Can You Can Have MS without MRI Lesions?

[Quixotic1]

I know we have covered this before, and I really should spend more time on the National MS Society site, but this is a quote from the NMSS Sourcebook on MRI's.  It says everything so much more succinctly than I do when I'm "winging it."

"Diagnosis
Because MRI is particularly useful in detecting central nervous system demyelination, it is a powerful tool in helping to establish the diagnosis of MS. It should be remembered, however, that approximately 5% of patients with clinically definite MS do not show lesions on MRI, and the absence of demyelination on MRI does not rule out MS. Also, since many lesions seen on MRI may be in so-called "silent" areas of the brain, it is not always possible to make a specific correlation between what is seen on the MRI scan and the patient's clinical signs and symptoms. In addition, with advancing age (probably over age 50), there are often small areas seen on MRI in healthy people that resemble MS but are actually related to the aging process, and are of no clinical significance."

http://www.nationalmssociety.org/site/PageServer?pagename=HOM_LIB_sourcebook_mri

Guys, not to restate the obvious but this is 1 out of every 20!!!  I'll keep looking, but even my MS Neuro, whom I consider very smart, felt that MS was ruled out by normal MRI's.  I need to understand whether the 5% got diagnosed because they presented so classically - maybe with Optic Neuritis, more than one clear attack, a very positive LP, and a tatoo on their forehead that says, "I have MS!"

Quix

[maralact]

Thank you, Kyle, for being so quick to respond. I've read posts before, but I've never participated in any. I guess I'm just tired of telling my story again and again. I've seen my share of doctors, even wrote down for them a chronological recount of my symptoms, and I still don't have a Dx., hence no treatment. I barely feel my legs, and when I do it's mostly burning pain. Hands are getting there as well. For this day and age,to say nothing about the research done in this country alone, I (and many others) shouldn't be sitting numb without a Dx. for such a long time. My question for Quix was pretty targeted : has anyone been diagnosed with MS after a flu shot? All hell came lose after my H1N1 vaccination in 2009. I particularly seem sensitive to physical exercise and hot water. My doc says the hot water strongly suggest MS, but do the muscle twitches do too? I read somewhere that in spite of being an autoimmune disease, MS does not respond to IVIG treatment. My initial treatment with it worked. I'd like to make sense of all this.

[maralact]

I must have pushed the wrong button, so I'll go on with my story. I never really was the same as before. What triggered my symptoms was physical exertion and longer showers or hot baths. My neuropathy was all overmy body, scalp included. I worked around those issues and 2012 was altogether a better year. Encouraged, I started working out again (but nothing compared to my healthy years,) and by late September symptoms came back with a vengeance. I developed a stubborn twitch under my left eye, iritis, more numbness, a knot in the throat, itching, insomnia, and the list goes on. I am seeing a different neurologist, and she believes that bases on my symptoms I might have MS. My MRI , EMG test, and neuro exam were fine. I'm scheduled for LP next week. Blood tests showed nothing spectacular aside from an elevated platelet count (650 for a max. Of 400, ) which I've been having from 2004. The doc believes that an old inflammation in my body was excited by the vaccine and caused all this. I did some reading, and found no instance of vaccination triggering MS. I need a fresh eye, a look outside the box. When more complex things develop, doctors have a tendency to sent you from one specialty to another, but none is willing to look at it in a comprehensible way. An input would be much appreciated.

[maralact]

In 2009 I got my first flu vaccine (H1N1) and a few days after that I developed symptoms in my feet and legs, and worked their way up to my hands and face. Got IVIG treatment, and got better. I retained some numbness in my left palm, but it wasn't present all the time. I went back to my workout routine which my doctor approved. In August 2010 symptoms returned, and as treatment was not immediate (docs seemed to be puzzled,) I started experiencing more nasty things: muscle twitches and cramps, heavy legs, inner tremors in my hands. Eventually, they put me on another IVIG treatment in late November, but it didn't do the magic of the previous one. I also saw a homeopathic doc around the same time,so when I finally got better again I wasn't sure which treatment kicked in. In 2011 I was Ok for a while, and then worse again, but didn't seek medical help as I wanted to avoid the unpleasant experience I had with them. I took Lorazepam 0.5 mg when needed, and marched on. Every time I got better I was tempted to do things as before, walk more, l

[kwarendorf]

Hi-  This is a rather old thread. It was started in 2007. Quix, our former resident MD, has moved on to other things and is no longer participating on the board. You might want to post a new question. While there are no doctors, there are lots of really smart folks here :-)

Kyle

[maralact]

I asked for help  which I believed to be on the same forum as this one, yet comments stopped in 2009. I don't know if you have access to that or if I have to repost. Please let me know.

[Mammy2819]

Not sure whatever happened with your condition, but Dr. David Mattson is an excellent neuro.  Look him up!  Indiana.