Hi, Dr. K is not around, but the search is ongoing. I know that he has, in the past, stated that repeated T3 MRIs are essentially proof positive that MS can be excluded from the diagnosis.
Combined with the normal neuro exam and the normal LPs, MS is VERY unlikely, but clearly something is happening to you. The Evoked Potentials document slowed nerve conduction velocities within the CNS as would occur with demyelination. I am impressed that these tests (the VEP and the SSEP) were repeatedly abnormal in different labs. I am far more aware of false negative EPs than false positives. Have the EPs been repeated since 2005? Have they done OCT? (though OCT has not yet been shown to be of value in the diagnosis)
Have you had EMGs and NCS? Have peripheral neuropathies been ruled out?
Were there ANY abnormalities in the CSF? Like just a high protein? (considering here something like CIDP)
With the consideration of Transverse Myelitis and the abnormal VEP was there consideration of NMO - Neuromyelitis Optica (an MS mimic that where demyelination is limited to the spine and the optic nerve)? There is a blood test for this called NMO-related Antibody that is positive in about 70% of cases and is a definitive test.
Do you feel that you have really had thorough neuro exams? A really complete one takes quite a while to do. Your tendon reflexes are really normal? With the level of your disability, it is hard to accept that your exam would not show something in the hands of a competent neuro.
In my never so humble opinion, I am not convinced that even the T3 machines show the whole story 100% of the time. I think the cases that the T3 miss are likely few and far between, but I am convinced as a scientist that they occur. My "evidence" is based on the objective studies that show the 7T machines are still picking up lesions that the T3 missed. It is also based on the very anecdotal evidence of things like the fact that my Trigeminal Neuralgia did not show a corresponding brainstem lesion - and 100s of similar examples with others.
Have you seen the same neuro for this whole time? With ongoing and increasing disability, I would have a hard time accepting no diagnosis at all. Myself, I would seek another opinion from an MS specialist. My experience from the MS forum, though,, is that it no one will get an MS diagnosis with a normal 3T MRI and a normal neuro exam. I have definitely seen it happen with a normal MRI and very suggestive history and exam.
Also, it is common to believe that the mimics have truly all been excluded, but this frequently is not the case. It might behoove your docs to repeat this testing and also make sure that Lyme Disease has been excluded with a Western Blot sent to two good labs, with reporting of the specific Bands found. Lyme Disease with CNS invasion is one of the mimics which could give the entire picture you have presented.
I have to add the disclaimer that, although I am a physician, I was not a neurologist. I do have MS and read everything I can get my hands on. I invite you to the MS Patient Forum where we have a good number of PhD and other scientists.
http://www.medhelp.org/forums/Multiple-Sclerosis/show/41?camp=msc
I hope this has helped.
Quix, MD