When determining whether a patient is experiencing a relapse or something else, medical teams have many tools at their disposal, including:
- Clinical History
- Have you had this symptom before?
- Any clear triggers?
- Duration of symptoms
- Medication compliance
- Obtain imaging
- MRI scans with contrast (gadolinium)
- Brain vs cervical spine vs thoracic spine
- Looking for a new contrast enhancing lesion
- Neurologic exam & rule out non-MS causes
- Search for infection
- Urinalysis/ Urine culture
- Chest Xray
- Stool test (if diarrhea)
- Skin examination (for wounds, rashes)
- Blood tests (indirect evidence of treatment effect)
- White blood cells (looking for infection)
- Anti-rituximab or anti-Tysabri antibodies
- Immunoglobulin levels for those on Rituxan, Ocrevus or Kesimpta, which may cause depletion of these normal antibodies and increased risk of infection
