Thanks Bob,
I had a quick read last night, what I did notice was the O bands was 2 and still not Mayo's 4 or more and like Bob said, still nothing to support a lack of O bands excludes MS.
It would be nice to think ALL neurologist were actively updating to current diagnostic tables but the truth on the ground is that just like a lawyer or accountant etc they update and focus on their specialist field or personal interests. I've seen 2 neurologist, both were doctors referals to investigate MS, but neither specialised in MS.
The first was just the top name on an alphabetical list of neurologists at the local hospital, he turned out to specialise in epilepsy, splitting his time at an eplilepsy clinic in his home state and general neurology in mine. He sent me for an MRI (no contrast) because of clinical 'objective' sx consistent with brain and spinal lesions, the suspicion was MS. Radiologists after the MRI both asked me how long i'd had MS but the neurologist stated I had a normal MRI, no lesions "A perfect brain!" He lied, the MRI found T2 lesions in the white matter and deep white matter of my brain. So he looked for lesions to account for my sx, found them but with out one in the CC, all those I do have in other classic MS locations are irrelevant. A perfect brain my arse!
The second was a profesor of neurology, private and local, GP could get me in to see him the following week, GP expected a dx of MS. He turned out to be semi retired, I saw him at the only place he still practiced which was his dementia clinic, average age of his patients would logically be 60>. He stated "it was normal to have brain lesions", "eye sight has nothing to do with MS!!" and the old and new clinical signs he brought out of my body eg. falling over when stopped, unilateral hyperreflex, uni reactive muscle spasms, uni ancle clonus and the inability to walk a straight line "you dont have a neurological condition". LOL even my cognitive losses were nothing "IQ is subjective!"
I think it wouldn't of mattered if MS was tatoo'd all over me and my MRI, pick any criteria and i'd not think it would of mattered, and I dont think even this new version would of mattered. It maybe out there but if the neuro isn't specialising in MS they may never even read it. Seriously a professor of neurology saying eye sight has nothing to do with MS, what criteria (decade) was he getting his information from?
No matter what, you need to make sure your neuro really does specialise in MS, and not just say they do!
Cheers..............JJ
Bob,
this again is a good example of why we recommend people find an MSologist to see, rather than using a general neurologist. I'm not sure how well the neurologist understands the small changes made or wants to take the time to really compare it to previous MD rules. :-)
The MSologist stays current with the changes in other ways and not just by reading the peer reviewed journals. The process of getting information out is very slow - even if you look at the article you reference, it was submitted in 2010 for publication. Peer review publication moves slowly, just like neurological time.
Lu
Lulu,
I posted this one since once it comes out in the Annals of Neurology, most neurologist will learn of the new criteria. Even though the meeting was held early in 2010, most of the neurology community was pretty much unaware of this. I think the MS Centers and MSologist may have know. Since it was published last month, most general neuros will now be aware of it.
Bob
This was informative though. Thank you for posting this.
It seems to be the same old story. If you have OC Bands and no other reason for them, positive OC Bands support the DX of MS. Lack of OC Bands should not prevent a diagnosis of MS if the correct clinical signs, DIS, DIT and the mimics have been ruled out.
Bob
This just goes to show how slow it is to get published in a peer reviewed journal. This is the same criteria changes that we notes last year when they were first announced back in May 2010.
The criteria is constantly being reviewed by experts and receiving minor tweeks here and there as they can reach a concensus.
A good source for up to date McDonald is always mscare.org. This consortium keeps the criteria current and we don't have to wait almost a year to get the newest version.
best,
Lulu
Wish that was written in English!!
My CFS secured my MS diagnosis. I can not tell if the new criteria supports CFS use or not!
LA