Diagnosing Multiple Sclerosis

Correcting Misdiagnosis

 As many as 25 percent of people (or 1 in 4) who come to the multiple sclerosis program at UC San Diego Health have been incorrectly diagnosed with MS.

In diseases that do not have a single, definitive test, such as MS, accurate diagnosis depends on a well-experienced clinician who is knowledgeable about the disease.

When you seek MS care at UC San Diego Health, you have the benefit of receiving a more accurate evaluation and expert clinical care from our experienced specialists. Our program director, Revere Kinkel, MD, has treated thousands of people with multiple sclerosis cases and other immune-mediated diseases. In many situations, Dr. Kinkel will correct a diagnosis and provide treatment options when a patient has been living with a misdiagnosis.

A challenge in the neurology community today is the overreliance and misinterpretation of MRI results. Regular MRI scans are performed to establish diagnosis and monitor MS patients. For neurologists who lack clinical expertise in MS, relying primarily on MRI findings can result in diagnostic error.

Diagnostic Tools

There is no definitive test available to diagnose multiple sclerosis. Physicians may confirm diagnosis through clinical criteria, a combination of tests and the use of advanced diagnostic tools, such as MRI. An individual’s medical history and a neurological examination are also carefully considered. Because there are numerous diseases that present similar symptoms to MS, it is critical that an experienced specialist confirm diagnosis.

One way of ensuring a correct diagnosis and applying appropriate management strategies over time is the use of precise imaging tools that provide quantitative volumetric measurements of brain structures involved by MS.

Our imaging services and diagnostic tests include:

  • Volumetric magnetic resource imaging (MRI): Unlike regular MRI, volumetric MRI provides an objective, quantified record and monitoring of disease progression, activity and tissue loss. NeuroQuant takes high-resolution, three-dimensional MRI images to measure volumes of the hippocampus, thalamus, cortex, white matter and ventricles, and compares these volumes to age-related reference values. NeuroQuant also provides volumetric measurement of the white matter lesion involvement.
ms-brain images 2.jpg

NeuroQuant images showing a healthy brain (left) and a brain with signs of progressive injury from MS (right). In individuals with MS, the brain forms scar tissue (lesions), has greater whole and white matter volume loss
and a shrunken thalamus.

  • Evoked potentials tests: Measure the brain’s electrical response to visual, auditory, and sensory stimuli. In people with MS, electrical activity is slowed due to damage caused by demyelination.
  • Cerebral spinal fluid analysis: Also called spinal tab or lumbar puncture, this procedure examines extracted spinal column fluid to check for cellular and chemical abnormalities associated with MS.