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Neurology (Expert Forum)
lumbar puncture to rule out MS?
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lumbar puncture to rule out MS?
by aliciadawn, Apr 24, 2006 12:00AM
I am a 35 year old woman, who had been very healthy until about a year ago, when I suffered a terrible panic attack that left behind underlying anxiety. I am on lexapro, which has helped.
My question is, after a year of having strange headaches(head didn't really hurt, my legs did, but it felt like it was originating in my head.) Nauseated, but not the typical "migraine". I did have some tingling and numbness, but was very transient and fleeting.
MRI showed scattered nonspecific bright foci in coronal radiata. Suggested diagnosis included chronic migraine, chronic hypertension,(I have low blood pressure), lyme disease, post-viral infection, early-onset small vessel disease, or ms; although the radiologist noted that it was not the typical pattern for ms.
My neurologist now wants to do a lumbar puncture to "rule out" ms, since I have vague symptoms and am in the right age group.
The question-if the lumbar puncture comes out negative, then what are the white spots? Could it still be MS or is it more likely migraines? I love my neurologist, but just wanted some other input . I realize you haven't seen my films, but she just wasn't too concerned about it being anything but ms. Also showed some abnormal flow artifacts that she didn't seem too concerned about. Just wanted an opinion.
Thank you!
aliciadawn
My question is, after a year of having strange headaches(head didn't really hurt, my legs did, but it felt like it was originating in my head.) Nauseated, but not the typical "migraine". I did have some tingling and numbness, but was very transient and fleeting.
MRI showed scattered nonspecific bright foci in coronal radiata. Suggested diagnosis included chronic migraine, chronic hypertension,(I have low blood pressure), lyme disease, post-viral infection, early-onset small vessel disease, or ms; although the radiologist noted that it was not the typical pattern for ms.
My neurologist now wants to do a lumbar puncture to "rule out" ms, since I have vague symptoms and am in the right age group.
The question-if the lumbar puncture comes out negative, then what are the white spots? Could it still be MS or is it more likely migraines? I love my neurologist, but just wanted some other input . I realize you haven't seen my films, but she just wasn't too concerned about it being anything but ms. Also showed some abnormal flow artifacts that she didn't seem too concerned about. Just wanted an opinion.
Thank you!
aliciadawn
Doctor's Answer
by CCF-Neuro-M.D.-PW, May 01, 2006 12:00AM
Unfortunately I cannot give a specific medical opinion on your case. In general, there is no deficinte indication to do a lumbar puncture, it is at the discretion of the physician and their best clinical judgement. The white spots could be justwhat the report suggests ie migraine, vascular etc. There are specific criteria for the diagnosis of MS with regard to the number and type/locations of spots, clinical symptoms and CSF, called the McDonald Criteria, try looking it up.
Abnormal flow artifacts are usually just that - artifacts. Turbulent flow in a bllod vessel causes a signal change in the MRI image, that sometimes make it look like there is no or decreased flow due to an arterey narrowing, but it is just artifact
Good luck
Abnormal flow artifacts are usually just that - artifacts. Turbulent flow in a bllod vessel causes a signal change in the MRI image, that sometimes make it look like there is no or decreased flow due to an arterey narrowing, but it is just artifact
Good luck
Member Comments (6)
by bengalcats, Apr 24, 2006 12:00AM
over the last few months i was having headaches which was rare for me so i went to a neuro who did a brain mri and it showed some bright spots in the subcortal ,he said it was from my newly problem with headaches and not to worry, how ever i have had other things going on for apx 20 years now with tingling in my arms hands and legs, vaginal numbness, weird feelings in my brain, vision problems ect, as soon as the neuro said i had white spots i got so fearfull that i would have ms so i went back to him and he wouldnt even talk to me about ms, i was worried especially with my long history of ms like symptoms, he gave me headache pills and sent me home. i switched neuros and the new one after reading my 3 page detailed report that i wrote about my health and symptoms felt that ms was a possibility so she ordered a lumbar puncture to check. i was terrified of the puncture but very honestly it did not hurt! it hurt me more to give blood. however i did end up with spinal headaches and had to go back for a blood patch. i was so anxious till i got my results back in 2 weeks which were neg, thank god!the peole on this forum have been very helpfull and helped me get throught this. keep us posted.
by joshua217777, Apr 25, 2006 12:00AM
Alicia read some of my posts from about a month ago. Nonspecific white spots I had the neuro thought it was from migraines. I dont have migraines but thats what she thought it was from. Other causes could had been old stroke, ms, and a head injury in the past. Theres many others too. Also its normal to get white spots as we age. The nuero wanted me to get a spinal tap. I got a second opinion and my Dr said he didnt think I needed one. I never ever got headaches then suddenly after hurting my neck got daily headaches. Had face pain, teeth aches my Dr put me on Predinose and that got rid of headaches. Only problem is a numb feeling in my head and face I still get from time to time. Like a headache but doesnt hurt. You may have a problem in your neck or back causing headaches especially with tingling and numbness included. Go back to a few weeks ago if their still on here and read everything from Demi. He had tons of info.
by cklballs, Apr 25, 2006 12:00AM
I have mri's showing spots on the temporal lobe and right frontal. I too have been checked for ms (3 lumbars in 5 years). I have been through neurologists who have not been sure of what is going on. I was tested positive and negative for anticardiolipin antibody syndrome. I have been tested more negative than positive. I am taking plavix and aspirin due to sudden facial numbness (and at times feeling like it is slumped but it does not). They thought TIAs. However, when I'd go to get blood work up, the test in normal. I have had a neck mri and it was normal. Still having symptoms and now tremor (or very small shakes in the head and hands and sometimes the legs. Currently taking lexapro, asthma inhalers, prednisone, etc. Sleep problems. Unsure if I am being overmedicated or what. Either way, it is very aggrevating. I am a school teacher and I am having trouble coping with this. If you have any feedback, I would appreciate it. Thanks for posting.
by Pinky61, Apr 25, 2006 12:00AM
To: cklballs
Your medications may be part of your problems. Lexapro is VERY activating for some people and could be causing your sleep problems and tremor. Also, steroids such as prednisone can cause insomia. Just something to talk to your doc about. Good luck!
by NickyIsHere123, Apr 26, 2006 12:00AM
To: cklballs
Yes, you are taking a very dangerous drug :plavix. This drug can cause bad side affects. Just look into it. A man who is in his upper 60's came in and talked about how this drug made his heart condition worse. he said it made him go blind in one eye. Not trying to scare you, but warn you rather
