Diagnosis & Types of MS

How is MS Diagnosed?

Ideally, a neurologist or specialist physician should confirm a diagnosis of MS. The basis of that remains a careful neurological assessment, including analysis of symptoms and a physical examination. It depends on the demonstration of typical features and exclusion of other disorders that may produce similar symptoms.

Diagnostic tests have an important role and include:

• Magnetic Resonance Imaging (MRI)—this is scanning of the brain and spinal cord. MRI has been a major advance in the diagnosis of MS, but the changes seen are not always specific for MS and age-related changes may cause confusion.
• Lumbar Puncture to examine the cerebrospinal fluid (CSF).
• Evoked Potentials—these measure electrical conduction through CNS pathways but are not commonly used now that MRI is widely available.

What are the Types of MS?

In general three typical patterns of MS can be recognised:

• Relapsing-remitting MS—relapses with a flare up of old symptoms or the development of new ones (over several days or weeks) are followed by a remission with resolution or reduction of symptoms.
• Secondary-progressive MS—after an initial course of relapsing/remitting MS, there is the development of slowly progressive disability (over several years). In this phase relapses may also still occur.
• Primary-progressive MS—in about 10% of cases, right from the beginning there is slow progressive worsening of symptoms and disability without distinct attacks.