Should I have this test done?

[FGwen]

My primary Dr. would like me to do testing for MS. I have been testing positive for an ANA, have proximal muscle weakness, dry eyes, numbness in toes off and on and in fingers, abnormal gait, other odd sensation, and some twitching all over. I had in the past have had muscle spasms, a brief episode of incontinence, and some tripping problems.
I keep thinking that my leg weakness, tripping, numbness, abnormal gait, and spasms are from my osteoarthritis of both knees. That my other problems is just getting older. I have had other symptoms but these most prominent right now.
I have had other test done. One biopsy for small nerve fiber damage and one for Sjogren's. The nerve damage came back negative, the Sjogren's came back inconclusive but with some inflammation. I had a nerve conductive study done and it was negative. I'm just not sure doing the MRI is necessary?

[aspen2]

The problem with testing for neurological disease is there are so many overlapping symptoms.

You do have symptoms typical of Sjorgen's (especially the dryness), and it can cause lesions in the brain as well.  An MRI isn't such a bad idea; but presence of lesions will not make an MS diagnosis more likely, unless you clearly show Dawson's fingers which is more typical of ms than any other condition.  

Have you had an RF (rheumatoid factor) test?  There is also a skin biopsy that can confirm Sjorgen's.  Unlike MS, Sjorgens does have some specific testing available.

Having said this, there are still dozens of other possibilities as well, and a primary doctor may not even be aware of some of them. Mine wasn't.

Have you been referred to a neurologist? Sorting out a tricky diagnosis isn't really within the realm of a primary doctor's practice.  I would ask for a referral.

[FGwen]

Yes I had RF testing done by a Rheumatologists. The Rheumatologists takes test once a year and tells me to come back next year. Most of the test are negative. Except for the ANA,sedrate, and CRP is high. The reason I went to the Rheumatologists was I had muscle spasms so bad that I couldn't stand. The GP ran test. That's when I tested positive for the ANA and he sent me to the Rheumatologists.
I have seen a neurologest for the skin biopsy and nerve test. I keep thinking I should see her before I get the MRIs done. I'm  getting a second opinion from a Rheumatologists but not until the end of August.  

[aspen2]

You did have the skin biopsy done? What was the result?

[FGwen]

Negative. It was for small nerve neuropathy and a salivary gland biopsy. The focus score on the salivary gland was 0, but on the results it had an explanation, that there was a mild chronic inflammation. There are some other problems I have had. I have been tripping once in wile. Haven't fell yet. I have problems going up and down stairs. When I stand after sitting it takes me few seconds to move when I sand up.

[aspen2]

Are you taking any medications?  The dry eyes could be nothing to do with your symptoms. There are many meds that cause dryness.  In addition, dry eyes can be related to benign processes (my optometrist has dry eyes with no other condition).

I think your doctor is following best practice to ask you to consider doing an MRI at this point. Ultimately it's your choice, of course. Without it, your are diagnostically stuck.  I would want to either know there is CNS involvement, or be reassured that there is not.  If you go this way, be sure to get a copy of the radiologist's report.

Did you have vitamins B12 and D checked?  Magnesium levels?  Deficiencies in these things can cause some pretty haywire neurological symptoms, often mimicking neurological disease.  (You mentioned spasms, which is often a symptom of low tissue magnesium levels).

Another thing you could do would be to see a physiotherapist to assess your gait.  They may have some great ideas as well as some rehabilitation ideas.

Please remember that I, nor anyone here, is a doctor.  I was in diagnostic limbo for three years and am basing my response to you on things I learned during that time.

[FGwen]

It is nice to be able to talk to someone that's been there and get info. I appreciate the time you have spent with me.

I did go off my diuretic that was with the high blood pressure med to see if the medication was causing problems. I it did help the dry mouth a little. I still have problems with swallowing such things as bread and meet. I did go to my optometrists to have my eyes checked and he did confirm that I did have dry ice. He said they were so dry they were getting dry patches on them. I did ask him if it could be allergies or something else. He did not see any signs of the possibility of allergies.

I think I've had my magnesium and vitamin D checked but I'm not sure about B12. I will have to look into that. I've been hearing a lot about it.

I did do physical therapy for a while and it kind of did some good but not a whole lot. I will have to talk to my doctor about the physiotherapist.

I just kind of keep getting these new symptoms. Like the last 2 weeks now I've had this like buzzing sensation in my crotch area. And the numbness in my toes went away for a while but have come back.

I guess getting the MRI is probably not a bad thing. It's just that it cost so much and I've spent so much money in the last 3 years with all my problems that you wonder if it's really worth it. but I guess it is good to know if that is what's causing all the issues. My MRI is scheduled for next week. Thank you