Consulting with a neurologist

Please note that when you are referred to a neurologist, it does not automatically mean that you will be diagnosed with MS as there are still many possibilities. The initial appointment with a new neurologist will be a long one. A large portion of the appointment will be comprised of The Precise Neurological Exam. (Follow this link for the most thorough explanation of the neurological exam designed as an educational tool for medical students at NYU.)

Also for that first appointment, come prepared to complete “new patient” forms including a detailed medical history. It would be wise to take with you information regarding past surgical procedures, other health issues, and those of your parents/grandparents (ie. history of heart disease, cancer, autoimmune disorders, etc.) You want to give the doctor as much pertinent information as possible.

Since my MRI had been conducted without gadolinium (a contrast agent injected into a vein halfway through the MRI procedure), the neurologist ordered a new series of MRI scans of the brain and cervical spine, with and without contrast. This is necessary so that active lesions will show up more clearly.

Other tests included a battery of Evoked Potentials to calculate the speed and response of electrical impulses over sets of nerves and a Lumbar Puncture to test for oligoclonal banding in the spinal fluid.

It is possible - even after finding a lesion or two on the cervical spine, testing positive for oligoclonal bands in the spinal fluid and positive for damage to an optic nerve during the evoked potentials - that you may not receive a diagnosis of definite MS There are very specific criteria involved in diagnosing MS. For an overview, read By What Criteria and Guideline Were You Diagnosed with Multiple Sclerosis.

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Beginner's Guide to MS: Consulting with a neurologist