From Dr. Pat Coyle—Neurologist


This video focuses on the diagnosis of MS. The goal is to give you some important topic questions or things to think about during this critical time period when the diagnosis of MS is being established.

My name is Dr. Pat Coyle. I’m a neurologist and I direct the Stony Brook MS Comprehensive Care Center on Long Island in New York.

As you’re being evaluated by your healthcare provider, they’re going to do a very complete history and examination. The history may focus on prior neurological problems that you may have dismissed or thought were so minor that you didn’t even mention them, particularly neurological issues that may have lasted for longer than 24 hours. The examination is going to be a very complete examination focusing on the nervous system. It will check your memory and thinking, cranial nerves around the face, your reflexes, your motor strength, your sensation, your coordination or cerebellar function, and finally your walking ability. And then there’s going to be a workup. Your healthcare provider is going to send blood work—things like a Vitamin D level, a Vitamin B12 level. Then they’re going to do an MRI scan. You’ll have a brain MRI, unless there’s a contraindication, with and without contrast, and you’re also most likely at the time of diagnosis to have MRI scans of your spinal cord done. Since there’s no single diagnostic test, you’re really using a compilation of factors.

How to speed up the process: Make sure you show up for appointments. Be flexible. Prioritize. This is a very important thing. If there’s some mix-up, let your healthcare provider and office know right away so they can do some problem solving. And if your tests are scheduled a long time away, let them know that you are concerned and you want to get this done as quickly as possible.

Questions to ask: Make sure you know the results of your testing. Get copies of it. Keep it in one file—a diagnostic file. When you get your MRI scans, get a disk. Carry that with you. Make sure you keep a copy. Your healthcare provider and anybody that you may see—it’s good that they actually look at the MRI scan films themselves and not just read the official report. So make sure you get all of those things.

And, finally, other tips: The more you learn about MS, the better. Keep in touch and be connected with the societies that are really promoting care for MS patients and that focus on MS.

About the contributor: Dr. Pat Coyle

I am Professor and Vice Chair (Clinical Affairs) of Neurology and Director of the Multiple Sclerosis Comprehensive Care Center at Stony Brook University Medical Center, New York. I qualified and completed my residency at Johns Hopkins University School of Medicine. I’ve received research funding from the National Institutes of Health and the National MS Society. I lecture widely on MS and neurologic infections.

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