Diagnostic Process
If your doctor feels you may have a problem he will refer you to your local neurology department where you will be seen by a neurologist. You may then be sent for a series of diagnostic tests, these may be performed as outpatient tests or occasionally you may be admitted to hospital and the tests carried out while you are there.
Blood Tests
A blood test will be looking to see if there is any rise in a creatinine kinase. This is produced when muscle breaks down and can occasionally be found in the blood of people with MND. It is not specific for MND and may also be an indicator of other medical conditions.
Electromyography (EMG)
The EMG test is sometimes called the needle test, because fine needles are used to record the naturally-occurring nerve impulses within certain muscles, recordings are usually taken from each limb and the bulbar (throat) muscles. Muscles, which have lost their nerve supply, can be detected because their electrical activity is different from normal healthy muscles. The EMG can be shown as abnormal even if that particular muscle is as yet unaffected. It is a very important diagnostic test.
Nerve Conduction Tests
This test may be carried out at the same time as the EMG. An electrical impulse is applied through a small pad on the skin; this measures the speed at which your nerves carry electrical signals.
Transcranial Magnetic Stimulation (TMS)
This is a new procedure, which may be carried out at the same time as a nerve conduction test. It is designed to measure the activity of the upper motor neurones; its findings can help in the diagnostic process.
Magnetic Resonance Imagery (MRI) scans
This involves being placed in a cylinder-like machine. The machine takes images of the internal structures of the body. The MRI Scan can show up damaged areas caused by Stroke, Alzheimer’s disease, Parkinson’s disease, Multiple Sclerosis, tumours and trapped nerves as well as damage to the spine and brain caused by injury. An MRI scan will not diagnose Motor Neurone Disease, the damage caused by this disease does not show up on this scan, it is used as a tool for eliminating other conditions which can mimic symptoms of MND.
Other tests
The neurologist may request other tests such as a lumbar puncture or muscle biopsy if the clinical findings indicate they could be useful, but they are not always used as diagnostic tools for MND.