Testing for MS – What’s Available?
When I look back at all the tests I had to endure to for my multiple sclerosis diagnosis, I shudder. It was nearly ten years ago, and I wonder if testing has changed and simplified since then?
Neurologists tend to investigate and rule out other conditions which may be causing your symptoms before they start looking for MS.
When a neurologist initially saw me, he thought I might be suffering from a vitamin B deficiency. I went through sessions of high dose injections to rule out vitamin B deficiency. However, it tuned out I was deficient, but that didn’t mean I also didn't have MS.
According to the MS Society UK, there needs to be a complete neurological examination, where “history taking” will occur, to find out more about your life and symptoms. They will ask lots of questions and use specific criteria to diagnose MS – the McDonald Criteria.
A physical examination will then follow where they check for changes and weaknesses in leg or hand coordination, balance, sensation, speech or reflexes. At this point, your neurologist may strongly suspect MS, and I remember asking mine what he thought I had which he skillfully avoided.
They can’t be sure till other test results confirm MS. Below are some options for MS testing that your neurologist may refer you to.
Magnetic Resonance Imaging (MRI)
An MRI scanner uses a strong, magnetic field to take detailed images of your brain and spinal cord to detect any tell-tale damage and lesions caused by MS.
To get a clear image, you have to lie down in a long, cylindrical tunnel and keep as still as possible. For me, staying completely still for 30 minutes to an hour is no easy task because all I wanted to do was scratch my nose.
My diagnosis pushed because at the time I was pregnant with my first child and wasn’t allowed an MRI. Consequently, I had my first scan when my son was three months old, and I was still breast feeding.
I had to put plasters over my nipples to avoid any embarrassing leakage, and my mom looked after my son while I went in. I was amazed at how loud it was, and I suffered one or two moments of panic where I imagined being left inside while the world ended around me.
I’ll never forget the look on the radiologist's face when I got ready to go afterward.
She asked if I had an appointment with my neurologist soon and the pity in her eyes betrayed what she’d seen on the scan. I shrugged it off at the time, believing I’d imagined it, but looking back – I’m sure she suspected I had MS.
I am now used to MRI scans. I remember the one time I fell asleep during one despite the loud, deafening noise around me.
It’s important to keep having scans to detect any further damage or disease activity.
Evoked Potentials
The second test involves testing the time it takes your brain to react to messages. It’s painless and monitors your brain waves using electrodes on your head, and if myelin damage has occurred your brain will be slower.
I remember enjoying this test and thinking I’d done well.
However, I don’t remember seeing the results, but I suspect they were communicated to me when I was informed I had MS, but now that meeting is a complete blur to me.
Lumber Puncture
The final test, in my experience, was the worst and I still shudder when I think of it.
It’s sometimes called a spinal tap and it involves having a needle inserted into the space around your spinal cord and extracts a small sample of your spinal fluid.
People with MS will have antibodies in this liquid, so it will conclusively prove the diagnosis. I remember it being excruciatingly painful, even with the local anesthetic, and I felt dreadful afterward. They told me to expect a headache, and I remember the banging sensation in my head.
I remember it being excruciatingly painful, even with the local anesthetic, and I felt dreadful afterward. They told me to expect a headache, and I remember the banging sensation in my head.
Luckily, I’ve only needed to have this test once.
Other Tests
As mentioned above, neurologists will also want to rule out other conditions which may be causing the symptoms and may order blood tests or inner ear tests if your balance is a symptom.
Once all the above tests have been carried out, your neurologist will be able to inform you of the diagnosis accurately.
I’ll never forget being shown a picture of my brain on a screen while the neurologist pointed out lesions and damage. I burst into tears and didn’t listen to a lot of what was said. He referred me to an MS specialist nurse, and it took me many years to get my head around what was happening to me, but ten years on I think I’m doing okay.
