Specialists to See for Diagnosis
As an MS patient, you will work with a neurologist, a doctor who specializes in diagnosing and caring for people with disorders of the nervous system, to find out if you have MS and to determine the best management strategy for your course of the disease. A neurologist is specially trained to evaluate different areas of evidence to arrive at a diagnosis of MS. However, in certain cases, it can take time to determine whether you have the disease because a diagnosis requires evidence of multiple attacks/exacerbations or evidence of a steady progression of neurologic damage.
Diagnostic tools your neurologist will use
A diagnosis of MS is called a clinical diagnosis because it requires evidence that your neurologist gathers from your medical history, your present symptoms, results from a thorough neurologic examination, as well as findings from other special tests including magnetic resonance imaging (MRI), evoked potentials, and cerebrospinal fluid (CSF) analysis. Among different medical specialties, only neurologists are trained to gather and evaluate these different threads of evidence. As an MS patient, it is important to find a neurologist who has additional training and expertise in treating MS.
Medical history. Most likely you are initially referred to a neurologist because you have experienced symptoms that suggest something may be going wrong with your CNS. The first thing your neurologist will do is to take a thorough medical history. He or she will ask you to bring your complete medical records and the results from any relevant tests that you have had taken. Your neurologist will inquire about the symptoms that you’ve recently experienced, as well as symptoms that you experienced in the past. Additionally, he or she will ask about your general health, your family history of health problems, and where you’ve traveled recently, as well as lifestyle issues, such as whether you smoke, drink alcohol, or use recreational drugs. All of the questions and data that are part of the medical history will allow your neurologist to piece together the puzzle of what may be going on inside your body.
Neurologic exam. The next important step will be a thorough neurologic examination. Your neurologist is specially trained to evaluate your neurologic function and will use different techniques to assess how well your nerves function. He or she will assess your cranial nerves, including optic nerves. The nerves that control major muscles will be assessed during walking tests and strength tests requiring you to push against resistance. Additionally, your neurologist will test your reflexes and ability to feel sensations in different areas of your body. All of the individual parts of the neurologic exam will give the neurologist a picture of the health and function of your central nervous system.
Medical tests. Finally, your neurologist will use a number of different medical tests to look for signs of neurologic problems. These may include magnetic resonance imaging (MRI) and/or a series of neurologic tests called evoked potentials that measure the response of the CNS when different nerve pathways, including the visual, auditory, and sensory pathways, are stimulated. Your neurologist may also use a procedure called a lumbar puncture to take a sample of cerebrospinal fluid (CSF) for analysis to detect evidence of MS. Further tests may include blood work to look for other possible causes of your symptoms.