This article discusses the role of blood tests in the diagnosis of MS.
Early Symptoms of MS
As with most autoimmune illnesses, the symptoms of MS and their severity vary from person to person. It’s important to note that not everyone with MS will experience the same initial symptoms, and symptoms may vary and cluster together differently.
For many people with MS, visual changes are the first symptom experienced, the most common of which is optic neuritis (ON).
Optic neuritis is the sudden inflammatory demyelination, or myelin damage, of the optic nerve in the eye. Commonly seen in younger females, ON presents as sudden, painful, one-sided vision loss without any other neurological symptoms.
It is usually treated with corticosteroid drugs. People living with ON should be monitored for development of MS.
In addition to optic neuritis, other commonly experienced early symptoms of MS may include:
Extreme fatigue Numbness and tingling sensations Weakness Tremors Dizziness Paralysis Bladder and bowel dysfunction Cognitive changes
Another common early symptom of MS is dysesthesia, commonly referred to as the “MS hug.” With this symptom, you would feel a squeezing, banding, tightening sensation of the torso, much like a blood pressure cuff which is tightened too much. These associated symptoms often mimic those of a heart or panic attack.
Tests and MS Diagnosis
In 2017, the McDonald Criteria used to determine an MS diagnosis were revised to offer more specific guidance and to avoid misdiagnosis of the disease.
The McDonald Criteria combines information about your symptoms with magnetic resonance imaging (MRI) and cerebrospinal fluid (CSF) findings.
In addition to imaging, neurologic testing, and spinal fluid analysis, lab work and a thorough medical history are also important to help rule in or rule out the diagnosis of MS.
Blood Testing
There is no specific blood test available to determine if a person has MS or not. However, extensive blood work is necessary to help rule out other conditions that can mimic multiple sclerosis.
Diseases which resemble MS and can be ruled out by a thorough history and specific blood tests include, but are not limited to:
Lupus Sjogren’s syndrome Lyme disease HIV Antiphospholipid syndrome B12 or copper deficiency Sarcoidosis
In order to correctly diagnose MS, all other possible diagnoses must be ruled out. For this reason, blood testing plays an important role in the proper diagnosis of MS.
Medical History
A thorough medical history combined with a neurologic exam may provide enough information to suspect MS. Your history will provide information and necessary details on possible past “attacks” or symptoms. It also provides information on your birth location and the geographical region where you were raised.
MRI
Magnetic resonance imaging (MRI) uses magnetic waves to produce images of various parts of the body. For diagnostic use in MS, MRIs of the brain and spinal cord can provide findings consistent with MS.
MRIs of the brain can demonstrate characteristic white matter lesions, while MRIs of the spinal cord and associated nerves can show myelin damage. After diagnosis, repeat MRIs can help to monitor the progression of MS.
Lumbar Puncture
Cerebrospinal fluid (CSF) surrounds the brain and spinal cord and helps to provide them with adequate nourishment. CSF also filters and helps remove toxins from the brain and other sensitive areas within the CNS. When demyelination occurs, certain types of proteins get released into the CSF and accumulate.
A lumbar puncture, or spinal tap, is a procedure performed to try and extract CSF for analysis. Common CSF findings in people with MS include a high level of oligoclonal bands. Oligoclonal bands indicate an increase in autoimmune activity.
Evoked Potentials
Evoked potentials (EPs) are a type of neurological testing which evaluates how quickly nerve signals can communicate with each other. These tests also measure how large or small of a response the nerve signals may produce.
Since these nerve signals are disrupted in people with MS, the EP findings may be a way to predict disease progression and identify individuals who may be candidates for clinical trials. More research is still needed in this area to truly assess the role of EP testing in the diagnosis of MS.
Next Steps
As with any diagnosis, MS treatment can be tricky. Finding the right regimen may take time. Working with an MS specialist can help tailor treatment to your individual case. Just as symptoms vary from person to person, so do treatment plans.
Additionally, seeking support from local groups or foundations like the National Multiple Sclerosis Society is key to long-term treatment and success.
Disease-modifying therapies (DMTs), physical therapy, good sleep hygiene, and a healthy diet can also help you to manage symptoms.
Summary
MS is an autoimmune disease which attacks the body’s central nervous system. It leads to symptoms such as visual changes, weakness, fatigue, cognitive impairment, and more. Symptoms vary by individual.
Through a thorough medical history, neurologic examination, specific blood testing, and MRI imaging, providers can diagnose MS and develop effective treatment plans to manage symptoms and prevent future attacks.
There is no specific blood test to diagnose MS directly, but lab work plays a critical role in ruling out other diseases that may mimic MS.
A Word From Verywell
If you or someone you know is experiencing symptoms of MS, contact your healthcare provider as soon as you can. Quick and early diagnosis of MS can lead to a better prognosis. Many MS treatments are available to help you live well with the disease.
