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Neurology (Expert Forum)
CIS
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CIS
by bellaaa, Apr 22, 2003 12:00AM
I am a 30 year old woman.
Almost 2 years ago , i was told to have CIS (clinically isolated syndrome). (I felt weakness in my right and left hand, and my left leg).I did not recover 100% (my neuro did a mri: clear , and he did a MEP:not ok) He told me I have only a risk of 15% to develop ms.
One year ago I began to feel strange feelings (pins and needles-feeling in my feet, fatigue, numb feeling , burning feeling ankle....) The symptoms last for an hour or for a few days. My neuro asked to make another mri-scan. It was clear again. The spinal tap returned ok.
Should I be worried? Does this (to have new symptoms with a clear mri and spinal tap) increases/decreases the risk of getting ms?
I know they did a study about the prognostic value of mri in clinically isolated syndromes. But did they study the relationship between recovery after CIS and progression to MS?
thank you for your help...
Almost 2 years ago , i was told to have CIS (clinically isolated syndrome). (I felt weakness in my right and left hand, and my left leg).I did not recover 100% (my neuro did a mri: clear , and he did a MEP:not ok) He told me I have only a risk of 15% to develop ms.
One year ago I began to feel strange feelings (pins and needles-feeling in my feet, fatigue, numb feeling , burning feeling ankle....) The symptoms last for an hour or for a few days. My neuro asked to make another mri-scan. It was clear again. The spinal tap returned ok.
Should I be worried? Does this (to have new symptoms with a clear mri and spinal tap) increases/decreases the risk of getting ms?
I know they did a study about the prognostic value of mri in clinically isolated syndromes. But did they study the relationship between recovery after CIS and progression to MS?
thank you for your help...
Doctor's Answer
by CCF-Neuro-M.D.-JT, Apr 22, 2003 12:00AM
I did an extensive literature search and could not find a study looking specifically at amount of recovery and progression to MS. THe most important prognostic factor as you pointed out is amount of abnormality on the MRI. Oligoclonal bands in the CSF and the presence of a genetic marker (HLA DR2) are also important predictive factors. There was one study from London in 1993 looing at 89 patients who had a clinically isolated syndrome. Of the 89, 32 patients (36%) had a normal MRI. At 5 year followup, only 1 of the 32 patients (3%) went on to have MS compared to 65% of patients with abnormal MRI who developed MS.
It is somewhat reassuring that the repeat testing has been negative despite the presence of new symptoms. I assume your doc has also ordered spine MRIs in addition to brain. Although I certainly can't give you an exact number, the normal repeat test results (CSF and MRI) based on my own experience help make the diagnosis of MS less likely (not impossible or forever ruled out), just less likely at this time.
For now, keep in contact with your neurologist and return for followup appointments as needed, especially with development of new neurologic symptoms. Good luck.
It is somewhat reassuring that the repeat testing has been negative despite the presence of new symptoms. I assume your doc has also ordered spine MRIs in addition to brain. Although I certainly can't give you an exact number, the normal repeat test results (CSF and MRI) based on my own experience help make the diagnosis of MS less likely (not impossible or forever ruled out), just less likely at this time.
For now, keep in contact with your neurologist and return for followup appointments as needed, especially with development of new neurologic symptoms. Good luck.
