Confirming MS diagnosis

[SalMyGal]

Hi, I am 54 years old and had a positive MRI  (demyelinating disease and microvascular ischemic disease)16 years ago.  I had no symtoms of MS until earlier this year when I had a repeat MRI with contrast and the initial diagnosis was MS.  My symtoms are tingling and numbness in my left hand, face and leg.  Extremely tired, heat aggrevates my symptoms.  My husband noticed my speach is off. My questions is:  Does a lumbar puncture confirm the diagnoisis of MS and if the lumbar puncture comes back negative does that mean you DO NOT have MS?

[rendean]

I am 51 and my initial symptoms 4 years ago were like yours. I have only 2 lesions they count as "possible" demyelinating disease.  I also have migraines and hypertension.  My LP was negative. All of my neurologists had told me that a negative LP doesn't prove anything, ONLY if its positive is it useful. The LP experience was mixed. The LP under fluroscope (x-ray) was painless. It was the post LP headache and blood patch that was tough.


Other opinions from  other neurologists (at least one was a MS specialist) all sat on the fence and kept saying it's "probably" migraines as complex migraines can present this way minus the leg weakness lasting weeks. After I lost the strength in the left leg that required PT  to return function, they finally gave me the dx and I started a DMD.



My current MS specialist is  older and was not quick to dx me but he first excluded ALL mimics and after the leg episode he made the dx. Actually, I've had more symptoms this past year than I ever had before. I wish someone had made my dx earlier in the hopes that a DMD might help slow down the relapses.

Wishing well in your search for the correct answer.

Ren

[MsWobbles]

I would avoid the lumbar puncture like the plague!  I had mine done under fluoroscopy and they still hit a nerve bundle - ouch - huge electric shock down my right leg!!  The aftermath was just as bad.  It was totally not worth it.  You can be diagnosed by other means.

I agree with other here that it sounds like your MD will use a negative LP to mean you don't have MS!!  I've heard of so many others with MS who had negative LPs!!

Try another way!!

WAF

[sllowe]

Hi there,

Welcome.

If you do have MS, and though you are 54, you could very well still be relapsing remitting, which would enable your Dr. to describe a disease modifying therapy that will greatly increase your odds for MS management.  Dr. can treat your symptoms too  which can greatly enhance your quality of life.

I understand your reluctance as it does sound like this Dr. will only dx with a positive LP.  That is not good.  

Are you in the position to get a 2nd opinion w/out or at least before consideration of LP?
The Dr. shouldn't feel threatened by you asking for one.

You can definitely be dx'd without an LP - if that's a worry for you.

Thanks for joining us,
Shell

[jensequitur]

I can understand that you'd like to get on the medications and slow down progression...  Unfortunately, at this point, I'm not sure that medications will help.  Most of the DMDs provide 30% reduction in relapses, but it's best to start taking them when your symptoms first appear.

It sounds to me like your neuro will blow off an MS diagnosis if your lumbar puncture is negative.  Honestly, that's a lot to go through for a negative diagnosis... unless he's right, and it really is ischemic damage from migraines.  So it's up to you whether you go for the LP or not.  Just make sure they do it under fluoroscopy, so they don't nick a nerve.

[HVAC]

I was not eager for the LP but I am so glad I did.  

Good luck,
Alex

[SalMyGal]

Yes, the nuero I saw told me the ONLY way to verify MS was to have the LP. I have suffered from migraines all my adult life and he seems to believe the lesions I have on my MRI is from migraines, even tho other physicians have leaned towards the MS diagnosis.  I have many symtoms of MS and am really frustrated because I would like to get on the appropriate medications sooner rather than later because my quality of life has been affected.

[HVAC]

Test alone do not confirm MS. Some people have no signs of lesions on MRIs, and some people have negative LP and have MS. This is why you need a good Neurologist who is an MS Specialist or knows MS. Neurologists specialize  in are such as in pain, head aches, spinal injuries, etc. Symptoms and degrees vary from person to person. There are also many neurological disorders and diseases which mimic MS

I am 46. A PCP saw neurological problems on an exam 2 years ago. I had lesions on an MRI. The Next MRI  six months later one lesion was gone and more appeared. The third MRI six months later was about the same. I had a slightly abnormal VEP, although I am deaf and was born with double vision so that was discounted. I had lots of blood work which ruled out everything else.

I finally had an LP and for me it was way positive so I was diagnosed and started Copaxone.

Has your Doctor suggested a LP?

Alex