Multiple Sclerosis Diagnostic Criteria [Neurologist Explains]

While investigating what ER drs thought was a 'cervical spine strain' that resulted in numbness of the right side of my face extending down the entirety of my right arm/hand, I was sent to a sports med dr. At that appt, I asked if I might have MS, because I never sustained any injury to explain these symptoms. Since she planned to do an MRI anyway, she agreed to check for MS. As suspected, my MRI showed several lesions consistent with MS. A neuro confirmed diagnosis when I explained I had a vision 'issue' (optic neuritis) in my left eye 3 years prior that I never followed up on because it resolved after a week or two. Overall, I feel I was pretty lucky to be diagnosed relatively quickly. Thank you for the video!

Interesting video! I was diagnosed with MS in 2000, I was only a 20 years young man. The spinal tap part, I felt that throughout my whole body shrugs I remember referring to the guy performing it as "the temp" 😂 he was instructed how to perform it and bumped against nerves and it's the most uncomfortable feeling ever.  I remember hearing about some people only having one episode and that's it. But sadly, after the MRI the doctor informed me that I had already had a few. Long story short I was hospitalised for 2 weeks with stuttering speech, poor balance, loss of sensation half side of my body, sensitive hearing etc. I started medication a few months later. This was the weirdest part to me, as they weren't allowed to decide for me which brand/type to get, only which one they had the most experience with. I have forgotten the name, but remember the side effects put me off, so I went for a newer one called Copaxone.  Interesting detail around 2005, the only change in my life was that I went vegan and coincidentally, I have not had any symtoms since. And I stopped taking the meds around the same time. I remember asking my neurologist about any connection between diet and MS and he just smiled. I brought this up with another neurologist and he was more open to it but didn't think it had any serious "healing effect". I have since read about a connection between animal protein and MS, and heard about several other people getting better after adopting a plant based diet, but these are just personal anecdotes. Still interesting. Whatever changed, I'm lucky I'm in good health at 40+, out running each and every day. Thinking back to when I had to support myself using a crutch and a friend downtown asked me if I was drunk. Or the time I woke up and couldn't speak properly... or strum the guitar. Feels like a different life. I was lucky. I should get another scan done at some point. Well that's my story.

Thanks for this. I appreciate the value in not misdiagnosing other ailments as MS, but never having it considered was frustrating. Decades is right. There was a maybe (no testing no treatment and) 10-15 yr pass, possibly not conclusive (MRI no treatment) another 10-12 yr pass, Finally an absolutely and only needed the MRI for proof positive (treatment).

Thank you so much for your excellent video! My MRIs are clear of lesions, but I definitely have punch of symptoms and it was good to hear that there is also other possible diagnosis for "weakness on other side of the body". It is hard to advocate for oneself when one does not have information that clear MRI does not mean that I do not have some neurological condition going on. Doctors are trying to convince me that all my symptoms are only in my head. Hah, probably they are 😅 but NOT in a way they mean it 😄 This video was well made and it was easy to follow up without any previous medical knowledge. You are doing a good job! 👌

Wow! What a great video! It's great to be able to see MRI's that can lead to a diagnosis, as well as touching on other diagnosis options that may crop up.

Im 35 and started neurology with blood work after the initial exam. Within days they called me about my B12 results. I was scheduled for my first (monthly) (Cyanocobalamin) shot within 3 days. I will have to do them monthly for the rest of my life as I don't have the ability to process or absorb it. I had already been diagnosed with glaucoma and unexplained peripheral darkening 2 years prior. My first official neurology ordered MRIs conducted on 4/18/23 only took 2 days to come back and sure enough I have multiple white matter lesions in the frontal lobe no bigger than 3mm right now. 2 lesions found on the spinal cord, spinal stenosis, multilevel disc disease, spurrs and bulging discs. Multiple scattered lesions were discovered throughout my neck, on my thryroid and cysts on my lymph nodes. Im missing quite a bit but they absolutely could have caught this sooner! 3 years it took! I have more MRIs with contrast dye on May 16th. The neurologist are absolutely taking it seriously as of now. I haven't slept much in 2 days this spinal pain is KILLING ME. Right hand losing total sensation/stiff no movement and so painful!!! 😢 Dont stop fighting for yourself!!

I can't believe for the life of me that I missed this video Dr Brandon, as always you are brilliant my friend.

This was very helpful -- although I keep hoping I was misdiagnosed, this very clearly makes me understand how I was diagnosed. Thank you!

This was so well explained, thank you. I often wonder if my MS diagnosis is correct since I had ON 10 years ago and nothing since, but your video helps convince me again that the diagnosis is correct and I have to keep going with my therapy. I have 20+ lesions (but unchanged since the first MRI in 2013), positive iGg and borderline evoked potentials. So I couldn't have been a better example of MS at start, but a decade of no change sometimes makes me start doubting. Your videos help put me back to the right track. Thank you, Dr. Beaber.

I would love to see a video on nothing but the following topic: the subtle (or not so subtle) differences between MRI brain lesions and lesions commonly seen in the general population that end up in that UBO category. The lesions caused by migraine, in particular, look really "tricky" to my untrained eye -- to my eye, they do look like cortical MS lesions, and I'm curious how one is able to tell the difference (and with what level of certainty ... or is there a large overlap in the morphologies and locations of MS and migraine/UBO lesions?)

So glad I found this information as it exactly addressed some of the issues I am having regarding diagnosis and now I understand my situation so much better. The best part is now I can have an informed discussion with my neurologist later this month and also know what to look for in the future. You are awesome!

Great video. I am still unsure whether I have MS, but listening to the criteria, I think I probably do. Four years ago, I was told by two different MS neurologists in Sydney, Australia, that I definitely did not have MS. Why? (Too old 58 at the time, my lesions were in wrong part of brain for MS, no spinal cord lesions, no oligoclonal bands but CSF protein was four times the normal range, no motor disability, although lots of sensory effects such as left-sided paraesthesia, fatigue, numbness etc.). I fully recovered and enjoyed two years of perfect health with no treatment. Running 5kg, doing resistance training and yoga etc. Then, my symptoms (again, left sided paraesthesia - left arm , left leg, left side of face and extreme fatigue) returned this year. Had another spine and brain MRI. Interestingly, no change from two years ago, but because I have a relapse in symptoms, I have now been diagnosed by a different neurologist with relapsing remitting MS.She wants to start me on Kesimpta. I am terrified of going on it at age 61 just in case I don’t have MS, and my B lymphocytes get depleted and I end up contracting respiratory tract and urinary infections etc. When you’ve been told you definitely don’t have MS by two different neurologists and then two years later, you’re told you do have it, it’s a bit hard to get your head around. I wish I could send you my brain scans and CSF and blood results and letters from my initial neurologist to my GP and get you to do a thorough review of my case. I live in Sydney, Australia, so that’s probably not possible, but let me know whether you’d be willing to consider it. The parting comment from my neurologist of two years ago was that “if you do have MS, it’s a very atypical form!” What am I supposed to make of that? 😢

Thank you so much for posting this both very detailed but also very accessible information! I feel much more informed going into my evaluation of my "ms probable" mri with the neurologist. As someone with a just a single clinical event, it gives me a much better idea of what he will be looking for!

Thank you Doctor! Very helpful - I’ll be sharing this with family and friends that ask me about my diagnosis. Glad to have record of my LP as it appears to be something many studies require in order to participate. I’m unclear on why that is as my MRI and physical condition would appear to be sufficient

I was diagnosed with CIS in 2014 after having optic neuritis and a few brain lesions on MRI. I was told there was around a 65% chance that I would develop MS. I had several follow-up MRI’s with increasing intervals. In 2019, at the 5-year mark, new lesions were found and I was diagnosed. Thank you for your videos and efforts dr. Beaber, much appreciated!

Very good video and content, doctor! Thank you so much! I would love to see more topics about the ddx of MS (like neurosarcoidosis you just mentioned).

Thanks for this video Dr. Beaber! Excellent explanation of the criteria and other conditions that can cause lesions and symptoms.

I was pretty lucky, I guess. I woke up one morning while in the Navy (stationed at Navy Band San Diego) with slurred speech and right sided weakness. Went to Balboa Naval Hospital they told me to take Christmas leave (this was just before Christmas) and come back if it got worse. I took the leave and it got worse. Went back and was admitted. After a few days and the required tests (CT scan, MRI, lumbar puncture) I was diagnosed with "probable MS" (this was in 93 when i was 22). So all in all pretty fast. The only symptoms I had before then was 2 occasions when I had SEVERE chills accompanied by fever for half a day with difficulty walking that resolved very quickly. I thought it might be food poisoning.

Thank you for this video & channel. I've been struggling with health issues for years and trying to advocate for myself without trying to self diagnose. I was starting to wonder if MS could be a possibility and with the info in this video I can understand why this has never been mentioned to me before. I need to keep advocating for myself to get to the root of my symptoms.

I believe you helped bridge the gap between my neurologist and I. I have been looking for more definitive proof of MS. I’ve been told I have MS but I was skeptical and still worried it’s worse than MS. But I now understand how I was giving the diagnosis of MS. I have one brain lesion, 4Obands and many episodes/moments/flare-ups. I have lost use of my right leg. Lost feeling and reflexes in right leg. And it has been numb since. I would love to be able to communicate with you in a private way if possible. I did subscribe. My neurologist is sending me to a specialist now. I think he is frustrated with my denial of MS but he decided to transfer me when I showed him the many videos of aggressive fasciculations I’ve been encountering lately. Thanks and again this was very helpful