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Multiple Sclerosis : Diagnosis
Western Medicine Chinese Medicine

Few other neurological diseases of young people follow a similar relapsing and remitting course. The criteria for diagnosis is the requirement that the neurologic dysfunction not be a monophasic illness; that is, there are two neurologic events, separate in time (by at least a month) and separate in their location within the central nervous system. These simple clinical criteria have proven themselves 75% accurate.

Three factors help in more accurate diagnosis.

Cerebrospinal fluid
Cerebrospinal fluid may reveal that there is a rise in total protein, with a specific increase in the immunoglobulin concentration and the presence of oligoclonal bands in more than 90% of cases, providing evidence for synthesis of immunoglobulin within the central nervous system.

Evoked potentials are a quantitative, neurophysiologic means of demonstrating the interruption of the message-carrying capacity of axons whose myelin is affected. Whereas myelin speeds transmission, these tests show a slowing transmission. The utility in demonstrating abnormality in an area not necessarily having had symptoms or signs is less than that of cerebrospinal fluid oligoclonal bands.

Magnetic resonance imaging of the central nervous system usually allows us to see the evidence of multiple areas of inflammation. This is the most sensitive diagnostic tool for this condition, but it too suffers from a lack of specificity, with a large number of other diseases having similar changes.


In TCM, diagnosis is based on the four examination techniques, which stress the determining of the circumstances and manifestations of a disease through inquiry and symptom observation.

Procedures for a TCM diagnosis of multiple sclerosis (MS) can be explained as follows:

Meridian obstruction by phlegm and heat
This usually occurs in the late stages of a MS relapse. Invasion of heat evils give rise to symptoms like fever, thirst, irritable and urinary difficulty, while phlegm invasion tends to cause obstructions and interfere with the meridian flows. In addition to limb problems, the influence of phlegm is also blamed for chest tightness, distended headache, throat secretions and vision problems. On examination, the tongue is red and covered by yellow or yellow greasy fur. The pulse is rolling and rapid or taut and rolling.

Damp-heat dissemination
The acute stages of MS usually fit this pattern. Damp-heat is a pathogen mostly contracted from the external environment. Typical symptoms include fever, headache, body aches, generalized heaviness, fatigue, abdominal distention and poor appetite as well as scanty and yellowish urine. On examination, the tongue is red and covered by yellow fur; the pulse is hesitant and rapid.

Blood stasis accumulated in meridians
Features of blood stasis are characterized by numbness, contracting pain and tingling sensations. On examination, the lips are purple, the tongue is purple-blue or may appear bruised; the pulse is hesitant.

Deficiencies in the lung and spleen
In TCM, the spleen is the source of nutrients while the lungs play an important role in the distribution of nutrients. Dysfunction of the two organs not only affects the supply of nutrients to muscles and tendons, but also leads to general impairment of the whole body. Symptoms include weakness, as well as low resistance against infection, dizziness and a sallow complexion. On examination, the tongue is pale and covered by thin white fur. The pulse is fine and weak.

Deficiencies in the kidneys and liver
The kidney stores essence while the liver stores blood. Disorder in these organs therefore lead to inadequate nourishment in important structures like the brain, orifices and limbs lead to symptoms such as dizziness, ear ringing, speaking difficulty, numbness and soreness. Yin deficiency in this case leads to yang hyperactivity creating virtual heat symptoms. On examination, the tongue is red with little fur covered the pulse is fine and rapid.

Depletion in kidney yang
This pattern usually results from enduring yin deficiency; kidney yang has the effect of propelling transformation and warming the organs. It acts as the root of the body's physiological functions. As a result, all physiological activities decline, leading to coldness and inhibitory symptoms. On examination, the tongue is swollen and pale, and is covered by white thin fur. The pulse is deep and fine.

It should be emphasized that individuals usually present with different manifestations of their illness and not as described above. Therefore, an experienced physician is needed to ensure an accurate diagnosis.