Multiple Sclerosis Pathway - Provider Information: Diagnosis of MS
MRI for suspicion of MS should be requisitioned by the consulting neurologist and will identify the specific protocol requested and clinical question to be addressed.
Diagnosis of MS is made by a neurologist according to 2017 McDonald Criteria.
Revisions from 2017 reflect current evidence linking early diagnosis and treatment with better long term patient outcomes. The key requirement for a diagnosis of MS is evidence of damage to the central nervous system that is disseminated in time (DIT) and space (DIS). In the past, the DIT requirement led to patients waiting for a second relapse or lesion before a diagnosis could be confirmed. Under the new criteria, a diagnosis can be made using clinical symptoms, broader sources of MRI evidence, and the presence of oligoclonal bands in the spinal fluid that show disease activity in the past.
When MS diagnosis is not confirmed but is still suspected, a neurologist will follow the patient with imaging at regular intervals for five years or until a diagnosis is confirmed.