MRI like MS, normal LP

Hi and thanks for this great forum.  I am a 44 yr old female. Recently had MRI based on symptoms I was having over the years (mainly sensory - numbness, tingling and wekness in both arms - on and off but each attcke getting worse each time).  My MRI came back with radiology report of "lesions consistent with diagnosis of MS".  Neuro commented while significant number of lesions they were not big (he was counting while we looked at pictures - I counted 12 - yikes). I then had an LP that came back normal.  Neuro exam shows no permanent damage at this point.  My neuro is referring to neuro that is MS specialist.  I do have other weird neuro symptoms and also have suffered migarines since my 20s - random super sensitive skin on arms or thigh lasting for a few days with no visible rash, lower back spasms, toe cramping, dropping things with hands - all come and go).  My question is should this likley be treated as MS or can we take a wait and see approach? What's the risk of waiting for things to get worse or more frequent?  Is there anything else we should be considering besides MS that could cause symptoms and  barin lesions that look like MS?

[SarahL2491]

I get from reading your post that your neuro is not MS savvy and is referring you to someone who is....in your defense.

I would not worry too much until you talk to the new neurologist.  There are other diseases that should be ruled out as they mimic MS.  Granted your neurologist says there are lesions but he has backpedaled by referring you to a specialist.  That said, tongue in cheek, there are other causes of lesions.

So, I would wait until your visit.  MS marches to its own timeframe.  You can also, in the meantime, go thru some of the Health Pages on the right side of this page which have some wonderful explanations and suggestions.

Welcome to our little corner of the web

[supermum_ms]

Hi and welcome to our little corner of the web, you might (if you haven't already) get a lot of good information out of reading through our health pages, just right of your screen. There is a wealth of information in those pages and well worth your time.

You do not need 0 bands in the LP for a dx of MS, its just one test that helps with the diagnostic process, though if you did have 0 bands, the dx would of been simpler. In my humble opinion, your clinical profile isn't exactly clearly pointing towards MS, highly suspicious yes (especially with MS type lesions) but if the neuro testing didn't indicate a specific neurological abnormality, that too could be whats making dx not simplistic.

If you have a look at the 'Mcdonald criteria' then you'll see that there are a few slightly different diagnostic data sets within the criteria. The 'location' of the lesions are in most sets more important than the number, so where they are makes a difference. Eg brain and spinal lesion, non enhansing and enhansing lesions which then meets the space and time aspect for dx etc etc. I could go on and probably just confuse you even more, so I'll stop whilst you have an idea, read the health pages if you can.

The best thing to do is to get a second opinion, preferably a neurologist that specialises in MS, which your getting, so thats a bonus. There is research that CIS (clinical isolated syndrome) has better outcomes if treated as a first MS attack, but the 'wait and see' is still most common. MS has many mimics, though not all generate lesions, (there's a health page on mimics too) example alternative lesions dx hypertension, migraine.

Example questions that are relivant to dx's of MS:
Did any lesions light up?
Where are the lesions located?
Is the patient dx's with hypertension, migraine, degenerative disks?
Does the patients sx warrent a spinal MRI or only brain? (u need both)

Risk? there are no guarantees even with treatment, dont think about risk because getting the correct dx before treatment is imho more important than worrying about risks and what if's.

Cheers.........JJ

PS again welcome!

  



  

[kwarendorf]

Hi kp - Your neurologist has done right by you. Rather than waste time, he referred you to an MS specialist. The MS doc will be better able to sort out the  data and determine whether or not you are dealing with MS.

MS is not a fast moving disease. If you have an appointment with the MS doc you in good shape time wise :-)

Kyle

[Twinsmom06]

Sounds like we are in the same spot! I have the same type of symptoms, many brain lesions, some very typical of MS, some pretty large and some smaller, no lesions on my spine, a negative LP but also tested negative to all the mimics..soooo...I'm headed to an MS specialist in about a month from now.

For now...I am on the wait-and-see journey until someone can give me a pretty clear answer!

When is your MS specialist appt?

Please keep us posted:) Take care,
Kim

[kp001]

Still waiting to get that scheduled with the MS specialist office. I assume ti will take a few weeks minimum to get the appointment. Hopefully we will both have more info soon.  Just curious - do you suffer from migraines too? How long do your symptoms last when they come?

[kp001]

Thanks for the suggestions about the additional links. Very helpful!

[Twinsmom06]

I don't have many symptoms...lucky to say! The only things that I can say is that I used to have fainting spells, sometimes with a sizeure when I was in my early twenties. This spell of events lasted a few months. I had vertigo last year that lasted about a day and half. Then about a month later I thought I was having a stroke which landed me in the ER. I had left hand numbness for about a day and then the next day it started creaping up my arm, to my neck, acroos my check and back and stopped at exactly the center of my body...like a line...very odd. And when they took my BP it felt like my arm was on fire where they had the cuff...again...very odd. I felt pretty normal by the next day but still get odd feelings of numbness in my left arm now and again and it feels different to the touch than my right...just slightly. The Vergtigo and the numbness happened about 7 months ago. I can't say that much has happened after that.

I sure the time to get into the MS Specialist will vary by practice. It was about a month and a half wait from the point I called to my appointment on June 4th.

I know it can be interesting to look at others MRIs and I have some posted if you want to check them out for comparison or what not.

Again, take care and I do hope we can both get some answers!!
Kim

[Twinsmom06]

Oh sorry...no, I don't have headaches other then sinus issues every now and then. I also saw a hemotologist to make sure it was not vascular due to some gene issues that came up during blood work. That was ruled out as well.