Before conducting a neurological examination for multiple sclerosis (MS), the doctor will collect information about your symptoms. The kinds of symptoms, as well as how and when they occur, are important in evaluating whether you might have MS. Even symptoms that you might have had several years ago can be important.
The neurological examination will cover both how well you think and how well you move.
Mental ability and emotional condition
The doctor may ask you to repeat a series of numbers or answer simple questions about dates, places, and current events. The doctor can usually judge your emotional condition during the exam by paying attention to your actions and statements.
If the doctor suspects mental problems caused by multiple sclerosis (MS), he or she may order tests designed to identify more subtle changes than the ones that may be evident from the brief mental section of the neurological examination.
Coordination, strength, senses, and reflexes
The doctor will look for injury to the 12 pairs of nerves in the head (cranial nerves) that relate to:
- Sense of smell.
- Sense of taste.
- Eye movement.
- Sensation in the face and scalp.
- Muscle coordination in the face and neck.
- Hearing and balance.
- Swallowing and the gag reflex.
- Movement of the tongue.
To evaluate muscle strength, the doctor will have you push with the arms and legs against the doctor's hand. Dexterity, muscle tone, and muscle control will also be tested.
You will be examined for the ability to:
- Feel pain (a pinprick), a light touch, temperature, and vibration (a tuning fork).
- Sense the position of the arms or legs.
Also, your reflexes will be tested.
The neurological history and examination may take as long as 2 hours but usually take 1 hour or less.
Why It Is Done
A brief neurological examination is part of any complete physical exam. If you report symptoms that suggest a problem with the nervous system, the doctor may do a more thorough neurological exam. Such an exam will always be done if you have symptoms that suggest MS.
Findings on the neurological exam may include the following.
All tested functions are within normal ranges.
Abnormal findings may include evidence of nervous system abnormalities, such as weakness, blindness, coordination or balance problems, or changes in sensation.
What To Think About
Because MS lesions (injured or inflamed nerve tissues) may be found in several locations on the brain and spinal cord, symptoms can vary greatly. Some lesions may not cause signs or symptoms that the doctor can evaluate during an exam. Other tests may be needed to help make the diagnosis, especially when there is a history of several attacks.