General
Multiple sclerosis (MS) can manifest itself in many different ways. This is because the inflammation and breakdown of myelin sheaths can affect different parts of the central nervous system. The first signs are therefore often different, which can often make an early diagnosis difficult.
Anamnesis and physical examination
Diagnosis usually begins when the patient has recognized one or more of the early symptoms and consults the family doctor. The doctor must first take the patient’s medical history by asking specific questions (anamnesis). Here it is important to find out when the symptoms were first noticed and to tell the patient about other early signs that he or she has not associated with the disease himself or herself.
For example, the patient may have been unable to concentrate properly for a long time, but this may have been due to other causes. The possible occurrence of autoimmune diseases in the family must also be investigated. This is followed by a physical examination in which various neurological aspects are examined.
These include vision, attention and concentration, which can be checked by means of various standardized tests. Skin sensitivity and reflexes are also tested. Through these tests, other diseases with similar symptoms can be detected or excluded. If the presence of multiple sclerosis is suspected, further examinations must be carried out. These include a blood test, imaging procedures (for example, magnetic resonance imaging (MRI)), measurement of brain activity (electroencephalogram, EEG), measurement of nerve conduction velocity using evoked potentials, and possibly examination of cerebrospinal fluid (liquor puncture).
Examination of the blood
If multiple sclerosis is suspected, a blood test should be performed mainly to rule out other diseases. There is no blood test available that can detect MS. As a rule, a large blood count is made as part of the blood test. Liver and kidney values, as well as thyroid function, blood sugar, vitamin B12, rheumatoid factor, inflammation markers and other values indicating certain diseases are determined. As a rule, however, most values are unchanged in patients with multiple sclerosis.
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