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The diagnosis of multiple sclerosis is not always easy, but medicine has many techniques to help you make an accurate diagnosis. What tests can diagnose MS?

The diagnosis of multiple sclerosis( sclerosis multiplex ,MS ) is difficult from symptoms alone that's why specialists reach for specialized tests. Imaging tests are used in the diagnosis of MS, but also the examination of the cerebrospinal fluid or the analysis of the so-called evoked potentials. There is even a special classification that helps in the diagnosis of multiple sclerosis - doctors help in this case, the so-called McDonald's criteria.

MS diagnosis: McDonald's criteria

International Panel on MS Diagnosis, chaired by W. McDonald, in 2001 published the so-called McDonald's criteria. Less than 10 years later, in 2010, the diagnostic classification for multiple sclerosis was modernized. The main assumption of these criteria is that the diagnosis of MS requires the presence of diffuse disease-related changes in time and space. In the case of temporary dissemination, it is said that pathological changes in the nervous system appear at different times in patients. By spatial diffusion, it is understood that changes in the structures of the nervous system caused by multiple sclerosis occur in more than one location. The diagnosis of multiple sclerosis according to the McDonald criteria can be made by identifying different changes in patients. The simplest situation is when a patient has at least two relapses of MS, and the neurological symptoms occurring during them come from two different foci (this means that patients' ailments are related to defects in at least two parts of the nervous system, i.e. that pathologies may concern, for example, the structures of the brain and spinal cord). In this case, the diagnosis of the disease can be made even without additional tests.

A slightly different situation may arise when a patient has two relapses, but his symptoms come from one disease site - then, in order to diagnose MS, imaging tests are already required. A diagnosis of multiple sclerosis can beshould be placed in the event that MRI shows pathologies typical of multiple sclerosis in at least two places in the nervous system.

MS diagnosis: imaging tests

The imaging test that can visualize the changes associated with multiple sclerosis is magnetic resonance imaging. Disease outbreaks related to, inter alia, With demyelination that occurs in the course of MS, they can occur in various locations of the nervous system, but there are certain areas where their occurrence may be a particular indication of MS. The subcortical, periventricular and subtentorial zones of the brain are considered to be the regions in which the appearance of lesions is typical in the course of multiple sclerosis.

MS diagnosis: CSF testing

Cerebrospinal fluid is obtained by lumbar puncture. Currently, the examination of its composition is less frequently used in the diagnosis of multiple sclerosis, although sometimes the examination of this substance supports the diagnosis of multiple sclerosis. In MS patients, various abnormalities can be found during the examination of the cerebrospinal fluid: the protein content may be elevated or the amount of leukocytes may be increased, but these changes are not really the characteristic features of the cerebrospinal fluid in the course of this disease. The most important factor in the diagnosis of multiple sclerosis is the presence of an increased amount of one of the antibody fractions in the fluid - the so-called gamma-globulin. Both their increased amount in the tested material can be detected, and the fluid can be examined by electrophoresis. In the last of these studies, in the case of multiple sclerosis, the presence of the so-called oligoclonal bands.

MS diagnosis: other tests

When discussing the diagnosis of multiple sclerosis, one cannot fail to mention the examination that can be performed without the use of specialized neuroimaging equipment or other advanced instruments. We are talking about a neurological examination - it plays a fundamental role, because it is here that the entire diagnostic process of multiple sclerosis begins. A neurologist can find out about various ailments in a patient, such as disturbances in sensation and balance or increased muscle tone. It is this doctor - if he finds any deviations in the patient - also orders other, more advanced tests.

In the diagnosis of MS, beyond alreadywith the mentioned tests, the so-called electrophysiological studies. They consist in analyzing the so-called evoked potentials, e.g. visual or somatosensory evoked potentials can be assessed. During such tests, individual senses are stimulated with various stimuli, thanks to which it becomes possible to assess the rate of signal transmission in the structures of the nervous system. In the course of multiple sclerosis - due to the occurrence of, inter alia, demyelinating processes - the rate of information transfer within nerve cells may decrease.

SM diagnosis: differential diagnosis

As already mentioned, there is no single specific study that can conclusively confirm the presence of multiple sclerosis in a patient. Therefore, one of the conditions for a diagnosis of MS is to rule out other potential causes of the patient's symptoms. The differential diagnosis of multiple sclerosis takes into account a number of different conditions, the most important examples are:

  • infectious diseases of the nervous system (such as Lyme disease or syphilis)
  • sarcoidosis
  • systemic lupus erythematosus
  • leukodystrophie
  • Devic's disease
  • MELAS team
  • neoplastic diseases of the CNS (developing either inside the skull cavity or in the structures of the spinal canal)
  • spondylosis
  • vitamin B deficiency12
  • CADASIL team
  • vascular malformations
  • changes related to the occurrence of numerous ischemic foci in the structures of the central nervous system

Time matters in MS treatment

About the importance of rapid implementation of appropriate therapy in the treatment of multiple sclerosis, says Magdalena Fac-Skhirtladze, Secretary General of PTSR. The statement was recorded during the scientific conference "Physiotherapy for he alth".

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Category:

Neurology