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Normal MRI of brain-can I still have MS?
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Normal MRI of brain-can I still have MS?

I have been having a lot of symptoms that sound like I have MS. So many doctors have asked if I have been tested and I tell them I had a MRI of just my brain without contrast in Dec 07' and it came back 'normal'. I have had no other testing or imaging done of any kind besides that one MRI of the brain without contrast. I want to know if I could still possibly have MS even with a normal MRI of my brain? Is that possible? Is that common? Also, since I have many symptoms suggestive of MS and just had that one MRI, should I have more testing and imaging done to test for MS? If so, what tests should I have and of what? I want to know all this bc right now I've given up on the possibility of having MS just based on that one MRI and maybe I shouldn't give up that easily. I'd appreciate any help and knowlege anyone can give.
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559187_tn?1330786456
Hi and welcome to the MS forum.  We have excellent representative of both sides of the MS issue - diagnosed and undiagnosed, so you will be in good company here.

You are asking a very popular question i.e., can you have a normal MRI with MS.  We have several resources that can assist you with this question.  A good place to start is the MS Health Pages link, which is located in the upper right corner of this page.  

Please tell us a little more about your symptoms and what testing you have had so far if you feel comfortable sharing this information.  For example, what prompted you to get an MRI?  Was it ordered by a neurologist or your primary care doctor?  

The answer to your question is complex and depends on what other symptoms and signs your are having.  Technically you can have lesions that just didn't show up on the MRI, especially since they didn't use contrast and apparently didn't image the spine.  I wonder why contrast wasn't used.  Did your doctor mention this?  In addition to the MRI, there are several other tests such as a spinal tap, evoked potential tests, clinical exam, and others that help with the diagnosis, so a normal MRI isn't a deal breaker for diagnosing MS.  

I hope you will find this information and the info in the Health Pages helpful.   I'm sure our other members will be along soon to share their feedback and experiences with you as well.    Again, welcome, we're glad you found us.  

Julie
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147426_tn?1317269232
Hi, and welcome to our little family of people who have MS or think about it a lot.  The answer to your question is that Yes, you can have MS with one previous MRI that was negative.  As Julie said above.  There is more to the sotry than just that single MRI was negative.  Things that can play a role in an MRI being negative include the strength of the MRI machine and the techniques used in running the MRI that are especially helpful in seeing MS lesions.

Since you have so many symptoms, have you told your own doctor about these?  Have you seen a neurologist?  When any suspicion of MS comes up, the first thing you need is a thorough history and neuro exam by a good neurologist.  If there are things suspicious in your symptoms and/or in your exam, you need a repeat MRI.  That is where you have to start.

But, why don't you tell us about what things have made doctors suspicious that you might have MS?  How old are you and what country do you live in?  Tell us your whole story, what is worrying you and what other people/doctors have said to you.

We have a wealth of wonderful people here to help you move along to answer your main question which is, "Do you have MS?"

Join us.

Quix
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Avatar_f_tn
Thank you for your answers and help. I am 24yrs. old and I live in America. My symptoms started in January 2007. It all started by me getting a stress fracture in my right foot by running in place in my house. I didn't feel any pain or know anything was wrong until a few days later when I started limping bc I had so much pain in my entire foot. I knew something was wrong but didn't know what or even what part of my foot bc the whole foot felt like it was on fire. I went to my primary dr 6 weeks later(after the pain wasn't getting any better but was getting worse) and he ordered an x-ray and then an MRI on my foot which revealed a stress fracture in my calcaneus. I had to wait another month to get seen by an orthopedist who put me in a boot and had me use crutches and stay off it. I was in the boot for 3 months and as time went by I was still feeling more pain than I had in the beginning of the injury. I noticed when I took the boot off at night that my foot was turning bluish/purple and was really swollen. It felt cold and numb yet felt like it was on fire at the same time. I had the same feelings going up my right calf all the way to my knee on the same side as my foot. When I would try to walk on it, it would feel limp and heavy like a dead limb so it was extremely painful and difficult to walk on it. I kept telling the dr(orthopedist) about my symptoms and pain and he kept saying this was normal and that nothing was wrong but I knew it was. After I got out of the boot, I started p.t. at the doctors. That's when I REALLY knew something was wrong. I couldn't even stand to bear any weight on my foot bc it was so painful. I ended up having to drop out of p.t. and dr suggested me going back in the boot which I did for 3 more months. By this point(when I first got out of the boot and dropped out of p.t) both feet and both legs had all the same color problems and coldness and pain and numbness/tingling/pins and needles and on fire feeling. During this time, since I wasn't getting anywhere with my foot dr not taking my symptoms seriously, I went back to my primary dr and told him what was going on and after he listened to my symptoms and looked at my foot and leg, he sent me for an EMG and a vascular test. Both came back normal but he knew like I did that something was definitely wrong. He sent me to a neurologist who diagnosed me with Reflex Sympathetic Dystrophy(a chronic neurological disorder that messes up your whole nervous system that you get as a result of an injury). I started taking medicine for it and 2 weeks later not only did I have RSD in both feet and legs, but by then it had spread to all four limbs(hands, arms, legs, feet), my face, my neck, my back and shoulders. Since that time I went to several pain mgt. drs. who have all tried several medicines and have also given me symathetic nerve blocks and nothing has helped my pain any. One dr. I went to(a pain doc) had me get the MRI of my brain w/o contrast bc he thought I might possibly have MS instead of RSD since I had a lot of the same symptoms as one with MS and MS and RSD have a lot of symptoms in common. When I went for the MRI that morning at 5:45 am, the radiologist said "I wonder if your dr meant to put it with contrast bc usually they want that for this purpose of MS but since he didn't I'll call and ask him since he might've just made a mistake. She said the office was still closed and she didn't want to call his cell and wake him up so she said they could'nt override him and take it with contrast without his permission so she just took it without contrast. So the MRI came back normal and he dismissed the MS diagnosis and said I did have RSD. He didn't do any more MS tests,he just said I didn't have it based on that one MRI of the brain. I went to more pain drs after that who gave me 2 triple-phase bone scans which confirmed the RSD and I even saw the RSD specialist in Florida who has worked with RSD only for 30 yrs. He did all these tests(RSD specific, not imaging tests) and listened to my symptoms and story and he confirmed that I did have RSD. However, when I told him my other symptoms I have besides pain(all of these same symptoms I'm about to mention can also go along with RSD) he asked if I had been tested for MS and I said I had and he just dropped it after I said that.The other symptoms I'm talking about besides the pain I have (which is burning, cramping, stabbing, shooting,pins and needles like, tingling,cold feeling, allodynia(extreme hypersensitive to touch) and numbness) is that I also have frequent muscle spasms, fatigue, sleeping problems, dizziness, coordination and balance problems(problems walking), memory loss, concentration and focusing problems, frequent migraines, several vision problems such as blurriness, pain and redness in eyes, seeing floaters(spots) in vision, and extreme photophobia(sensitivity to light). The latest symptoms I've had are severe jaw and teeth pain, extreme ear pain in both ears, hyperacusis(hypersensitive to all sounds), and pulsatile tinnitus(hearing heartbeat in ears). Again, all of these symptoms that I have can go along with RSD. So I've had all of these symptoms for over 2 yrs now.My diagnoses so far from all my doctors are: RSD, Fibromyalgia, Myofacial Pain Syndrome, TMJ, Migraines, Hyperacusis, and Tinnitus. I am not doubting that I have any of these disorders, but a part of me still wonders if I might also have MS....it's just an unsure feeling and I always wonder since so many of the symptoms I have are both a part of RSD and MS. They're just so similar in a lot of ways(a lot of the same symptoms I mean). I just wonder if I might have MS and just think that maybe if I had had more testing done for MS that it would've shown up if I had it. But ever since that jone pain dr gave me the one brain MRI, no one else has questioned that and said "Let's just do some more testing and be sure" and now I wish they had so I could no for sure. So that's where I'm at with all this.

Precious Girl
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Avatar_f_tn
I also have muscle weakness and am always tired but can't sleep well. I have no energy and don't feel well ever. I'm sure I'm leaving out some symptoms but I can't remember them all right now off the top of my head. Precious Girl
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147426_tn?1317269232
Hi, I'm sooo glad you have answered and given us this information.  but, I'm going to have to ask you to copy and repost your long answer.  When you do would you break it up into paragraphs and put a blank spce between them?

I ask this because many of us, me included, have trouble controlling the movements of our eyes and we have trouble eye-tracking the long paragraphs.  I get lost over and over again and end up not being able to read something.  So if you would do us that favor, we would certainly appreciate it.

And please do not feel bad.  None of us are upset, except that we can't read what you wrote.

Looking forward

Quix
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Avatar_f_tn
Sorry about that. I know it is a long, long story. Let's see if this is any better.

Thank you for your answers and help. I am 24yrs. old and I live in America.

My symptoms started in January 2007. It all started by me getting a stress fracture in my right foot by running in place in my house. I didn't feel any pain or know anything was wrong until a few days later when I started limping bc I had so much pain in my entire foot. I knew something was wrong but didn't know what or even what part of my foot bc my whole foot felt like it was on fire.

I went to my primary dr 6 weeks later(after the pain wasn't getting any better but was getting worse) and he ordered an x-ray and then an MRI on my foot which revealed a stress fracture in my calcaneus(heel bone). I had to wait another month to get seen by an orthopedist who put me in a boot and had me use crutches and stay off it.

I was in the boot for 3 months and as time went by I was actually feeling more pain than I had in the beginning of the injury. I noticed when I took the boot off at night that my foot was turning bluish/purple and was really swollen. It felt cold and numb yet felt like it was on fire and burning at the same time. I had the same feelings going up my right calf all the way to my knee on the same side as my foot. When I would try to walk on it, it would feel limp and heavy like a dead limb so it was extremely painful and difficult to walk on it.

I kept telling the dr(orthopedist) about my symptoms and pain and he kept saying this was normal and that nothing was wrong but I knew it was. After I got out of the boot, I started p.t.(physical therapy) at the doctors. That's when I REALLY knew something was wrong. I couldn't even stand to bear any weight on my foot bc it was so painful. I ended up having to drop out of p.t. and the orthopedic dr suggested me going back in the boot which I did for 3 more months.

By this point(when I first got out of the boot and dropped out of p.t), both feet and both legs had all the same color problems and coldness and pain and numbness/tingling/pins and needles and burning like they were on fire feeling.

During this time, since I wasn't getting anywhere with my foot dr not taking my symptoms seriously, I went back to my primary dr and told him what was going on and after he listened to my symptoms and looked at my foot and leg, he sent me for an EMG and a vascular test. Both came back normal but he knew like I did that something was definitely wrong.

He sent me to a neurologist who diagnosed me with Reflex Sympathetic Dystrophy(a chronic neurological disorder that messes up your whole nervous system that you get as a result of an injury). I started taking medicine for it and 2 weeks later not only did I have RSD in both feet and legs, but by then it had spread to all four limbs(hands, arms, legs, feet), my face, my neck, my back and shoulders.

Since that time I went to several pain mgt. drs. who have all tried several medicines and have also given me sympathetic nerve blocks and nothing has helped my pain any. One dr. I went to(a pain doc) had me get the MRI of my brain w/o contrast bc he thought I might possibly have MS instead of RSD since I had a lot of the same symptoms as one with MS and MS and RSD have a lot of symptoms in common.

When I went for the MRI that morning at 5:45 am, the radiologist said "I wonder if your dr meant to put it with contrast bc usually they want that for this purpose of MS but since he didn't I'll call and ask him since he might've just made a mistake. She said the office was still closed and she didn't want to call his cell and wake him up so she said they could'nt override him and take it with contrast without his permission so she just took it without contrast. So the MRI came back normal and he dismissed the MS diagnosis and said I did have RSD. He didn't do any more MS tests,he just said I didn't have it based on that one MRI of the brain.

I went to more pain drs after that who gave me 2 triple-phase bone scans which confirmed the RSD and I even saw the RSD specialist in Florida who has worked with RSD only for 30 yrs. He did all these tests(RSD specific, not imaging tests) and listened to my symptoms and story and he confirmed that I did have RSD. However, when I told him my other symptoms I have besides pain(all of these same symptoms I'm about to mention can also go along with RSD) he asked if I had been tested for MS and I said I had and he just dropped it after I said that.

The other symptoms I'm talking about besides the pain I have (which is burning, cramping, stabbing, shooting,pins and needles like, tingling,cold feeling,  severe allodynia(extreme hypersensitive to touch) and numbness) is that I also have frequent muscle spasms, fatigue, sleeping problems(insomnia), dizziness, coordination and balance problems(problems walking), memory loss, concentration and focusing problems, frequent migraines, several vision problems such as blurriness, pain and redness in eyes, seeing floaters(spots) in vision, and extreme photophobia(sensitivity to light).

I also have stiffness, muscle weakness, and muscle and joint pain, and am always so tired but can't sleep well. I have no energy and don't feel well ever.The latest symptoms I've had are severe jaw and teeth pain, extreme chronic ear pain in both ears, hyperacusis(hypersensitive to all sounds), and pulsatile tinnitus(hearing heartbeat in ears). I'm sure I'm leaving out some symptoms but I can't remember them all right now off the top of my head. Again, all of these symptoms that I have  (mentioned in this paragraph and the one above) can go along with RSD.

So I've had all of these symptoms for over 2 yrs now. My diagnoses that I have so far are: RSD, Fibromyalgia, Myofacial Pain Syndrome, TMJ, Migraines, Hyperacusis, and Tinnitus.

I am not doubting that I have any of these disorders, but a part of me still wonders if I might also have MS as well as all these other disorders....it's just an unsure feeling and I always wonder since so many of the symptoms I have are both a part of RSD(and all my other disorders) and MS. They're just so similar in a lot of ways(a lot of the same symptoms I mean).

I just wonder if I might have MS and just think that maybe if I had had more testing done for MS that it would've shown up if I had it. But ever since that one pain dr gave me the one brain MRI, no one else has questioned that and said "Let's just do some more testing and be sure" and now I wish they had so I could no for sure. But don't get me wrong, I don't want to have MS or any more diagnoses, believe me.

So that's where I'm at with all this.I just think about it a lot and wonder...

Precious Girl

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Avatar_m_tn
Hi, I hav a question. July 31st 2008 was a tragic day for me. All of a sudden after lunch I felt completely lost, totally spaced out, couldnt do basic things, total lack of short term memory... it was so weird. Then came dizzyness that lasted 11 days...then slowly it went away... the dizzyness was so extreme that I felt things spinned around. I experienced daily hadaches that lasted for hours ..like 4 or 5 hours... felt off balance, noticed an overall lack of well being. Anyway.. I worked in a mercury injection lab... so that was the first thing that crossed my mind...Hg poisoning! So I went to the doctor and got tested. I had a high mercury lvel in blood and urine... it wass higher than recommended but according to a toxicologist it wasnt too high for an intoxication. So she gave me DMSA (chelating) pills to bring the levels down anyway. Levels came down (not zero yet) but it was a lot lower and it fell under the safe range.  This doctor told me to go see a neurologist to rule out other things...which I did... and he had me do an MRI without contrast. It came normal and he said that it can be a viral infection or Hg poisoning. After a couple of months I went to the best place in Houston to see another neurologist, just for another opinion, this was in december 2008. She noticed something was wrong specially with my pupils...one wouldnt close as much as the other one so she said she thought it was MS. She had me do a Brain and neck MRI with and without contrast... an eye evoked potential... and x rays of my neck. I called Januray (2009) to see how they came out, and everything was normal. Now she wants to perform a spinal tap. How likely is it for me to have MS after having all these tests done and coming back normal? I will get the spinal tap done anyway just in case, but Im just wondering how likely is it to be MS??
Thanks a lot
Gaucho
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Avatar_m_tn
Ill break what I just wrote into paragraphs!!! sorry!!

Hi, I have a question. July 31st 2008 was a tragic day for me. All of a sudden after lunch I felt completely lost, totally spaced out, couldnt do basic things, total lack of short term memory... it was so weird. Then came dizzyness that lasted 11 days...then slowly it went away... the dizzyness was so extreme that I felt things spinned around. I experienced daily hadaches that lasted for hours ..like 4 or 5 hours... felt off balance, noticed an overall lack of well being.

Anyway.. I worked in a mercury injection lab... so that was the first thing that crossed my mind...Hg poisoning! So I went to the doctor and got tested. I had a high mercury lvel in blood and urine... it wass higher than recommended but according to a toxicologist it wasnt too high for an intoxication. So she gave me DMSA (chelating) pills to bring the levels down anyway. Levels came down (not zero yet) but it was a lot lower and it fell under the safe range.  

This doctor told me to go see a neurologist to rule out other things...which I did... and he had me do an MRI without contrast. It came normal and he said that it can be a viral infection or Hg poisoning. After a couple of months I went to the best place in Houston to see another neurologist, just for another opinion, this was in december 2008.

She noticed something was wrong specially with my pupils...one wouldnt close as much as the other one so she said she thought it was MS. She had me do a Brain and neck MRI with and without contrast... an eye evoked potential... and x rays of my neck. I called Januray (2009) to see how they came out, and everything was normal. Now she wants to perform a spinal tap.

How likely is it for me to have MS after having all these tests done and coming back normal? I will get the spinal tap done anyway just in case, but Im just wondering how likely is it to be MS??
Thanks a lot
Gaucho
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Avatar_f_tn
Hi Gaucho, and welcome to the forum!!

I don't want anyone to miss your post, could you start your own thread?  Just go to the top of the page and click on the "post a question" icon.  You can copy and paste what you wrote above.

I will give you my novice opinion, though.  I am undiagnosed, but have been here since July of 2007 and these great people have taught me so much.

I would get the LP, as sometimes it is hard to pick up lesions on the MRI.  Do you know what strength the MRI machine was?  A 3T is the best, but they are somewhat hard to find, and most MRIs are done on the 1.5T.

From what I understand the 1.5T can pick up brain lesions, but spine lesions are much more difficult to see with this strength machine.

Did your dr mention Optic Neuritis as a diagnosis for your eye problems?  This is a normal MS symptom, and is usually from a lesion on the optic nerve.  If your VEP was normal, I don't know if this is the case or not.

Good luck with all this, and again, welcome to the forum.  This is a great place for support and knowledge.  Check out our health pages, they have a lot of important info.  Just click on the icon in the upper right of the page.

I look forward to getting to know you better.

Take care,
doni
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