Who diagnoses multiple sclerosis?

If you feel you’re experiencing symptoms that are associated with multiple sclerosis (MS) then you should book an appointment with your GP.

Initially, the GP will ask you about what symptoms you’ve been experiencing. There are several MS symptoms that present in patients, but some are more common than others. These can include but are not limited to the following.

• Fatigue
• Numbness and tingling
• Stiffness and spasms
• Pain
• Bladder and bowel control issues
• Memory and cognition
• Vision
• Tremor
• Loss of balance

If they believe you are experiencing any or some of these then you should speak with your doctor and they will most likely go through some tests for a deeper look into what is happening.

The initial tests carried out

MS can be tricky to diagnose because many of the symptoms can be mistaken for other conditions. First of all your GP will want to test and rule out some of those other conditions, such as vitamin B12 deficiency and migraines to name a few.

Below is a list of tests they might conduct to rule out some of the conditions mentioned above.

• A full blood count
• Inflammatory marker test
• Liver function tests
• Renal function tests
• Thyroid function tests
• Vitamin deficiency tests
• Glucose and Calcium checks

If after conducting these tests your GP is not satisfied they have found a cause of your symptoms they will then refer you to a neurologist.

Who can diagnose MS?

Only a neurologist has the authority to officially diagnose multiple sclerosis should the tests they perform come back positive.

The steps to diagnosis

Your neurologist will begin by conducting a full medical examination to rule out anything else that could cause MS-like symptoms such as numbness. From here, you’ll go through some simple checks for movement, coordination, balance, reflexes and sensory compliance – the aim here is to see if there are obvious signs of inflammation.

If signs of inflammation are evident from these simple tests your neurologist will move on to more in-depth measures. Your neurologist will be on the lookout for lesions in the brain and spinal cord, as well as scarring to the myelin sheath.

These tests include

MRI Scans

An imaging technique which uses magnets to create an image of a patient’s brain and spinal cord. A neurologist will be looking out for lesions and scarring to identify if MS is present in your body.

Lumbar puncture

This is the process of extracting cerebrospinal fluid (CSF) from the body for analysis. The fluid will show evidence of any abnormalities that could indicate MS such as oligoclonal bands (OCBs) – they often hint at the presence of inflammation in the body.

Evoked potentials

This is a simple electrical test that measures how long it takes for your nerves to react to stimuli. Electrodes are attached to the scalp and visuals such as strobe lighting and checkerboard patterns are shown to you. This test measures how long it takes for nerve impulses to reach the optical region and is over fairly quickly (30 – 45 minutes).

What you should do in your diagnosis journey

Being diagnosed with multiple sclerosis can be a daunting and frightening time, and so there are things that people often forget or are unaware of.

Firstly, it is important to know that the diagnosis process can sometimes be a long one – so you’ll need to be patient. It is very frustrating but necessary. It is good to speak to someone about how you’re feeling during this uncertain time. MS-UK’s Helpline is available to provide information and emotional support in situations just like this, so do pick up the phone and call 0800 783 0518, Monday-Friday, 10am-4pm.

When you have appointments, it’s a good idea to write down what questions you have so that you don’t forget to ask them. With loads of information from a neurologist coming your way, in addition to how daunting it is, you can easily become overwhelmed and just forget to ask them. Don’t forget you can always bring someone along with you, like a family member or a friend, for support in appointments. They will be less likely to forget about these important questions.

Lastly, it’s a good idea to record your experiences with symptoms and pain so you can take it with you to your appointments. It makes it a lot easier to explain what you’re experiencing without forgetting crucial parts as well as your thoughts and feelings and helps your neurologist understand how you are being affected.

You can find these resources linked below in addition to our deep dive into the whole diagnosis process by reading our dedicated Diagnosis Choices booklet.