Exams and Tests

Diagnosing multiple sclerosis (MS) isn't always easy and in some cases may take time.

Your medical history and neurological exam can identify possible nervous system problems and are often enough to strongly suggest a diagnosis of MS. Tests may help confirm or rule out the diagnosis when your history and exam do not provide clear evidence of the disease. MRI and neurological exam may help doctors predict which people will develop MS after a first attack of symptoms.

Tests to diagnose MS

• Magnetic resonance imaging (MRI) of the brain and spinal cord. This test is done to confirm a diagnosis. See an image of an MRI showing MS in the brain.
• Lumbar puncture (sometimes called a spinal tap). This test may be done to evaluate cerebrospinal fluid. Most people with MS have abnormal results on this test.
• Evoked potential testing. This test can often reveal abnormalities in the brain and spinal cord and in the optic nerves that other tests may not detect.

Confirming the diagnosis

MS is diagnosed when it is clear from neurological tests and a neurological exam that lesions (damaged areas) are present in more than one area of the central nervous system (usually the brain, spinal cord, or the nerves to the eyes). Tests will also clearly show that damage has occurred at more than one point in time.

Some people have had only one episode of a neurological symptom such as optic neuritis, but MRI tests suggest they may have MS. This is known as a clinically isolated syndrome. Many of these people go on to develop MS over time.

Tests to diagnose other health problems

Urinary tract tests may be needed to help diagnose a problem with bladder control in a person who has MS.

Neuropsychological tests may be needed to identify thinking or emotional problems, which may be present without the person being aware of them. Typically, these tests are in a question-and-answer format.