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Can a LP give me a diagnoses of MS if I already have an autoimmune dise...
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Can a LP give me a diagnoses of MS if I already have an autoimmune disease?

Hi everyone!

I am a 49 year old female and I have a possible diagnoses of MS.  I was diagnosed with Crohns disease in 1994.
I have gone through all the meds (either allergic or they quit working) and now I am on Humeria.
In January of this year, I was put on Flagyl for Bacterial Vaganosis, three days later I noticed tingling in my toes.
Five days after taking the Flagyl, I noticed the tingling had moved up into the foot.  One week later I noticed tingling
had moved up to the knees.  Two weeks after being on Flagyl, I went to my GP.  The GP did blood work.  Everything came back normal except for my Thryroid came back on the low end of normal.  GP sent me to Neuro.  

Neuro wanted to check my ferritin levels (GP did that but didn't tell me).  Ferritin levels came back low. (remember Gp did this and it came back normal 2 weeks earlier). So he put me on iron and wanted a MRI done on the lumbar and thoracic.  The thoracic came back a with lesion and he order a brain MRI. The brain MRI came back with several (three or four) very, very, small lesions.  

So husband and I went in to talk with Neuro and he said the lesion on my thoracic looked like something took a bite out of it.  I just thought that was kinda weird.  A bite out of it, of course that got me all paranoid that I had some kind of weird critter in me eating away at my spine. (lol)(JK).  So now he has order a lumbar puncture and I am hoping for the best.
The Neuro did say that if it was MS, it would be the paralyizing kind because it started in the spine.

question:  Can a lumbar puncture give me a diagnose of MS if I already have an autoimmune disease?
                Is the Neuro correct in telling me that it will be paralyizing because it started in the spine?

Next Symptoms:

I tingle from the from the waist down sometimes and it is only if I touch it or if I have been walking a great deal.
Some muscle spasms in the left calf.  The bottom of my feet are driving me insane.  I really don't know how to describe it but I will try.  It kinda feel like I have dried mud caked on them, but it is not a heavy feeling, they are not numb because if I step on something it really hurts. sometimes my muscles in the top of my feet feel like they are trying to pull my toes up (if that makes sense).  I sometimes have swelling in my legs also.

My head does a lot of swimming and dizziness. Today I feel like I have been drinking alcohol very heavily and no not drinking anything but water  :).  Sometimes I have what I call electrical currents in my vision.  I do have to wear glasses for reading and distance driving but find myself wearing my glasses most all of the time now.  My face does the tingling sometimes too and that is when I notice the dizziness and swimming more.  

I am having some difficulty remembering things and walking steadily(mostly I think because of the swimming head), saying the proper word or speaking correctly.  Typing this today has been loads of fun.  You would not believe the back spacing and correctingI have had to do.

In the mornings, I wake up with my feet swollen, sometimes they are red.  Sometimes during the day my legs will swell as well and my stomach and abdomen will gradually swell during the day and at night it looks like I am very badly bloated.  I have alot of gastrointestinal distress.
(possibly crohns disease).

Please keep in mind that these symptoms do not happen every day, except for my feet.

Medications:

Humira, proferrin-forte tablets, Gabapentin (suppose to help with tingling, not working yet but only been on it a couple of days)
D3, keto 7 DHEA, B 12 shots, premarin.

I am very concerned that already having one autoimmune disease and now possibly having another.  I also know that Humira can rarely cause MS and neuro problems but right now the Neuro seems to think it is MS.  I guess I will find out when the LP results come back.

Just want to thank everyone for taking the time to read.  

Sue
14 Comments Post a Comment
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1983221_tn?1333509785
Hi Sue,  I can't answer your questions but I believe that Crohns Disease can cause lesions on the brain.  I will see if I can find an article for you regarding this, perhaps it's something to discuss with your neurologist.
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1983221_tn?1333509785
http://www.ncbi.nlm.nih.gov/pubmed/21091817
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Thank you, will go and read that now.
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Avatar_f_tn
Okay, I went and tried to read that and to be honest didn't understand a word of it.  lol
Thanks
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Another thing to look at is gluten ataxia.  It causes 90% of the same symptoms as MS.  It could also explain your stomach bloating and gastro distress.  If you haven't already, get yourself tested for Celiac disease as a lot of Crohn's disease is really Celiac.  Gluten ataxia may not necessarily show up on a Celiac test as not everyone with GA has gastro involvement.  There are other tests for GA, but you'd have to have a look at the article "Gluten Sensitivity: From Gut to Brain" to find out what they are - my brain fog won't let me remember the names.

All my symptoms were initially put down to gluten ataxia until I wrote to the world expert (Prof M Hadjivassiliou) and he categorically told me that the sudden deafness I experienced, was not a GA thing.

Hope this is some help to you.

Poppy
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So, how can he prove which started first, the ones in the brain or the ones in the spine?  kinda like which came first, the chicken or the egg?

neurontin is for pain.

I'd want a 2nd opinion before I accepted any diagnosis and prognosis that intense.  Just for peace of mind.  The LP may or may not help.  Many people have no bands in their LP tap, I don't.

I can't help you on the other problems you have but many have gotten 2nd opinions often help one way or another!
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Thanks for the reply Sarah.  I hadn't thought of the which comes first, and that kind of bothers me (how could he possibly know?).
and having not looked up neurontin, didn't realize it was for pain.  I am not having any pain and he said it would help with the tingling.  Maybe why I have been drunk all day. hmmmm.  I am definitely going to get a 2nd opinion.  I know that MS can cause paralysis but I have not read anything as of yet that says that one kind of MS definitely cause paralysis.  Maybe I haven't been reading the right material.  
Thanks again

Sue
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neurontin will give you a run for your money til you get used to it.  it can mask tingling as a pain sensation .  I am going to PM you tomorrow with a reading suggestion.  have to crawl in right now
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667078_tn?1316004535
Another autoimmune disease will not distract the findings for MS with a LP. They look for O-bands in serum of the brain, CSF, only not the blood. They do a blood draw at the same time and compare them. If you have O-bands in the CSF and blood its not MS. I had no O-bands in the blood serum and 12 in the CSF. Some people with MS have no O-bands so a LP is inconclusive.

Alex


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So if I am understanding you correctly, the O-bands have to be in the blood as well as in CSF for it NOT to be MS?  and so if there are no O-bands in the blood and O-bands in the CSF it IS MS? or if there is O-bands in blood and not in CSF it IS MS?   Please forgive me,  I am having a lot of trouble comprehending things with the stress and depression right now.  
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5112396_tn?1378021583
Ah, the mysteries of the LP. It's confused most of us at some point or another! We've people on here who've explained it far better than I can. You may find this page (from our health pages) helpful.

http://www.medhelp.org/health_pages/Multiple-Sclerosis/Can-you-Diagnose-MS-with-an-LP-that-is-Negative-for-O-bands/show/142?cid=36


Unfortunately no test rules MS in or out completely. We wish it were that cut-and-dried.
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1831849_tn?1383231992
"and so if there are no O-bands in the blood and O-bands in the CSF it IS MS?"

This is the only combination that points towards MS. It does not state definitively "You have MS". The finding of o-bands in CSF but not in blood would support clinical findings, MRI's, Blood tests etc.

As immisceo said, there is no smoking gun test for MS.

Kyle
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Thanks everyone for your replies.  I guess I will find out the Neuro diagnoses after the LP Tuesday.  

sue
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667078_tn?1316004535
For MS O-bands only in the CSF not the blood. It took me six weeks for my LP results they have to send them to special labs. In my case they sent them to several.

Alex
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