Multiple Sclerosis Diagnosis

Multiple sclerosis is a chronic autoimmune disease characterized by multiple demyelinating lesions of the central nervous system. Its pathogenesis is complex, often involving the brain, spinal cord, and optic nerves. The disease primarily occurs in young adults aged 20 to 40. Early manifestations are subtle and symptoms fluctuate significantly, making it prone to misdiagnosis or missed diagnosis. Without timely confirmation and intervention, the disease may relapse repeatedly, gradually worsening and leading to irreversible neurological damage. Therefore, a rigorous and scientific diagnostic process is key to formulating an effective treatment plan.

Diagnostic Basis

1. Clinical manifestations and medical history review

Clinicians first conduct a detailed inquiry into the patient’s medical history, symptom onset time, duration, and remission patterns to assess whether “time and space distribution” characteristics exist—neurological dysfunction occurring at different times and in different locations. Typical manifestations include blurred vision, limb numbness, fatigue, and unsteady gait, recurring intermittently.

2. Neurological physical examination

Through physical examination, doctors may detect neurological signs such as hyperreflexia, abnormal muscle tone, ataxia, and nystagmus, which help in the preliminary judgment of central nervous system involvement and lesion location.

3. Magnetic Resonance Imaging (MRI)

MRI is one of the most sensitive methods for diagnosing multiple sclerosis, capable of clearly showing typical demyelinating lesions in the brain and spinal cord. Contrast-enhanced scans, in particular, can reveal new lesions, helping determine disease activity and progression trends.

4. Cerebrospinal fluid (CSF) examination

Lumbar puncture is used to obtain CSF for testing oligoclonal bands (OCB) and immunoglobulin index, which can support diagnosis. The presence of positive oligoclonal bands suggests a chronic inflammatory process in the central nervous system.

5. Evoked potential tests

Visual, auditory, or somatosensory evoked potential tests can help evaluate nerve conduction function and detect asymptomatic lesions. These tests are especially important for patients with mild symptoms suspected of multiple sclerosis.

6. Differential diagnosis

Because multiple sclerosis symptoms vary, it must be distinguished from stroke, encephalitis, neuromyelitis optica, systemic lupus erythematosus, and other neurological or immune diseases. Accurate differentiation prevents misdiagnosis and inappropriate treatment.

7. Diagnostic criteria references

Internationally, the McDonald diagnostic criteria are commonly used, combining clinical presentation with imaging, biochemical, and electrophysiological results. This standard has been continuously updated in recent years, placing more emphasis on early detection and lesion distribution characteristics.

8. Multidisciplinary consultation for auxiliary evaluation

For complex or relapsing cases, multidisciplinary consultations involving neurology, radiology, and immunology can help confirm diagnosis and guide subsequent treatment strategies.

Conclusion

The diagnostic process of multiple sclerosis must be rigorous and scientific, as any delay may worsen neurological damage. Experts at United Life International Medical Center point out that combining imaging, laboratory, and electrophysiological tests in the early stage enables efficient diagnosis and secures a better treatment window for patients.