Although there are tests that can be performed for helping to diagnose Multiple Sclerosis, it is not necessarily an easy task, when it comes to actually diagnosing Multiple Sclerosis.

Since Multiple Sclerosis can include any combination of a broad range of symptoms, it can sometimes be difficult for doctors to determine if a person has Multiple Sclerosis or some other disease, which can cause the symptoms that the patient is experiencing.

Other conditions that can mimic the symptoms that are often associated with Multiple Sclerosis can include Lyme disease, or some less common nerve disorders.

The initial symptoms of Multiple Sclerosis can vary from mild to severe and can come and go over a period of time, typically for 2 to 5 years, before it can be determined if indeed Multiple Sclerosis is present for creating the symptoms that are being observed.

Before tests are performed to determine if Multiple Sclerosis is present, the doctor usually asks a series of questions of the person experiencing a group of symptoms that appear to be nerve-related in nature.

Once the initial information is gathered, the doctor usually tests a series of responses of the person’s body. This can include testing the reflexes, checking person’s balance, ability to stand, or ability to walk, test the degree of numbness and how widespread it is, check for unexplained nerve pain, and gather more information from the patient of any odd symptoms that they may be experiencing that can help in determining if the characteristic MS symptoms are present to suggest further testing is required.

Tests that can used to diagnose Multiple Sclerosis can include the following:

*  Pin-prick test - this determines the degree of MS numbness that the person appears to be having problems with.

* MS MRI tests -- Magnetic Imaging Resonance or MRI tests uses magnetic fields to perform tests at a deeper level, as far as bone, nerve, muscle and other tissue damage to the body. 

This type of test involves inserting the patient, either partially or totally into a tube like device that can scan the whole body or any part of the body and produce pictures or films of what is detected inside of the body.

In most cases of Multiple sclerosis, the MS attacks the central nervous system or in nerves throughout the body result in scarring, that can be detected by the MRI tests and shown on the films that are a result of this type of testing. MRI testing can be done on the brain, as well as the spine, for helping to determine if Multiple Sclerosis is present.

Demyelination of the spinal cord and throughout different areas the brain can be detected and shown by scarring on the spinal cord or lesions in the brain by performing this type of test. Often the MRI tests are used more widely to diagnose Multiple Sclerosis, along with clinical evaluation of the symptoms that the patient is experiencing.

* Sensory Test - this MS test has been used in the past to determine if there is damage to the retinal nerve to determine if damage to the retinal nerve can be causing MS eye or MS vision problems, including problems seeing (blurriness, problems focusing, seeing double, dimness of vision, fuzzy vision or out of focus vision), loss of vision or eye pain.

In the past this test was performed by sitting the person in front of a computer screen, while flashing patterns and different intensity colors on the screen to stimulate the retinal nerve and determine the response of the optic nerves to light stimulation.A special pair of glasses with sensors on it are worn and patterns, colors and light of different intensity is flashed on the computer screen. 

The sensors measured the response of the eyes to the stimulation and it was used to determine what degree of damage there was to the retinal nerve.  This test isn't used quite as often as it was in the past, since more advanced testing techniques have been developed over the last 10 to 15 years. 

* Spinal Fluid Analysis - a sample of spinal fluid is drawn from the base of the spine and analyzed for certain protein markers.  This used to be the only way to diagnose Multiple Sclerosis before he invention of the MRI or magnetic imaging resonance testing was available.

The MRI tests have become more often used to diagnose Multiple Sclerosis, but there are other ways that continue to be developed and tested through doing clinical trials and clinical studies to determine what may help to make it easier to diagnose Multiple Sclerosis.

If there is not as many clearly defined symptoms and scarring seen on the MRI tests to make a more definitive diagnosis of Multiple Sclerosis, to avoid the confusion between the MS and Lyme disease diagnoses, the spinal Tap or Spinal Fluid analysis test is used to tell the difference between Lyme disease and Multiple Sclerosis diseases, since at times these 2 diseases can have some similar symptoms in common that can make it more difficult to determine the correct diagnosis.  In the case of presence of Multiple Sclerosis the protein markers that are present in the spinal fluid are not present if Lyme disease is present instead of Multiple Sclerosis.

* Retinal Scan or OCT scan -- this test is performed using a device called an Optical Coherence Tomography or OCT for short.

This is a computerized imaging technique that uses laser light to make a 3-D image of the retina to make it possible to scan the layers of the nerve fibers of the retina in the back of the eye.  It is a simple test to perform.

The OPC test involves first dilating the pupils of the eyes.  Next, pictures using a special type of camera are taken, which allow 3D pictures of the structures inside the eye and in the brain to be taken.  These pictures allow the doctor to determine how much brain shrinkage and brain scarring is visible.  The pictures also allow the doctor a way to examine the eyes and the retinal nerves in one or both eyes.

This OPC test can help the doctor to determine if Multiple Sclerosis is present by the degree of brain shrinkage or by the brain lesions that are typically present in the majority of cases of Multiple Sclerosis.  The OPC test is much easier to do and requires much less time to perform the test, as compared to using the MRI tests as a method of diagnosing Multiple Sclerosis.

Being able to examine the brain is this way helps the doctor to determine more about what health conditions may be present that are causing the symptoms that are being experienced by the patient, including the presence of Multiple Sclerosis.

OCT provides remarkably detailed information about the retina and allows doctors to "see" abnormalities that are not apparent on regular clinical examination.  It is particularly useful in certain diseases of the macular and in glaucoma and to diagnose Multiple Sclerosis, by determining if the characteristic traits of Multiple Sclerosis are present.

In 2007, a study was conducted with 40 MS patients at John Hopkins University using OCT with very encouraging results being seen.  Peter Calabresi, M.D. was the lead author of the study, which appeared in the October 2007 issue of Neurology.

Further tests run with the OCT have brought conclusions that the MRI test is an imperfect tool that measures the result of many types of tissue loss rather than specifically nerve damage itself.

With OCT we can see exactly how healthy these nerves are, potentially in advance of other symptoms. This exam and test can also be used to determine what degree of damage there is to the retinal nerve. 

The retinal nerve fiber layer is the one part of the brain where nerve cells are not covered
with the fat and protein sheathing called myelin, making this assessment specific for nerve damage as opposed to brain MRI changes, which reflect an array of different types of tissue processes in the MS brain

Testing the Brain for MS Lesions

The brain can be tested in more than one way using either MRI tests or using the OPC test.

A brain MRI can be performed using a standard MRI test or a newer test can be performed
that is less invasive and doesn't take as long
to perform as an MRI test can take.  In addition the newer test is also cheaper to perform,
while providing a in depth examination of the brain and the retina at the same time.

In the past. the 2 main tests used to diagnose Multiple Sclerosis were MRI tests and spinal tap, where a sample of spinal fluid was taken from the base of the spine, but that may change, since more doctors are starting to switch to using the OCT test.  Since this is a newer test, the OCT test is not as widely used as a diagnostic tool in diagnosing Multiple Sclerosis.

If the new testing method of OCT becomes more widely used in the future, this may make it easier to diagnose Multiple Sclerosis and
give the doctors so much more detailed information on which parts of the body of each MS patient have been damaged because
of the results of attacks of Multiple Sclerosis
on the body.