At present, there are no clinical signs or signs, or laboratory tests that will determine whether a person has MS. The doctor takes several strategies to determine whether a patient’s condition meets known criteria for the diagnosis of MS, as well as to rule out any other causes of symptoms that the patient complains about. This includes multiple magnetic resonance imaging (MRI), latency test (Evoked Potential), and spinal fluid analysis.
The criteria by which MS is diagnosed
Diagnosis of multiple sclerosis The doctor should:
He finds evidence of injury in two separate areas, in the central nervous system that includes the brain, spinal cord, and optic nerves.
There is evidence to suggest that the damage to each area occurred during periods of at least one month.
Exclude all other possible diseases.
In 2001, the International Committee on the Diagnosis of Sclerosis updated the diagnostic criteria to include criteria for the use of magnetic resonance imaging (MRI), testing the latent inducement of the optic nerve (VEP), and analysis of cerebrospinal fluid to accelerate the stage of diagnosis. These tests are used to look for a second area where CNS damage has occurred in a person who has had a single attack associated with multiple sclerosis called clinically-isolated syndrome (CIS). Note that a patient with this syndrome (CIS) it is possible to develop multiple sclerosis.
In 2005, the previous standards, now called The Revised McDonald Criteria, were revised to make diagnosis easier and more efficient.
Means used to diagnose multiple sclerosis
Pathological history and clinical examination of the nervous system
The doctor records the patient’s medical history accurately so that he or she can identify any symptoms that the person has felt or felt in the past, which may be the result of multiple sclerosis and also to collect information regarding the place of birth of the person, family history, and areas that traveled to the doctor, which may provide It needs evidence to diagnose the disease.
The doctor also evaluates mental, emotional, and ability to speak properly, as well as movement, coordination, balance, vision, and the other four senses.
In many cases, the patient’s history and clinical examination provide evidence for diagnosis according to known criteria.
The remaining tests are performed to confirm the diagnosis or to provide additional evidence if necessary.
Magnetic resonance imaging (MRI)
Magnetic resonance imaging (MRI) is the best imaging technique to detect MS-associated spots, also called white spots, scarring or lesions that are present in different parts of the central nervous system. Magnetic resonance can distinguish whether spots are old, new or active.
Magnetic resonance imaging alone cannot be relied solely on the diagnosis of MS, because other diseases also cause spots in the central nervous system similar to those caused by MS, and such spots may be found in people without any disease. Especially the elderly.
Although magnetic resonance imaging is a very useful tool in the diagnosis of multiple sclerosis, the fact that the results of magnetic imaging does not mean to exclude the incidence of multiple sclerosis completely, as about 5% of patients who are diagnosed with a sure MRI does not show any White spots at the beginning of the disease. However, the longer you do not detect spots in your brain or spinal cord with magnetic resonance (MRI), the more important it becomes to look for a diagnosis other than multiple sclerosis.
Optical nerve-induced latency test (VEP)
Evoked potential (EP) test is a record of the response of the electrical nervous system to the stimulation of certain sensory pathways (visual, auditory, or general sensation).
Since the destruction of myelin membrane is caused by slow response time, the induced latency test (EP) can sometimes prove scarring in the pathways of those nerves that do not appear during clinical neurological examinations.
Visual inducer latency test (VEP) is one of the most useful tests in confirming the diagnosis of multiple sclerosis.
Analysis of a sample of cerebrospinal fluid: –
Analysis of a sample of cerebrospinal fluid determines the level of immune proteins and reveals the presence of oligoclonal bands. These strips indicate an immune response within the central nervous system and because these strips are also found in the case of other diseases and are found in cerebrospinal fluid in about 90-95% of patients with multiple sclerosis. Because these strips are also found in the case of other diseases, they can not be relied upon as a proven proof of multiple sclerosis.
Blood tests:-
There is no definitive blood analysis to diagnose multiple sclerosis, but blood tests help to rule out other diseases that may cause symptoms similar to multiple sclerosis, such as Lyme disease, and a group of diseases called collagen-vascular diseases. As well as some rare genetic disorders, as well as HIV / AIDS.
Other diseases cause the loss of myelin, myelin.
It has myelins in the central nervous system
Although MS is the most common, there are other diseases that may cause the loss of myelin in the central nervous system, including: viral encephalitis, exposure to a high percentage of certain toxic substances in large quantities, severe lack of vitamin B12 (vitamin B12), diseases Autoimmune which leads to vasculitis, collagen-vascular diseases and some rare genetic disorders.
Loss of myelins in the central nervous system: –
Although MS is the most common, there are other diseases that may cause the loss of myelin in the central nervous system, including: viral encephalitis, exposure to a high percentage of certain toxic substances in large quantities, severe lack of vitamin B12 (vitamin B12), diseases Autoimmune which leads to vasculitis, collagen-vascular diseases and some rare genetic disorders.
Loss of myelin in the peripheral nervous system: –
The destruction or demise of myelin in the peripheral nervous system (which is the nerves outside the brain and spinal cord) occurs in Guillain-Barré Syndrome syndrome. After some injuries, the myelin membrane regenerates in the peripheral nervous system, restoring and recovering lost function.
Some cases of vandalism or myelin are not continuous, while others may be persistent and advanced.
A person may need careful and sometimes frequent examinations to determine an accurate diagnosis through possible causes of neurological symptoms.
Shaza Al – Otaibi from the Saudi MS Forum. عبدالرحمن الطحان Free Membership
This text has been translated with the official permission of: National MS Society