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Neurology (Expert Forum)
MRI suggests ALS or MS
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MRI suggests ALS or MS
by shferolie, Jan 07, 2006 12:00AM
I am seeing a spine doctor and as of November we have scheduled a laminaplasty for the first part of February. I have pronounced spinal stenosis with a myelomalacia at the level of C5. I am only 29 but have skeletal dysplasia. My doctor wanted a more recent MRI before the surgery for a better reference because my first MRI was over a year old. However with this MRI the radiologist saw the Myelomalacia and said something about it being leisions suggesting it may be ALS or MS. The radiologist however didn't have the first MRI to compare. Is it possible to detect such conditions with a MRI? I have no weakness, just numbness and tingling in my arms and hands (mostly hands) with flexing my neck. My symptoms have gotten a little worse since the first MRI but not much. He has referred me to a neurologist before we go ahead with my surgery, and I am in knots worrying about this. Do you have any advice? Does this sound at all like ALS?
Doctor's Answer
by CCF-Neuro-M.D.-PW, Jan 13, 2006 12:00AM
There is no way of radiologically diagnosing ALS. Myelomalacia just means thinning of the spinal cord at that level, and is most commonly due to an old or chronic injury at that level (like degenerative spine disease)
ALS would be an extremely rare cuase of this finding and others would be much more common
I have not seen the scan so my advise is somewhat limited though
MS can be identified by MRI but if myelomalacia is the only finding in teh cord, it is still very non-specific and most likely due to chronic injury over time from your stenosis. If you have had discrete episodes over time of neurological symptoms like loss of vision, weakness or clumisness on one side etc, then a further evaluation for MS might be warranted due to the clinical picture (and not the MRI finding above)
Good luck
ALS would be an extremely rare cuase of this finding and others would be much more common
I have not seen the scan so my advise is somewhat limited though
MS can be identified by MRI but if myelomalacia is the only finding in teh cord, it is still very non-specific and most likely due to chronic injury over time from your stenosis. If you have had discrete episodes over time of neurological symptoms like loss of vision, weakness or clumisness on one side etc, then a further evaluation for MS might be warranted due to the clinical picture (and not the MRI finding above)
Good luck
MS plaques can show up on a cervical spine MRI. MS is part of the differential diagnosis for patients with spinal cord damage, especially if caused by stenosis. It is reasonable to be worked up for MS with further MRI (brain), VEP and/or CSF testing. However, in the absence of any motor weakness, visual problems, brainstem dysfunction, sphincter disturbances or other neurological problems, MS would seem unlikely. The sensation changes your experiencing in your arms are called Lhermitte's sign which indicates some type of spinal cord damage, but does not specify a cause in and of itself. I think seeing a neurologist before your surgery would be a good idea.
Are you saying that people with stenosis are more likely to get MS?