To determine if a person meets the criteria for a diagnosis of multiple sclerosis and to rule out the possibility of other causes and symptoms that the person is experiencing, several strategies have to be used. These strategies include a careful study of medical history, evoked potentials and spinal fluid analysis, a neurologic exam and various tests including magnetic resonance imaging (MRI). As there are no symptoms in the early stages, physical findings and laboratory tests determine if a person has multiple sclerosis.

The main criteria for a diagnosis of multiple sclerosis are damage in the central nervous system, in at least two separate areas. It includes the brain, spinal cord, and optic nerve. Evidence that damage had occurred at different points in time has to be found. This would rule out all another possible diagnosis.

Guidelines have been specified for using MRI and cerebrospinal fluid analysis to speed up the diagnostic process, by the International Panel on MS Diagnosis. When a person experiences an MS-like symptom (clinically-isolated syndrome) and has one attack, also called relapse, an MRI is used to look for a second area of damage. The MRI is used to confirm that damage has occurred in two different points in time. In some cases instead of dissemination, the presence of oligoclonal bands in a person’s cerebrospinal fluid is used to analyze and confirm the multiple sclerosis diagnosis.

In many cases, the person’s medical history and neurologic exam give enough proof to meet the diagnostic criteria. A variety of tests to evaluate emotional, mental, and language functions, coordination, and movement, vision and balance are done. Though there is no blood test to confirm MS, they are done to rule out other conditions that could cause similar symptoms. Some rare hereditary disorders, Lyme disease, collagen-vascular diseases, and AIDS could have a few symptoms that are similar to that of MS and as an abundant precaution; blood tests will be done to rule out these conditions.

Treatment
To slow down the progression of multiple sclerosis and help with symptoms, medication to suppress the immune system and physiotherapy are used.

Medications

• Immunosuppressive drugs
• Anti-inflammatory drugs
• Steroids
• Chemotherapy

Therapies

• Physical therapy
• Acupuncture
• Counseling
• Support group

Self-care

• Physical exercise

Specialists to treat MS

• Neurologist
• Clinical psychologist
• Physiotherapist
• Speech therapist
• Occupational therapist
• Primary care provider

As there is no cure for multiple sclerosis, treatment focuses on quick recovery from attacks, slowing down the progression and managing the symptoms of MS. Some people usually have mild symptoms which do not need treatment. Most of the immune response associated with multiple sclerosis usually occurs in the early stages. Aggressive treatment given as early as possible lowers the rate of relapse and also slows the formation of new lesions.

There are significant health risks in the use of disease-modifying therapies to treat MS. The choice of the right therapy depends on careful consideration of many factors such as the duration and severity of the disease effects of previous treatment, cost of the treatment, other health issues and also childbearing status.