Psychiatry & Neurology | Neuromuscular Medicine Questions Multiple Sclerosis

How is multiple sclerosis detected?

I'm a 20 year old guy with a family history of multiple sclerosis. If I wanted to get tested for multiple sclerosis, how can I do that? Where do I start?

4 Answers

Psychiatry&Neurology|NeuromuscularMedicineMultipleSclerosis
Consult a Neurologist as a first step
The reassuring aspect is that multiple sclerosis is a disease requiring "a combination of multiple factors" to develop. Most often (more than 95%) of the time, patients diagnosed with MS will not transmit it to their children. We usually do not require a mandatory screening for children of MS patients, unless they present symptoms suggestive of the disease, as more than 95% of the children will never develop MS. The diagnosis is based on clinical symptoms of isolated neurologic deficits restricted in time (3 days-3 months) and space (lesions seen on the brain MRI). People need to be careful if they wish to do a brain MRI without any symptoms. First, without Sx MS is unlikely going to be diagnosed no matter the results of the MRI, and no treatment would be offered anyways if the person is asymptomatic. Secondly, if we do brain MRIs to everyone of the population, most people present some variants of the normal, from birth, migraine, or due to deep small vessels that reorganize, so most totally healthy persons will have a little dot somewhere without significance. I suggest to express the concerns to the family physician, but to proceed with complete investigation only if there is clinically a legitimate reason to suspect new symptoms related to MS.
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Multiple sclerosis is a disease that is considered once the patient presents with symptoms. Although MRI of the central nervous system is important to the diagnosis, symptoms are even more important. If you don't have any symptoms, then my recommendation would be not to pursue any investigations.
Multiple sclerosis by definition is diagnosed by lesions in MRI separated by time and space. Though it may run in families, pre-symptomatic screening MRI is not recommended.