Q. Since MS may not be treated in its early stages, why is it important to obtain a definite diagnosis?

A. One of the most important reasons to establish a definitive diagnosis of MS is to allow the patient and his or her family to begin the process of learning about the disease and planning for the future. Also many patients are reassured when they learn that their symptoms are in fact due to MS, and not another condition, and that they are not iimagining things."

There are other reasons to make a diagnosis of MS. Many people with MS are entering clinical trials of new drugs, and are unable to do so unless the diagnosis is established. Secondly, other disorders of the central nervous systems may be the cause of symptoms. Many of these conditions, if promptly treated, will respond well, and thus should be differentiated from MS.

Q. I understand that MS lesions sometimes exist only in the spine. Why then are magnetic resonance imaging (MRI) scans done only on the brain when trying to establish whether or not a person has MS?

A. MRI technology is steadily improving as more and more is being learned about this imaging technique. MRI studies of the spine are done for other disorders of the spine but the typical lesions of MS are difficult to evaluate in that area. With greater refinement, it may be that the technology will allow for greater reliability of MS lesion presentation on spinal studies sometime in the near future. Until that time, diagnostic imaging for MS is still the most reliable on brain and brain stem MRI.

Q. I thought the cerebrospinal fluid (CSF) was not being used much anymo)re tor diagnosing MS. Does it serve a particular purpose?

A. CSF analysis is no longer always done when MS is suspected. It may be needed, however, if there are confusing symptoms that could indicate other central nervous system problems. A variety of central nervous system disorders. particularly infections or some tumors. require CSF studies for a diagnosis. While CSF does not offer a test result that always indicates MS and only occurs with MS, the CSF can be examined for the presence of certain abnormalities that lend support to the diagnosis of MS.

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