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1510649 tn?1301575339

MRI done; next up: spinal tap. Is this MS?

Hi everyone. I'm new to this forum and have yet to be diagnosed with MS, although I will be one step closer after March 4 when I have my spinal tap.

To give you a little background, I'm a 33-year-old female, and back in November, I went to the hospital because the left side of my face went numb. My doctor's office thought I had Bell's Palsy, but at the emergency room, they did some tests and ruled out Bell's Palsy. Apparently, my facial droop was not consistent with that of Bell's Palsy. My CT scan showed no abnormalities, but the MRI found "two nonspecific punctate foci of elevated T2 and FLAIR signal...within the subcortical white matter of the parietal regions bilaterally."

The MRI report went on to say, "Nonspecific punctate foci of elevated T2 and FLAIR signal within the subcortical white matter of the parietal regions, one site on the left and a second on the right which may represent changes secondary to demyelination, vasculitis, chronic small vessel ischemic changes or another nonspecific underlying inflammatory or infections process."

The report advised "clinical correlation," so I made an appointment with a neurologist who pretty much just blew me off, so I made an appointment with another neurologist who knew my medical history--the same neurologist I'd seen almost three years prior because I was having weakness in my hands, apparently unrelated to the cervical spine surgery I had about four years ago (I had a disc removed). (This is the same guy who had sent me for an EMG that I decided not to have done because a friend of mine told me that "it hurt.") Anyway, this neurologist listened as I described all of my symptoms--the feeling of weakness/numbness in my legs (mainly in my left leg), terrible back spasms and spasms in the muscles of my legs and feet/toes, and most embarrassing of all, incontinence (not complete urinary incontinence, but I do have to wear a pad all the time to avoid having to do laundry all the time). I also have occasional nystagmus, where my eyes will dart back and forth from left to right several times really fast and for no reason. And I have been getting terrible vertigo lately, especially late in the evening and when I lie flat on my back.

Anyway, my neurologist is sending me for a spinal tap, which I'm going to have done on March 4, but I'm wondering if the results of my MRI are consistent with MS? My neurologist has already told me that "this could be nothing, or this could be MS," so I'm prepared for the diagnosis (as much as one can prepare for a diagnosis)... Honestly, I'm just ready to find out what's wrong. These strange symptoms have been disappearing and reappearing for the past three years or so, but only lately have they gotten worse, and this past Saturday the left side of my face went numb again, and I had slurred speech with it, too. (Thankfully the numbness and slurred speech has since gone.)

Anyway, I'm just wondering what other diagnoses could be made? Do you think this is MS? And will the spinal tap definitely prove one way or the other that I have or don't have MS? And how bad is a spinal tap? I'm terrified about having one done. Oh, and here's one other thing: I found out that my B12 was 210 a while back, which I guess is pretty low, but the neurologist told me that wouldn't cause what was seen on the MRI.

Sorry I'm being so long winded. I am just really scared about what's going to happen next.
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Avatar universal
The doctor prescribed you 90 days worth of Doxycycline and you've taken it for 2 wks so far?  Did he tell you how quickly it may work?  
I think if you've had Lyme for a while (if that's what it really is we don't know) and had the symptoms for a while, then it's not supposed to get rid of your symptoms right away.  

Maybe it will start working in a little bit.  

But would Lyme cause issues with your eyes - I'm not sure. ?

I hope you start to feel better soon.
Take care,
Kelly
Helpful - 0
1475492 tn?1332884167
(((BIG HUG))) I am not in pain... but I know what it feels to be in limboland, have scary symptoms and not know what's wrong!

I am sorry you are feeling this way.
Helpful - 0
Avatar universal
OMG,, I hear you loud and clear and I am chiming in!! Please see my journal,... I have my story, and my timeline. You will see that we are in the same boat!!
Please don't give up hope, I started to and then it was my endocrinologist that is willing to go the extra mile for me and form a team of docs to help me.
If you want to talk, you can PM me.
Hope to hear from you soon,
Pam
Helpful - 0
1510649 tn?1301575339
Well, I've been on Doxycycline for just over two weeks now and I've still got major pain in my neck, my right shoulder and my back. I was so concerned because of the pain--which is on the SEVERE level--in my right shoulder and in my neck and the fact that I've been experiencing pins and needles all down my right arm and into my hand (the pins and needles have also started slowly in my left shoulder, too) that I had to make an appointment with my orthopedic neck surgeon, who sent me for an MRI of my neck AGAIN. (I just had one neck six months ago.)

I also emailed my neurologist's assistant to see about getting an MRI of my thoracic, since I've still got major pain in my back, too, and because I started experiencing pins and needles all down my right leg on Friday (I nearly went to the ER to make sure I wasn't having a stroke and to be sure I didn't have a disc that was compressing my spinal cord or something). The calf muscle in my right leg has also started spasming throughout the day, for no apparent reason. Anyway, my neurologist's office is going to be sending me a prescription for an MRI of my thoracic, but I have already had one clean MRI of my neck and one of my lumbar spine. The likelihood of having a herniated thoracic disc is pretty nil, although not impossible...

I asked my endocrinologist, who is a fantastic doctor, if any of the medication I was on could cause such terrible cramps and back spasms, and he said no, and then proceeded to tell me that a negative LP didn't necessarily mean that I didn't have MS, although my neurologist seems to think otherwise.

I cannot sleep at night because I am in constant pain, although my new prescription for Flexeril seems to help somewhat, and definitely is more helpful than the Skelaxin my neurologist had me on. I am terrified of what this could be, but I just want more than anything to know, and the Doxycycline seems to be doing nothing whatsoever to help. (I guess feeling better initially was just a placebo effect?) My chiropractor says he thinks people are just giving me different diagnoses to pass me along to the next doctor, and it's very tiring, not to mention depressing.

My endocrinologist wants to send me for an EMG just to see what's going on. I honestly don't know what to do anymore and I don't even want to go to another doctor, because I don't think anyone believes me. I can't be the only person who's gone through all of this. Hoping that someone can chime in here. I'm losing hope of finding an answer for all my pain and pins and needles.
Helpful - 0
Avatar universal
I hope the new med works for you and that you really have Lyme, instead of MS.
I'm crossing my fingers with you!!!

-Kelly
Helpful - 0
1510649 tn?1301575339
I did follow up with my neurologist. I actually emailed his assistant and then I got a phone call from him. He said I didn't have MS or anything bad and that it was just a "virus." That was about a week ago that I got that phone call. This past Monday night, I went to a massage therapist, seeking some relief from the pain, but after 10 minutes, she stopped because I was in so much pain, and told me I needed to see a doctor. Her husband, who is also a massage therapist and works in the same Massage Envy location, took one look at me and said he thought I was acting like someone who had fibromyalgia, although he said he couldn't diagnose because he wasn't a doctor. Well, I cried right there in the front lobby of Massage Envy because someone else had told me that I needed to see a doctor. Then I drove home and cried some more. Then I turned on Netflix and started watching a documentary called "Under Our Skin"--a documentary about Lyme Disease. Everything these people were talking about sounded a lot like me and I began to wonder if the tests I'd had run on me for Lyme Disease had produced accurate results. I had a Lyme titer, which came back negative, and my CSF came back negative too, but I still wondered.

When my husband came home I told him about Lyme Disease and his response was, "Well, I told you months ago that if this was anything bad, it was Lyme Disease." I live in Northern Virginia, and Lyme is prevalent in my neighborhood. In fact, a lady just down the road was diagnosed with it 20 years ago. One of my very good friends also has Lyme.

The next day (just this past Tuesday), I called a doctor friend of mine who had also, back when this first started, suggested that I had Lyme Disease (his wife had Lyme and, as a result, he's very familiar with it) and told him that I was still, seven months after my initial bout of Bell's Palsy, having CNS problems and was in a massive amount of pain, too. I told him that all my tests for Lyme had come back negative, but he said the tests weren't reliable and immediately prescribed Doxycyclene (I have a 90-day prescription, but he said I may need to be on it even longer than that depending on how this prescription goes). I started on the Doxy Tuesday evening, I believe, and it seems to be working!!! Honestly this is the best I've felt since November, for sure, but I really cannot remember the last time I felt this good. My mid- and lower-back pain, which was the last of my symptoms to develop, around the beginning of April (I've had the Bell's off and on since November and I've had the neck issues for years), is now nearly completely gone!

I'm crossing my fingers that it's Lyme I've been dealing with all these years, but having searched the Internet about Lyme ever since I (hope) figured this thing out, I have found that it commonly lurks in the parietal lobes of the brain (bilaterally), and I've got that on my MRI (the spots weren't there three years ago) when it goes to neurological Lyme. Bell's Palsy is extremely common with Lyme, too. It all definitely makes sense.

There's a young girl in my neighborhood who's been pretty sick, too, for the past few years and lost her scholarship to play volleyball as a result of her sickness... I wonder if she may be dealing with Lyme, too, and just doesn't know it. Scary. I'm going to have my daughter tested for it when I take her to her annual physical.
Helpful - 0
198419 tn?1360242356
Hi there,

Adding a big 2nd to Kay, please call the neuro- it's important to be seen with the return of these symptoms and no dx yet.

-shell

Helpful - 0
1694605 tn?1306510027
Hi Elizabeth!  sorry you are struggling again with symptons.  Have you tried calling your neuro?  maybe he can call in an Rx for prednisone and avert the emergency room -  hope you are better soon.
Helpful - 0
1510649 tn?1301575339
So I got up this morning and my face is once again numb on one side. I've also noticed that the bottoms of my feet are tingling. I don't want to go to the hospital, but if this gets any worse and I can't walk, I'm going to have to go in. I don't have any o-bands in my CSF, and for that reason my neurologist says I do not have MS, so now I'm wondering if these are mini-strokes I'm having? It's really scaring me. Help!
Helpful - 0
1510649 tn?1301575339
Yes, I had an MRI of my lumbar spine, since I was having mid- and lower-back pain, which was the reason my neuro prescribed Skelaxin for me. I also had an MRI of my neck after the initial bout of supposed Bell's Palsy, just to be sure the problems weren't coming from my neck. No herniated discs or anything in either my lumbar or C-spine. Muscle enzymes are mildly increased, but that's pretty much it. Still having the weird sensation of ants on my legs and my muscles are still locking up occasionally, especially in my neck and shoulder. I just wish I could figure out what the heck this is. I'm so tired of being on Prednisone every few months and muscle relaxers. That stuff can't be good for you!
Helpful - 0
1394601 tn?1328032308
Did you ever get the MRI of your spine?

I am sorry you are still in pain.
Helpful - 0
1510649 tn?1301575339
Here we are two months later and I now know I'm negative for Lupus. No other herniated discs, either. But I turned my head about a week ago and all the muscles in my neck locked up. It is so painful! Was trying to avoid having to take Prednisone again, but I'm starting on that this morning. This is just so frustrating!
Helpful - 0
1510649 tn?1301575339
New script for Skelaxin being filled today. Hopefully that will do the trick. Doc says the pain is definitely muscular but he can't figure out why I have it. Says I may need to get an MRI of my spine if the Skelaxin doesn't take care of the pain.
Helpful - 0
1580434 tn?1378596528
I generally end up on prednisone 4 times a year. It helps many things. however, I always have to tapper down slowly. Also drink lots of water or get bad spasms in feet,legs and back.
I love the way it makes me feel, energy, breathe better and it stops the spasms. don't like the munchies ha. yet coming off of them can be harder. also makes my tremors worse and I don't like that.

Raz
Helpful - 0
1510649 tn?1301575339
Well, I went on 60 mg per day of Prednisone for five days as directed by my neurologist. By day three I was feeling pretty good and even able to get some time in on the elliptical at the gym. Today was the first day without the Prednisone, though, and my back hurts again. Legs starting to cramp up again, too. What IS this?!
Helpful - 0
1510649 tn?1301575339
Thanks, everyone, for all of this great information. And Bob, let's just hope that I don't have to have that autopsy anytime soon. LOL.

Wanted to update you all on my followup appointment with the neurologist, which I had yesterday. He thinks that whatever I have is being caused by a virus and prescribed me Prednisone to take care of these attacks I'm having, saying that the Prednisone should help the inflammation (diagnosis on the prescription said "myalgia," so that's what the Prednisone should take care of--I hope). I'm supposed to take 60 mg of Prednisone daily for three to five days each time I experience one of these attacks. He did check to be sure I hadn't herniated a disc in my lower back (I had a herniated disc between my C6/C7 spine removed about three years ago).

Bob, I haven't heard of invisible lesions, but that's pretty spooky! Makes me wonder if I have more hiding out somewhere...

Anyway, I have another appointment with my neurologist in six months, unless something happens between now and then and I need to schedule an appointment to see him sooner. In the meantime, he is sending me for bloodwork to check my Adolase, CPK and Myoglobin levels, since my CPK and Myoglobin levels were mildly elevated back in November when my face first went numb on one side back in November. He said the possibility of having some kind of myositis is pretty rare.

I was reading about Prednisone to see what the side effects were and found something interesting, though. Apparently Prednisone is used in the treatment of Multiple Sclerosis exacerbations. (See http://www.nationalmssociety.org/about-multiple-sclerosis/what-we-know-about-ms/treatments/medications/prednisone/index.aspx)
Helpful - 0
1453990 tn?1329231426
As far as "Invisible lesions," this is why it is important for people with MS to consider donating their brain and CSF to a tissue bank like the one at Rocky Mountain MS that is funded by the NMSS.  They compare the last MRI with the actual lesions in the brain.  It has been said several times on here that the only definitive diagnosis for MS happens at autopsy.  
http://www.mscenter.org/research/tissue-bank/

These invisible lesions have been demonstrated in brain sections.  Recent immunohistochemical studies have demonstrated extensive grey matter demyelination in chronic MS.  While the lesions were not demonstrated on MRI, the immunohistochemical staining made the ares of demyelination visible in both the white and grey matter.
--Grey matter pathology in multiple sclerosis.
Bö L, Geurts JJ, Mörk SJ, van der Valk P.
Department of Pathology, MS Center, VU University Medical Center, Amsterdam, The Netherlands. ***@****

Bob
Helpful - 0
1382889 tn?1505071193
Never heard before either but very depressing.  :-(

Julie
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Avatar universal
Bob, that's interesting about the invisible lesions.  I had never heard that before.
Helpful - 0
1453990 tn?1329231426
A neg LP does not rule out MS.  About 10% of patients with clinically diagnosed MS have a negative LP.  I happen to be one of them.  A positive LP "strengthens the possibility,"  but a negative doesn't mean that much.

A 3T MRI shows about 20% more lesions than a 1.5T on the same person.  So if you had 5 lesions on a 1.5T, you may have 6 on a 3T.  The big difference is that the Larmor Frequency of of a 3T is 127.74 MHz .  That is twice the Larmor Frequency of 63.87 MHz on a 1.5T unit.  The Larmor Frequency is the frequency the H1 proton "sings" at when the magnet lines up the molecules. This means more in spinal imaging than brain imaging.  It can better differentiate lesions from the cord and thecal sack.

One key thing to keep in mind is the "invisible lesion load."  The neuro-pathologists say that for every one visible lesion on MRI, there are 25 invisible lesions.  

Bob
Helpful - 0
1606301 tn?1304547195
I am late to this thread as well, but I just wanted to say that I was Dx'd RRMS two months ago with a negative spinal tap. My neuro made the Dx based on patient history and brain MRI. The way he sold the spinal to me was that we were doing it not so much to support the Dx, but to make sure that nothing else could be mimicing it.

My experiance with the spinal tap was a good one (well, as good as it can be I guess!!), so had it gone more like yours I'm not so sure I would have agree'd to it!

Good luck to you :)
JSSL
Helpful - 0
352007 tn?1372857881
From what I've read, LP's are not always needed to diagnose MS because some people who have MS have negative LP's.  Which makes me wonder why they bother with such an invasive procedure to begin with.  

I am anxiously awaiting your results and I hope you will let us know how you are doing.

My thoughts and prayers are with you.

Lisa
Helpful - 0
1253197 tn?1331209110
I have come in on this post rather late but read your story with interest. Your spinal tap sounded horrendous, and having had bad memories of an epidural at childbirth I declined the invitation and was fortunate (if that is the right way to look at it!) to be diagnosed without having an LP.

I just wanted to say that I wd agree with Jen that it is worth trying to get an MRI on a 3T machine and this will at least give you a good baseline. I hope that your journey in limboland is not extended into a lengthy one..it is so frustrating living with the unknown.

Best wishes

Sarah
Helpful - 0
1510649 tn?1301575339
Thanks, Jen. I actually know a woman who has been in limboland for years. She is going to have some more MRIs done in the next few weeks. I will ask about this 3T MRI.

I think my main issues now are the nystagmus and the vertigo, but more than anything else these awful spasms. My calf muscles feel heavy and my lower back hurts terribly. And it's strange but there are patches of skin on my right leg that I can't feel. I still have those strange pins and needles feelings, too. I just wonder what those spots on my MRI were. My neurologist swears to me that I didn't have a stroke...

I have a feeling the next test the neurologist is going to want to run is going to be an EMG, but I'll take that over an LP any day of the week.
Helpful - 0
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