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
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.
the face and scalp.
Muscle coordination in the face and
Hearing and balance.
Swallowing and the gag
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.
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