Another Neuro Myth?

LP results, early stages of MS?

I just read jane434's post about her MRI results:

http://www.medhelp.org/posts/Multiple-Sclerosis/BRAIN-MRI-RESULTS/show/1392062

She's been having symptoms for a relatively short period of time (2 months).

One of the responses suggested that she press her neuro for an LP and this leads to my question.

When I saw my new neuro, I had an LP about 13 months after the onset of my symptoms. She said that LP was done too early. Given that she specializes in MS and demyelinating disease, I accepted her explanation.

Another myth? If what she says is correct, then people who have just started experiencing symptoms should not go through this potentially invasive procedure which will not produce any conclusive results. If she is wrong, then it gives me more reason to consider changing doctors (after I clarify with her my understanding of what she said).

There is an old, but ongoing post "Lies my neuro told me", but this falls into another category. Feel free to respond directly to the question at hand or add another possible myth you may have been told.

Boy, are we at the mercy of our doctors. Thank goodness we have a place like this to come to for information and clarification.

Audrey

[jensequitur]

I think much of the problem is that diagnosis is so inconsistent - I've heard that LP will show banding after some time of disease activity.  However, I had an LP after I started having symptoms, and it showed 5 o-bands.  So practically speaking, I think that many people who are eventually diagnosed with MS have some disease process going on, even if they don't recognize it.

[essdipity]

Well, Audrey, I remembered Quix saying that LPs are more likely to be negative early in the game. That's relatively speaking, of course.

So I searched around and found this---

http://www.medhelp.org/posts/Multiple-Sclerosis/Can-you-have-MS-without-oligoclonal-banding/show/462232

I believe the Health Page on LPs was written after this post, FWIW. Also, Quix says elsewhere that with newer and better techniques for LP analysis, and well-trained technicians, the rate of positives at any point in the process has gone up.

Any invasive procedure should come late rather than early in the diagnostic process, in my opinion, and an LP is pretty darned invasive.

Still, you just never know. I don't think your neuro's statement is a myth. People early in the process often do have positive results, but more people are likely to as time passes, so from that perspective she is right.

As for me, I had a negative LP in 2006. In 2000, I had a brain MRI that clearly showed MS, though it was misinterpreted and mishandled almost criminally. Long story there, but my point is that after at least 6 years, the LP was unremarkable.

I commented in Jane's thread that what she needs IMHO is a decent doctor. I wouldn't be concerned about an LP at her point, since if it's negative it doesn't prove a thing.

ess

[COBOB]

We need Quix's immunology background on this one, but you have to have anybody production before the NK cells and the other "active immune cells" can even damage the myelin.  Antibodies come before damage.  So the question is "How quickly or if the antibodies travel through the CSF to be withdrawn during an LP.  

Bob

[COBOB]

anybody should have been Antibody -  Yuck my typing stinks -

[twist330]

I had my LP done just 16 weeks after my very first symptoms of numb fingers. It came back negative. Having researched this a bit on the internet I believe this was done to early to support a Dx of MS.
Here is one of the websites that states this.

www.msif.org/en/about_ms/diagnostic_tests.html

[RedFlame]

I don't know the answer to this specific question.  I'm sure that Quix will be able to help.  

I had my LP done about 10 months from onset of symptoms.  My test was positive for O-Bands.  If it was me in your situation, I would request an LP.  It's worth the pain.  

Red

[kelly97]

My neuro also stated that it might be better to wait a little bit before getting an LP.  What doesn't show up as positive initally, may show up as positive within a couple of years.
So, you may initially be negative, then have another LP down the road, and that one will be positive.
And then again, I think there are still some that always stay negative, even though they do have MS.

-Kelly

[daisy.girl]

I believe that having a negative LP makes you question your diagnosis that much more. Even though the other testing and neuro exam pointed to a Dx of MS.....in the back on my mind, I keep saying....if I really had MS wouldn;t I have had O-bands in my LP??