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Multiple sclerosis

Diagnosis
Multiple sclerosis

Overview

Symptoms

Causes

Diagnosis

Treatment

Living with

It can be hard to tell whether your symptoms

might be caused by multiple sclerosis (MS) at first,
as some of the symptoms can be quite vague or
similar to other conditions.

See a GP if you think you have symptoms of MS.

Letting them know about the type and pattern of

symptoms you're experiencing in detail will help
them determine whether you might have the
condition.

If the GP thinks you could have MS you should see

a neurologist, a specialist in conditions of the
nervous system, for an assessment.

Tests for multiple sclerosis

Diagnosing MS is complicated because no single
test can positively diagnose it. Other possible
causes of your symptoms may need to be ruled out
first.

It may also not be possible to confirm a diagnosis

if you have had only 1 attack of MS-like symptoms.

A diagnosis can only be made with confidence

once there's evidence of at least 2 separate
attacks, although this may include signs of attacks
on an MRI scan that you may not realise you have
had.

Some of the tests you may need to confirm MS are

discussed on this page.

Neurological examination

Your neurologist will look for abnormalities,

changes or weakness in your vision, eye
movements, hand or leg strength, balance and co-
ordination, speech and reflexes.

These may show whether your nerves are

damaged in a way that might suggest MS.

MRI scan

An MRI scan is a painless scan that uses strong

magnetic fields and radio waves to produce
detailed images of the inside of the body.

It can show whether there's any damage or

scarring of the myelin sheath (the layer
surrounding your nerves) in your brain and spinal
cord. Finding this can help confirm a diagnosis in
most people with MS.

A standard MRI scanner is like a large tube or

tunnel. The machine is noisy and some people feel
claustrophobic while the scan is done. Tell your
neurologist if you're worried about this.

Newer scanners are more open and work quicker

than those used in the past, and most people have
scans without any problems.

Evoked potential test

There are several types of evoked potential test.

The most common type assesses how well the eyes
work.

Light patterns are shown to the eyes while your

brainwaves are monitored using small, sticky
patches called electrodes placed on your head.

It's a painless test and can show whether it takes

your brain longer than normal to receive
messages.

Lumbar puncture

A lumbar puncture is a procedure to remove a

sample of your spinal fluid by inserting a needle
into the lower back.

Spinal fluid is the fluid that surrounds your brain

and spinal cord, and changes in the fluid can
suggest problems with the nervous system.

The procedure is done under local anaesthetic,

which means you'll be awake, but the area the
needle goes in will be numbed.

The sample is then tested for immune cells and

antibodies, which is a sign that your immune
system has been fighting a disease in your brain
and spinal cord.

Lumbar punctures are very safe, but are often

uncomfortable and can cause a headache that
occasionally lasts for up to a few days.

A lumbar puncture will often be performed to

provide extra information if your symptoms or
scans are unusual.

Blood tests

Blood tests are usually performed to rule out other

causes of your symptoms, such as vitamin
deficiencies or a very rare, but potentially very
similar, condition called neuromyelitis optica.

Determining the type of multiple

sclerosis
Once a diagnosis of MS has been made, your
neurologist may be able to identify which type of
MS you have.

This will largely be based on:

the pattern of your symptoms – such as whether

you experience periods when your symptoms
get worse (relapses) then improve (remissions),
or whether they get steadily worse (progress)

the results of an MRI scan – such as whether

there's evidence that lesions in your nervous
system have developed at different times and at
different places in your body

But the type of MS you have often only becomes

clear over time because the symptoms of MS are so
varied and unpredictable.

It can take a few years to make an accurate

diagnosis of progressive MS because the condition
usually worsens slowly.

Further information
MS Society: Diagnosis

Page last reviewed: 22 March 2022

Next review due: 22 March 2025

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