Why is MS Often So Difficult to Diagnose?

Jul 26, 2017 2 min

MS can be difficult to diagnose because the symptoms can be easy to ignore or put down to another condition, and because there’s no single test that can diagnose it.

What is multiple sclerosis?

Multiple sclerosis, or MS, causes the brain to degenerate over time. It’s characterised by damaged areas (lesions) on the brain and spinal cord. MS causes, among other things, muscle spasms, problems with thinking and learning, and mobility problems.

Why is MS often difficult to diagnose?

The symptoms of MS are varied. Not every patient will experience them all, and most will experience them differently. Many of the symptoms are also easy to dismiss or to put down to something else, which can make early diagnosis difficult. The most common symptoms are:

  • Fatigue
  • Problems with sight
  • Trouble with balance and dizziness
  • Numbness and tingling
  • Muscle spasms, stiffness and weakness
  • Problems when thinking or planning
  • Sexual problems
  • Bladder problems
  • Bowel problems
  • Problems with speech and swallowing

For more information on each, see What Are MS Symptoms?

For more information about multiple sclerosis in general, see MS: A Deeper Dive

The diagnostic process

Although multiple sclerosis is the most common culprit, other conditions can cause the same symptoms. A diagnosis of MS, therefore requires first ruling out the possibility of:

  • A viral infection
  • Side effects from toxic materials, which can cause similar effects:
    • Lead
    • Lysolecithin
    • Organotin
    • Hexachlorophene
    • Tellurium
  • Vitamin B12 deficiency – which can cause pins and needles, changes in walking and movement, vision impairments, decline in mental abilities
  • Other autoimmune conditions
  • Hereditary disorders
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Repeated examinations may be needed to come to an exact diagnosis or to confirm the cause.

As is the case with many neurological conditions (see Parkinson’s: a deeper dive) there are currently no singular symptoms, findings or tests that can definitively confirm the presence of multiple sclerosis. For this reason, multiple strategies are adopted to determine if a person meets the criteria for MS. These include:

  • Medical history
  • Neurological examination – assessment of sensory and motor responses, especially reflexes
  • MRI scan
  • EPs or Evoked Potentials – these tests are used to detect slowing of neurological responses, and there are 3 different types:
    • Visual Evoked Potentials – the patient sits in front of a screen and looks at changing checkerboard patterns
    • Brainstem Auditory Evoked Potentials – the patient listens to a series of clicks in each ear
    • Sensory Evoked Potentials – electrical impulses applied to an arm or leg
  • Spinal fluid analysis – measurement of chemicals in the fluid surrounding the brain and spinal cord

These will reveal evidence, which taken as a whole may enable a diagnosis. This evidence must include:

  1. Damage in 2 or more separate areas of the central nervous system
  2. Evidence that the damage occurred more than 1 month apart
  3. Negative diagnosis for all other possible causes

Caring for someone with Multiple sclerosis

Caring for a loved one is rewarding, but it can also be immensely stressful. Multiple sclerosis is a degenerative disease, so the care required will become more demanding as time goes by.

If your loved one’s MS becomes ‘advanced’, they will be entirely dependent on a carer for their personal care. At this time it’s likely that their clinical needs will be complex and they will need to be supervised most if not all of the time.

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If you are caring for someone with MS, HomeTouch can help. Simply search by postcode and browse the profiles of self-employed carers near you. All of the carers on our site have gone through a thorough 42-point vetting process, and only 5% are accepted. You choose the carer you want to work with, and we provide support with contracts, payments, and holiday and sickness cover.

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