MRI is considered the best test to help diagnose MS. However, 5% of people with MS do not have abnormalities detected on MRI; thus, a "negative" scan does not completely rule out MS. In addition, some common changes of aging may look like MS on a MRI. To track the progress of disease.
Although MRI is a very useful diagnostic tool, a normal MRI of the brain does not rule out the possibility of MS. About 5 percent of people who are confirmed to have MS do not initially have brain lesions evidenced by MRI.
MRI has greater than 90% sensitivity in the diagnosis of MS; however, other white matter diseases can sometimes have a similar appearance on medical imaging.
MRIs are not a 100 percent positive in the diagnosis of MS. In 5 percent of the people showing clinical MS disease activity, lesions were not visible on the MRI. However, if follow-up MRI studies continue to show no lesions, the MS diagnosis should be reconsidered.
If you have MS and it's early in the disease course, you might not have tested positive in all the MS tests. In fact, you might not have tested positive in any of the tests.
A wide range of conditions can be mistaken for MS, including: migraine, cerebral small vessel disease, fibromyalgia, functional neurological disorders, and neuromyelitis optica spectrum disorders, along with uncommon inflammatory, infectious and metabolic conditions (1, 3).
There are no specific tests for MS . Instead, a diagnosis of multiple sclerosis often relies on ruling out other conditions that might produce similar signs and symptoms, known as a differential diagnosis. Your doctor is likely to start with a thorough medical history and examination.
People should consider the diagnosis of MS if they have one or more of these symptoms: vision loss in one or both eyes. acute paralysis in the legs or along one side of the body. acute numbness and tingling in a limb.
While there is no definitive blood test for MS, blood tests can rule out other conditions that cause symptoms similar to those of MS, including lupus erythematosis, Sjogren's, vitamin and mineral deficiencies, some infections, and rare hereditary diseases.
However, MRI is not perfect and can, in some cases miss inactive or old lesions.
MS activity appears on an MRI scan as either bright or dark spots. Typical MS lesions tend to be oval or frame shaped. MS lesions can appear in both the brain's white and gray matter. Healthcare professionals may use a chemical contrast dye called gadolinium to improve the brightness of MRI scan images.
Do radiologists diagnose MS? Neuroradiologists interpret the findings of a patient's MRI, which is the most sensitive test for detecting MS-related inflammation. However, neurologists formally diagnose MS.
In addition, just 13% of patients with normal examination results ultimately were diagnosed with MS or possible MS. Thus, atypical history and normal neurological examination results were highly predictive of not diagnosing MS.
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.
Magnetic resonance imaging (MRI)
It's very accurate and can pinpoint the exact location and size of any inflammation, damage or scarring (lesions). MRI scans confirm a diagnosis in over 90 per cent of people with MS.
Numbness of the face, body, or extremities (arms and legs) is often the first symptom experienced by those eventually diagnosed as having MS.
Those symptoms include loss of vision in an eye, loss of power in an arm or leg or a rising sense of numbness in the legs. Other common symptoms associated with MS include spasms, fatigue, depression, incontinence issues, sexual dysfunction, and walking difficulties.
There are three main investigations that, because of their high specificity and sensitivity, are valuable in the diagnosis of MS: magnetic resonance imaging (MRI), evoked potentials; and cerebrospinal fluid (CSF) examination for the presence of oligoclonal bands (OCBs).
MS is best detected by a neurological examination and painless imaging studies of the brain and spinal cord using magnetic resonance testing (MRI). An ophthalmologist also can use a test called an optical coherence tomography (OCT) to determine if the optic nerve has been affected by MS.
Hypoxic-ischemic vasculopathy, specially small-vessel disease, inflammatory disorders, vasculitis, and non-MS idiopathic inflammatory disorders, as well as some toxic, metabolic, and infectious disorders, may present mimicking MS on MR examinations and should be included in the differential diagnosis of MS-like lesions ...
Some people are told they have benign MS. The term benign MS is sometimes used to describe a version of relapsing remitting MS with very mild or no attacks separated by long periods with no symptoms. 'Benign' means 'something doesn't cause any harm'.
There are also multiple infectious entities that mimic MS including; progressive multi-focal leukoencephalopathy (PML), Toxoplasmosis, Tuberculosis, Herpes Simplex Virus, Cytomegalovirus, Varicella zoster virus, Epstein Barr virus, Cryptococcus and Human immunodeficiency virus.