiple sclerosis (MS) can potentially be explained away separately, so doctors should not diagnose MS unless they are convinced about their diagnosis. This means that the symptoms need to be assessed in a structures way.

This article explains the main tests used for MS.

A. Nervous system function tests.

These are usually the first tests the doctor carries out, and are basically an organized test of your reactions and reflexes, usually including:

• tapping a knee with a rubber hammer to check reflexes. This is a quick and cheap way for a doctor to get an idea how fast the nerves are responding, and is a frequent starting point to many examinations of the nervous system.


• watching how the patient's eyes follow the doctor's forefinger from side to side.


• asking the patient to walk "toe to heel".


• asking the patient to touch the nose (or the forefinger of one hand against the forefinger of the other hand) with the eyes shut.


• asking the patient to ripple the fingers on the table as if miming playing the piano.


• checking how sensitive the backs of the hands or soles of the feet are to light touch.

B. The MRI Scan.

Magnetic Resonance Imaging (MRI) allows the hospital to create a computer image of the inside of the brain of a living person in a way that was totally impossible before the 1980s. If you have been recently diagnosed you will probably know the MRI scan is now the key tool in the diagnosis of MS.

How does a MRI Scanner work?

• MRI scanners use a strong magnetic field combined with radio waves to map water molecules.


• When a patient is placed in a strong magnetic field, the nuclei of the hydrogen atoms in water line up with the magnetic field.


• Computers track that process and create virtual slices of the inside of your head! This sounds worrying, but is quite painless, and only involves lying down and being slid into a large tube for a few minutes, while machinery clunks around about your head.


• If you have MS the computer will produce images showing scars (or "lesions"). These MS lesions have been left after the brain has repaired damaged nerve tissues. Your doctor should be able to show you MRI images showing the lesions dotted about like islands in the sea of your brain.

C. Evoked Potential Tests.

These tests involve electrodes being strapped to the head and show the time the nerves take to respond to touch, sight and sound. They are now only used as back-up to a diagnosis where a MRI Scanner is not available or its use is impossible (maybe where high magnetic fields would be dangerous to the patient), or the MRI Scan was somehow inconclusive.

D. Spinal Tap (or lumbar puncture).

As a back-up diagnosis, a small amount of fluid from the spine might be tested. MRI scans now shows lesions in the brains in 95% of cases where MS is diagnosed, but if the images are not conclusive or a high magnetic field could be dangerous to the patient than a spinal tap is needed. The tests are not dangerous but the loss of spinal fluid can leave the patient feeling very unwell for several hours.

Tests C and D, are now only used as back up tests, but each has its value in excluding other (non-MS) reasons for a patient's symptoms. After these tests have been completed and the diagnosis of MS has been made a patient needs to remain aware of what the body is reporting and ready to answer the questions it will be raising.