Diagnosing multiple sclerosis is complicated. If you’ve received an MS diagnosis, getting another opinion from a specialist might help.
You’ve experienced some neurological symptoms — numbness, vision changes, balance issues or difficulty walking — and therefore consulted your primary care provider or neurologist. After an abnormal MRI, you received a diagnosis of multiple sclerosis (MS).
What’s next?
Patients should understand that there is no single test that alone provides a diagnosis of MS, said Dr. Olivia Gruder, a neurologist with the Vanderbilt Multiple Sclerosis Center. “Diagnosing MS requires a combination of tests, including spinal fluid analysis, MRI results, a thorough neurological examination and a clinical history that aligns with the condition.”
Is it possible to receive an incorrect MS diagnosis?
“Receiving an incorrect diagnosis of MS is fairly common”, Gruder said. One study found that among people referred to a multiple sclerosis specialty care center, 30% to 67% were later diagnosed with something else instead.
It’s easy to mistake symptoms of other illnesses for those of multiple sclerosis. “Fatigue, headaches and weakness are common with MS,” Gruder said, “but these symptoms are also seen in many other conditions.” People who mistakenly receive a diagnosis of MS could possibly be treated for it for many years, in ways that are inappropriate for the condition they actually have. That’s why it’s critical to be seen by exerts in multiple sclerosis.
Understanding how MS is diagnosed
People with MS have various neurological symptoms and their MRI imaging often shows white spots on the brain or spinal cord. “While MRI is essential for seeing evidence of this illness, other findings also carry weight in the diagnosis,” Gruder said.
Specialists will take a comprehensive medical history, and develop an understanding of the timing and source of symptoms. A thorough neurologic exam will be done, and additional blood work or a spinal tap may be needed on a case-by-case basis.
With this data, your neurologist should be able to confirm the MS diagnosis or suggest another cause for your symptoms. Once a diagnosis has been made, individualized treatment plans can be explored.
What a multiple sclerosis center offers
At a comprehensive multiple sclerosis center, patients have access to specialized neurologists who are experts in other autoimmune neurological diseases that may be mistaken for MS. Patients can be referred to other specialists through the health care system, if needed, to address more complex problems with memory, bladder function, mood or other problems. Any necessary lab tests can be done in the clinic. There are opportunities for lumbar punctures to be done in the clinic or the hospital nearby. So can treatments such as steroid infusions and long-term medications that are delivered through IV.
If a patient has already received a diagnosis and has recent MRI images available to review for a second opinion, the team can often confirm that diagnosis and create a treatment plan during the first visit. If the diagnosis is new, the team may spend the initial days helping the patient understand multiple sclerosis in more detail, explaining symptoms, connecting the patient with resources, exploring lifestyle changes that could help with symptoms and setting up a later visit to review medication.
How to prepare for your first appointment
Before your appointment, be sure to obtain a copy of your MRI images on a CD. Bring that and paper copies of your blood test and spinal fluid testing to your office visit when seeking a second opinion. “It’s also helpful to have a simple timeline of symptoms and a list of your most important questions and concerns,” Gruder said.
The Multiple Sclerosis Center at Vanderbilt University Medical Center evaluates and treats adults and children with multiple sclerosis and similar conditions.
