Multiple sclerosis (MS) is a complex autoimmune disorder that affects the central nervous system (CNS). It is characterized by a wide range of symptoms that can vary in severity and duration from patient to patient, making it difficult to diagnose. There are also no specific tests that can diagnose MS.
Instead, doctors use a combination of tests and assessments to evaluate symptoms and rule out other conditions.
One of the primary challenges of diagnosing MS is that there is no single test that can confirm it. Instead, doctors use a combination of tools such as MRI scans, spinal fluid analysis, visual and evoked potential tests, and neurological assessments to look for signs of damage to the CNS. However, these tests alone are not definitive, as other conditions such as migraines, infections, or brain tumors can also cause similar symptoms.
Another issue is that MS symptoms can be vague and nonspecific, which can lead to misdiagnosis or delayed diagnosis. Symptoms such as fatigue, numbness or tingling, vision changes, dizziness or vertigo, and muscle weakness can be caused by a variety of conditions, making it difficult to pinpoint MS as the culprit.
Additionally, symptoms can vary widely between patients and can change over time, making it harder to establish a clear pattern or progression.
The onset of MS can also be subtle, and symptoms may be sporadic at first, making it challenging for patients and doctors to recognize the disease as a potential cause. Symptoms may also come and go, or they may be so mild that patients do not seek medical attention until the disease has progressed to a more severe stage.
Diagnosing MS requires a high degree of clinical suspicion, experience, and expertise. Patients with unexplained or persistent neurological symptoms should seek a referral to a neurologist who specializes in MS to receive a comprehensive evaluation and accurate diagnosis. Early detection is essential for initiating appropriate treatment and preventing or reducing long-term disability.
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Can you still have MS if all tests negative?
Yes, it is possible to still have multiple sclerosis (MS) even if all tests are negative. MS is a complex disease that is often difficult to diagnose and may require multiple tests over a period of time. While there are several diagnostic tools and tests that doctors use to diagnose MS, no single test can confirm the diagnosis conclusively in all individuals.
The diagnosis of MS is usually based on a combination of symptoms and diagnostic tests such as magnetic resonance imaging (MRI), cerebrospinal fluid (CSF) analysis, and neurological examinations. However, some individuals with MS may have a normal MRI or CSF analysis, and others may experience symptoms that are not characteristic of MS.
In these cases, making an accurate diagnosis can be extremely challenging.
It is also important to note that MS is a disease that can present a range of symptoms and may progress differently in each individual. While some may experience severe symptoms from the onset of the disease, others may exhibit mild symptoms that gradually worsen over time. Furthermore, symptoms may come and go, making it difficult to detect changes in the central nervous system that may be indicative of MS.
In addition to the challenges and limitations of the diagnostic tests used to diagnose MS, there are other factors that may contribute to a false negative diagnosis of MS. For example, some individuals may have other medical conditions that are similar to MS and may produce similar symptoms, but are not MS.
These conditions may need to be ruled out before a definitive MS diagnosis is made.
It is possible to still have MS even if all tests are negative. The diagnosis of MS is often based on a combination of symptoms and diagnostic tests, and no single test can confirm the diagnosis conclusively in all individuals. Additionally, some individuals may have other medical conditions that are similar to MS and may produce similar symptoms.
Therefore, a multidisciplinary team of healthcare professionals must collaborate to make an accurate diagnosis and develop an appropriate treatment plan for individuals with suspected or confirmed MS.
Can you have a clear MRI and still have MS?
Yes, it is possible to have a clear MRI and still have multiple sclerosis (MS). MS is a chronic autoimmune disease that affects the central nervous system (CNS), which includes the brain and spinal cord. It causes inflammation, damage and the formation of scar tissue (sclerosis) in the myelin sheath that covers and protects nerve cells.
This can lead to a range of symptoms, including vision problems, muscle weakness, balance issues and cognitive impairment.
MRI (magnetic resonance imaging) is a powerful diagnostic tool that uses strong magnets and radio waves to create detailed images of the body’s internal structures. It is often used to diagnose MS, as it can detect the presence of lesions or areas of active inflammation in the CNS. However, a clear or normal MRI does not necessarily rule out the possibility of MS.
In fact, up to 15-20% of people with MS may have normal MRI scans, particularly in the early stages of the disease. This is because not all MS lesions are visible on MRI, especially if they are small or located in areas that are difficult to image. Additionally, some people with MS may have lesions that do not show up on traditional MRI sequences.
In these cases, more sensitive MRI techniques, such as diffusion-weighted imaging (DWI), may be needed to detect MS-related changes in the CNS.
Other diagnostic tests, such as a lumbar puncture (spinal tap) or evoked potentials (tests that measure electrical activity in the brain in response to sensory stimuli), may also be used to help diagnose MS. However, a clear MRI scan should not be used to dismiss or discount the possibility of MS, especially if a person is experiencing symptoms that are consistent with the disease.
It is important to work with a healthcare provider who is knowledgeable about MS and who can help guide the diagnostic process.
Can you have MS with normal labs?
Yes, it is possible to have multiple sclerosis (MS) with normal laboratory test results. MS is a neurological disorder that affects the central nervous system (CNS) and occurs due to the damage to the myelin sheath, which surrounds and protects nerve fibers. The symptoms of MS vary widely and can include muscle weakness, cognitive impairment, fatigue, tremors, and vision problems, among others.
The diagnosis of MS is challenging, and doctors often use a combination of clinical symptoms, diagnostic imaging tests, and lab tests to identify the condition. However, there is no specific blood test or laboratory test that can diagnose MS conclusively. Therefore, a normal lab test result does not necessarily rule out the presence of MS in an individual.
Diagnostic imaging tests are often used to detect MS, and magnetic resonance imaging (MRI) is the most common technique used to visualize CNS lesions. However, not all MRI scans are definitive, and some individuals may have normal MRI findings despite having typical MS symptoms.
In some cases, doctors may use a lumbar puncture (LP) to collect cerebrospinal fluid (CSF) from the spinal canal. This procedure can help determine if there are any abnormalities in the immune system that may suggest MS. However, a normal LP result does not necessarily mean that MS is not present.
Another factor that can make diagnosing MS difficult is that the symptoms may come and go, or be triggered by various factors such as stress, fatigue, or temperature changes. As a result, some individuals may not experience symptoms or have abnormal test results during a clinical evaluation, but may still have MS.
While laboratory tests and diagnostic imaging studies are often an important part of diagnosing MS, a normal lab result does not rule out the presence of MS. Clinical symptoms, medical history, and diagnostic imaging studies may all be used in the diagnosis of MS, and doctors will take a comprehensive approach to determine the most appropriate diagnosis and treatment plan for each individual.
Can you have all the symptoms of MS and not have it?
Yes, it is possible to exhibit all of the symptoms of Multiple Sclerosis (MS) and not actually have the disease itself. MS is a chronic and unpredictable autoimmune condition that affects the central nervous system, including the brain and spinal cord. The symptoms of MS vary widely from person to person and can be similar to those of other medical conditions or diseases.
Some common symptoms of MS include muscle weakness, tremors, fatigue, problems with balance and coordination, vision problems, cognitive impairment, and difficulties with speech and swallowing.
There are several medical conditions that can mimic the symptoms of MS, including vitamin deficiencies, infections, brain or spinal cord tumors, and systemic lupus erythematosus (SLE). It is crucial for an accurate diagnosis of MS to exclude other potential causes or mimickers of the symptoms before coming to a conclusion.
A process of careful examination, selective history taking, and an array of medical investigations could provide insights into the cause behind the seemingly MS-like symptoms.
Moreover, MS can also present with asymptomatic phases or milder symptoms at the early stages when detected through clinical, radiographic or laboratory investigations. Such early stages of the disease can take years to progress into its clinical manifestation, making it even more challenging for the patient and the healthcare provider to reach a definitive diagnosis.
It is, therefore, vital to consult a healthcare professional if one experiences any symptoms of MS, undertake proper testing and examinations for an accurate diagnosis. A proper evaluation and early diagnosis can help improve the quality of life of the patient via early intervention with appropriate disease-modifying treatments, managing the underlying conditions mimicking MS, and providing appropriate symptomatic therapies to alleviate the suffering of the patient.
How do you rule out MS?
Multiple Sclerosis (MS) is a chronic and progressive autoimmune disease that affects the central nervous system. The medical community has not yet discovered a cure for MS, but early diagnosis and appropriate treatment can significantly improve patients’ quality of life and slow disease progression.
To rule out MS, healthcare professionals will typically follow a series of steps that include:
1. Comprehensive Medical History: The doctor will ask the patient about their symptoms, when they first started, and how often they occur. They will also inquire about any known genetic disease in the family and any previous illnesses or injuries. The patient’s medical history will help determine whether their symptoms are consistent with MS.
2. Physical Examination: The doctor will conduct a physical exam to assess reflexes, strength, balance, and coordination. This can include walking, standing, and sitting tests. During a neurological exam, the physician will test vision and evaluate the patient’s hearing to assess potential nerve damage.
3. Magnetic Resonance Imaging: MRI is a non-invasive and highly accurate test that allows the doctor to look for the presence of MS related changes in the patient’s brain and spinal cord. Lesions or areas of damage or inflammation will appear as bright spots on the scan. A spinal tap or lumbar puncture may also be performed to check for abnormal immune system activity and elevated levels of white blood cells.
4. Visual Evoked Potential: This test measures the electrical activity of the nerves that control vision. Patients will watch a series of black and white checks on a screen while electrodes placed on their scalp measure the response time of the signals from the eye to the brain. The test can determine if the person’s visual pathways are functioning correctly.
5. Blood Tests: The doctor may perform a series of blood tests to detect other conditions that cause similar symptoms to MS, such as Lyme disease or lupus. Blood tests can also rule out other potential underlying causes of nerve damage such as diabetes or low vitamin B12 levels.
In case a patient’s diagnostic work up indicates an ms diagnosis, ongoing monitoring and patients’ experiences and symptoms impact a physician’s decisions regarding medications and other therapies to control symptoms and slow disease progression. an accurate diagnosis helps healthcare professionals tailor treatment plans to individual patients’ needs and increase their chances of achieving the best possible outcomes.
Can a neurologist tell if you have MS?
Yes, a neurologist can detect if you have MS or not. Multiple Sclerosis (MS) is a chronic and progressive autoimmune disease that affects the central nervous system, leading to a deterioration of the myelin sheath that surrounds and protects the nerves in the brain and spinal cord. The typical symptoms of MS include difficulty with walking, vision problems, numbness, tingling, muscle weakness, and coordination issues.
Neurologists are specialists who primarily treat problems related to the nervous system, including the brain, spinal cord, and peripheral nerves. They are highly trained and experienced in diagnosing and treating neurological conditions such as MS.
To diagnose MS, a neurologist usually performs a series of tests and assessments to evaluate the patient’s neurological function. The neurologist will also review the patient’s medical history and symptoms to better understand the progression of the disease.
One of the most common tests performed is an MRI (magnetic resonance imaging) scan, which uses radio waves and magnets to create detailed images of the brain and spinal cord. If a patient has MS, the MRI will likely show damage to the myelin sheath surrounding the nerves.
In addition to an MRI, neurologists may also perform a spinal tap, or lumbar puncture. This involves inserting a thin needle into the lower back to collect a sample of cerebrospinal fluid (CSF), which surrounds the brain and spinal cord. The CSF is tested for the presence of certain antibodies and proteins that are associated with MS.
Other tests may include nerve function tests, such as an evoked potential test or electroencephalogram (EEG), which measure the electrical activity of the brain and nerve responses.
The diagnosis of MS is based on a combination of clinical evaluations, imaging tests, and laboratory tests. A neurologist is a crucial member of the medical team that diagnoses and treats MS, as they are the specialists best equipped to detect, diagnose, and manage neurological conditions like MS.
Do people with MS have symptoms everyday?
Multiple Sclerosis (MS) is a chronic autoimmune disorder that affects the central nervous system (CNS). The symptoms of MS vary greatly from person to person and depend on the part of the CNS that is affected. Some people with MS experience symptoms every day, while others may only have intermittent symptoms.
The severity and frequency of MS symptoms can also change over time, making it difficult to predict how someone will feel from one day to the next.
The most common symptoms of MS include fatigue, weakness, coordination problems, numbness and tingling, vision problems, cognitive impairment, and bowel and bladder dysfunction. These symptoms can interfere with a person’s quality of life and ability to carry out daily activities. Fatigue is one of the most common symptoms experienced by people with MS and can often be debilitating.
Many factors can trigger MS symptoms to flare up or become more severe, including stress, heat, illness, and physical exertion. Some people with MS may experience what is known as a relapse, where symptoms suddenly worsen or new symptoms appear. These relapses can last for a few weeks or months, and recovery can be slow.
Treatment for MS typically focuses on managing symptoms, slowing disease progression, and preventing relapses. Medications, rehabilitation, and lifestyle changes can all be helpful in managing MS symptoms. Regular check-ups with a healthcare provider are also important to monitor disease progression and adjust treatment as needed.
While people with MS may not experience symptoms every day, the unpredictable nature of the condition means that symptoms can flare up at any time. Managing symptoms and slowing disease progression is key to maintaining quality of life for people living with MS.
Is it common to be misdiagnosed with MS?
Multiple sclerosis (MS) is a chronic autoimmune disease that affects the central nervous system, causing various symptoms such as muscle weakness, numbness, fatigue, and problems with coordination and vision. However, MS symptoms can be similar to those of other medical conditions, which can sometimes lead to misdiagnosis.
Several studies have reported that misdiagnosis of MS is not uncommon. According to a study published in the journal Multiple Sclerosis and Related Disorders, around one-third of patients referred to an MS clinic for suspected MS are eventually found to have a different condition. Common conditions that can mimic MS include migraine, fibromyalgia, lupus, Lyme disease, and vitamin B12 deficiency, among others.
One of the main reasons for misdiagnosis is the lack of specific diagnostic tests for MS. There is no single test that can definitively confirm or rule out MS, and a diagnosis is usually based on a combination of clinical symptoms, medical history, physical examination, and imaging tests such as MRI scans.
However, these tests are not always conclusive, and doctors may rely on their clinical judgment and experience to make a diagnosis.
Another reason for misdiagnosis is the variability of MS symptoms, which can vary from person to person and even within the same person over time. Symptoms can also overlap with those of other conditions, leading to confusion and uncertainty in the diagnosis.
Furthermore, misdiagnosis can also occur due to bias or lack of awareness of healthcare professionals. MS is more common in women and often affects younger adults, but it can also affect men and older adults. Some doctors may have preconceived notions about who is at risk for MS and may overlook symptoms in patients who do not fit their stereotype.
Misdiagnosis of MS is not uncommon, and patients should be aware that their symptoms may be caused by a different condition. It is important for doctors to consider a differential diagnosis and rule out other conditions before making a diagnosis of MS. Patients should also feel empowered to ask questions and seek a second opinion if they feel unsure or dissatisfied with their diagnosis.
What conditions can be mistaken for MS?
Multiple Sclerosis (MS) is a chronic autoimmune disorder that affects the central nervous system (CNS). It’s a complex disease that can be challenging to diagnose because its symptoms can be similar to other conditions. This is why it’s important to rule out other conditions that can mimic the symptoms of MS.
Some of the conditions that can be mistaken for MS include:
1. Neuromyelitis optica (NMO): This is a rare autoimmune disease that affects the optic nerve and the spinal cord. Symptoms can be similar to those of MS, such as blurred vision, numbness, and tingling in the limbs.
2. Lyme disease: Lyme disease is a bacterial infection transmitted by ticks. It can cause joint pain, fatigue, and numbness, which can be mistaken for MS.
3. Lupus: Lupus is an autoimmune disease that affects various parts of the body, including the skin, joints, and organs. Like MS, it can cause fatigue, joint pain, and cognitive problems.
4. Sjogren’s syndrome: Sjogren’s syndrome is an autoimmune disorder that affects the glands that produce tears and saliva. Symptoms include dry mouth, dry eyes, joint pain, and fatigue, which can be mistaken for MS.
5. Vitamin B12 deficiency: A deficiency in Vitamin B12 can cause various neurological symptoms, such as numbness, tingling in the limbs, and cognitive problems that mimic the symptoms of MS.
6. Metabolic disorders: Certain metabolic disorders, such as Canavan disease or Krabbe disease, can affect the central nervous system and cause symptoms similar to those of MS.
7. Migraines: Migraines can cause visual disturbances, which can be mistaken for optic neuritis, a common symptom of MS.
The above-mentioned conditions can be mistaken for MS because they have similar symptoms. Therefore, it’s crucial to seek medical advice to confirm or rule out MS as soon as possible. An accurate diagnosis is essential to get the right treatment and manage symptoms. An expert neurologist can perform an array of tests to differentiate between MS and other diseases, such as MRI scans, blood tests, and spinal taps.
What autoimmune disease can mimic MS?
Multiple Sclerosis (MS) is a neurological condition that affects the central nervous system. MS can cause many debilitating symptoms such as muscle weakness, fatigue, difficulty with balance and coordination, and problems with speech and vision. Although MS is a unique condition, some other autoimmune diseases can mimic the symptoms of MS, making it difficult for healthcare providers to make a proper diagnosis.
One of the autoimmune diseases that can mimic MS is Neuromyelitis Optica (NMO), which is a rare yet severe autoimmune disease that affects the optic nerve and spinal cord. NMO and MS share many clinical and radiographic features, such as optic neuritis, spinal cord lesions, and brainstem involvement.
However, NMO tends to target the optic nerve and spinal cord more severely than MS, and spinal cord lesions are often larger and more extensive. Symptoms of NMO can include severe muscle weakness in the limbs and torso, inability to control bladder and bowel function, and vision loss.
Another autoimmune disease that can be mistaken for MS is Sjogren’s Syndrome, an autoimmune disorder that affects the body’s moisture-producing glands. The symptoms can include dry eyes, dry mouth, skin rashes, and muscle and joint pain. Because Sjogren’s may cause neurological symptoms, such as numbness, tingling, and fatigue, it may be misdiagnosed as MS.
Patients with Sjogren’s Syndrome may also experience unique symptoms like cognitive dysfunction, neuropathic pain, and autonomic dysfunction.
There are other autoimmune diseases that share similarities with MS and can be misdiagnosed. For example, Systemic Lupus Erythematosus (SLE), an autoimmune disease that can affect any organ of the body, can sometimes cause neurological symptoms similar to those of MS. Similarly, certain vasculitis conditions like Behcet’s syndrome may lead to optic neuritis and have overlapping symptoms with MS.
While MS is a distinct disease, there are other autoimmune conditions that can mimic its symptoms, making it challenging to diagnose. It is important that healthcare providers evaluate each patient’s unique symptoms carefully before making a diagnosis to ensure that patients receive the appropriate treatment.
Should I get a second opinion on MS diagnosis?
When it comes to any medical diagnosis, it is always a good idea to seek out a second opinion. This is especially important when it comes to conditions that have significant implications for your long-term health and wellbeing, such as multiple sclerosis (MS).
MS is a complex autoimmune disorder that affects the central nervous system, causing interruptions in the communication between the brain and the rest of the body. The symptoms of MS can vary widely from person to person, with some experiencing only mild symptoms while others may face significant disability over time.
Although there is no definitive test for MS, the diagnosis is typically made based on a combination of a patient’s symptoms, medical history, and certain diagnostic tests. These tests may include MRI scans to look for lesions in the brain and spinal cord, blood tests to rule out other conditions, and lumbar punctures to assess the presence of certain proteins in the spinal fluid.
Given the complexity and variability of MS, it is not uncommon for mistakes to be made in the diagnosis process. Receiving a second opinion from a different specialist can help to confirm or correct the diagnosis, while also providing you with information and insights about potential treatments and other options.
It is also worth noting that seeking out a second opinion does not necessarily mean you are questioning the expertise or judgment of your initial healthcare provider. Rather, it is simply a way to ensure that you have a full understanding of your condition and are making the best decisions for your health and wellbeing.
If you have recently received a diagnosis of MS or are experiencing symptoms that may be related to the condition, it is highly recommended that you consider seeking out a second opinion. Doing so can provide you with valuable insights and support as you navigate this complex condition and work to manage your symptoms effectively.
How many cases of MS are misdiagnosed?
There is no definitive answer to the number of cases of multiple sclerosis (MS) that are misdiagnosed, as the accuracy of diagnoses can vary depending on several factors. However, studies have shown that misdiagnosis of MS is not uncommon, and it can have serious consequences for patients, including delays in receiving the proper treatment and management of their symptoms.
Some estimates suggest that up to 10-15% of MS diagnoses may be incorrect, with some patients being diagnosed with MS when they have other neurological conditions, while others may not receive an MS diagnosis when they actually have the disease. Misdiagnosis is more likely to occur when the symptoms of MS are not clear-cut, or when patients have atypical or overlapping symptoms that can mimic other conditions.
One common cause of misdiagnosis is the reliance on imaging tests, such as MRI, which can show signs of MS but do not necessarily confirm the diagnosis. In some cases, doctors may also misinterpret the results of these tests, leading to incorrect diagnoses. A thorough evaluation of symptoms and medical history, as well as more advanced testing such as lumbar puncture and evoked potentials, can help reduce the risk of misdiagnosis.
Another contributing factor to misdiagnosis is the lack of knowledge and expertise among healthcare professionals. MS is a complex disease that can present with a wide range of symptoms, and many healthcare providers may not have the training or experience necessary to recognize all the signs of the disease.
Improvements in diagnostic tools and techniques, as well as increased awareness and education among healthcare professionals, can help reduce the number of misdiagnosed cases of MS. Patients should also be proactive in seeking multiple opinions and advocating for themselves if they feel their symptoms do not align with an MS diagnosis, as early and accurate diagnosis is crucial for effective treatment and management of the disease.
How do I know if I have MS or something else?
Multiple Sclerosis or MS is a chronic autoimmune disorder where the immune system attacks the myelin sheaths that cover the nerve fibers within the central nervous system. As a result, communication between the brain and other parts of the body is disrupted, causing a wide range of symptoms that may come and go over time.
If you are wondering whether you have MS or something else, it is essential to recognize that MS is a complex and challenging disease that can mimic many other medical conditions. Therefore, seeking out the expertise of medical professionals is crucial for proper diagnosis and treatment.
Some of the common symptoms of MS include blurred or double vision, fatigue, numbness or tingling, muscle weakness or spasm, difficulty with coordination and balance, cognitive impairment, bowel or bladder dysfunction, and more. However, these symptoms alone do not necessarily point to MS and can occur due to various other conditions.
To diagnose MS, doctors typically perform a medical history and physical examination to assess the symptoms and neurological signs, followed by a series of diagnostic tests. These tests may include MRI scans, evoked potentials, and analyzing cerebrospinal fluid for the presence of certain proteins, among others.
Since MS can be challenging to diagnose, it is essential to work closely with your doctor or a neurologist who has experience in diagnosing and treating MS. The earlier the diagnosis, the sooner you can start treatment to slow the disease’s progression and manage your symptoms.
If MS is confirmed, there are several treatments available that can help manage symptoms, slow down the disease’s progression, and improve the quality of life for people living with MS. Hence, it is essential to get accurate and timely diagnosis and treatment to manage the condition effectively.
To determine whether you have MS, you need to seek the expertise of medical professionals and undergo different diagnostic tests. It is essential to get an accurate diagnosis sooner to ensure timely treatment and better disease management.
How accurate is an MRI for diagnosing MS?
Magnetic Resonance Imaging (MRI) is considered one of the most reliable methods for diagnosing Multiple Sclerosis (MS). It is a non-invasive imaging technique that uses electromagnetic forces to create detailed images of the brain and spinal cord. The imaging process helps doctors identify the presence of MS lesions, which appear as dark white spots on the scan.
The accuracy of an MRI for diagnosing MS largely depends on the type of MRI used, the timing of the scan, and the expertise of the radiologist interpreting the images. A standard MRI, which typically involves scanning the brain and spinal cord, can detect over 90% of MS lesions. However, it is worth noting that the accuracy of MRI diagnosis can be affected by several factors.
Firstly, timing is critical. An MRI scan may not show lesions early on in the disease, and it may take years for these lesions to develop into the disease. As such, repeated scans are often necessary to track the progression of MS.
Secondly, different types of MRI scans can provide varying levels of accuracy. High-resolution MRI scans, for example, can detect smaller MS lesions that would otherwise be missed by a standard MRI. There are also specialized MRI techniques, such as Magnetization Transfer and Diffusion Tensor Imaging, that can enhance the sensitivity of MRI scans for identifying the presence of MS lesions.
Lastly, it is essential to have an experienced radiologist interpret the MRI images to make a definitive diagnosis. Radiologists specializing in MS have undergone specialized training and have the expertise to identify characteristic features of MS lesions on MRI.
While MRI is highly effective in diagnosing MS, there are several factors that can influence the accuracy of the diagnosis. In general, a combination of multiple MRI scans, with a highly specialized radiologist’s expert interpretation, can provide an accurate diagnosis of MS.
