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Test Results
I had an MRI that was suggestive of MS. My doctor then scheduled a spinal tap and EVR. Both were normal. She has referred me to the MS Clinic at the Brigham in Boston. My symptoms are constant and are mostly gait/balance issues. Do the normal spinal tap and EVR mean I don't have MS even though the MRI showed both brain and spinal lesions?
Thank you so much Quix for your response. Believe it or not, when the LP came back normal, that's when I got scared. The thought of having MS didn't really bother me. I was almost relieved when my neurologist said that's what I have. It put a name to what I knew what was wrong with me. Isn't that an odd reaction? The thought that I might have something more serious and life threatening scares me more. Disability has been part of my life since the day I was born. My parents were both deaf. My son has Down Syndrome.
My story isn't really that impressive. I am 56 years old. I have had a great deal of difficulty walking for several years. For most of that time, I thought it was knee, which I had replaced. If anything that made things worse. I walk with a single crutch. Without the crutch, I cannot walk unless I have furniture/walls/objects to hold onto. I can remember my mom (who was deaf) blaming herself for my walk. Walking a straight line has, for years, required a tremendous amount of concentration. I used to bump into walls constantly. My walking difficulties are a constant. I no longer go grocery shopping because by the time I leave a store both feet are dragging so much that I could fall if I weren't hanging on to the carriage. Complete strangers always come up to me and ask if I'm alright. Embarrassing.
Other symptoms: when I bend my head, I get what feels like an electic shock going all the way down my left side. My feet have a burning sensations at times. My lower back has a funny sensation, not numbness but a funny feeling that I can't describe adequately. And the spasms in my legs! I can't stand those. Thank goodness for tizanidine at night!
I know I'm rambling. Feel free to ask me any questions.
Sharlene
My story isn't really that impressive. I am 56 years old. I have had a great deal of difficulty walking for several years. For most of that time, I thought it was knee, which I had replaced. If anything that made things worse. I walk with a single crutch. Without the crutch, I cannot walk unless I have furniture/walls/objects to hold onto. I can remember my mom (who was deaf) blaming herself for my walk. Walking a straight line has, for years, required a tremendous amount of concentration. I used to bump into walls constantly. My walking difficulties are a constant. I no longer go grocery shopping because by the time I leave a store both feet are dragging so much that I could fall if I weren't hanging on to the carriage. Complete strangers always come up to me and ask if I'm alright. Embarrassing.
Other symptoms: when I bend my head, I get what feels like an electic shock going all the way down my left side. My feet have a burning sensations at times. My lower back has a funny sensation, not numbness but a funny feeling that I can't describe adequately. And the spasms in my legs! I can't stand those. Thank goodness for tizanidine at night!
I know I'm rambling. Feel free to ask me any questions.
Sharlene
I just looked up the incidence of a positive VEP in people with MS that have not clinical history of optic neuritis, that is, they never had symptoms of the kind seen in ON. these symptoms include eye pain (especially with movement), color desaturation, flashes of light, decreased vision, and decrease in visual fields. My favorite scientific and unbiased book reports that only about 50% of people "without a history of ON" will have a positive VEP.
This matches more with what I have read previously, but now when I looked it up online I found the 20% number. I believe the 50% is more correct.
Quix
This matches more with what I have read previously, but now when I looked it up online I found the 20% number. I believe the 50% is more correct.
Quix
Hi, and Welcome to the forum! I'm sorry you are going through this.
The answer is "no". The negative LP does NOT mean that you don't have MS. It is true that some neurologists believe that it does, but the scientific studies do NOT bear this out. Depending on the studies you read, between 90% and 97% of people with definite MS do not have any positive findings on the LP. Because the number is low, it is worthwhile, to be very thorough in the ruling out of other diseases that can mimic MS.
The EVR, also know as the VEP (Visual Evoked Response) is not a test that can rule MS out if it is negative. Up to 20% of people with MS can have a negative VEP. However, when the test is positive, the evidence points "toward" the diagnosis of MS, but doesn't prove it.
Neither the LP nor the VEP is a required part of the testing and neither is a "make or break" test for the diagnosis.
The main parts of the diagnosis come from the history of more than one attack of symptoms that are suggestive of demyelination in the central nervous system, the finding of two or more abnormalities on the neuro exam that demonstrate damage in the CNS, ruling out all better explanations for these symptoms and abnormalities, and finding consistent lesions on the MRI. If there is not a clear enough history and physical findings, then the docs turn to the auxilliary tests like the LP and the evoked potentials.
Having both brain and spinal lesions is heavy data in favor of the diagnosis if the mimics have been ruled out.
Would you be comfortable in telling us your whole story?
Quix
The answer is "no". The negative LP does NOT mean that you don't have MS. It is true that some neurologists believe that it does, but the scientific studies do NOT bear this out. Depending on the studies you read, between 90% and 97% of people with definite MS do not have any positive findings on the LP. Because the number is low, it is worthwhile, to be very thorough in the ruling out of other diseases that can mimic MS.
The EVR, also know as the VEP (Visual Evoked Response) is not a test that can rule MS out if it is negative. Up to 20% of people with MS can have a negative VEP. However, when the test is positive, the evidence points "toward" the diagnosis of MS, but doesn't prove it.
Neither the LP nor the VEP is a required part of the testing and neither is a "make or break" test for the diagnosis.
The main parts of the diagnosis come from the history of more than one attack of symptoms that are suggestive of demyelination in the central nervous system, the finding of two or more abnormalities on the neuro exam that demonstrate damage in the CNS, ruling out all better explanations for these symptoms and abnormalities, and finding consistent lesions on the MRI. If there is not a clear enough history and physical findings, then the docs turn to the auxilliary tests like the LP and the evoked potentials.
Having both brain and spinal lesions is heavy data in favor of the diagnosis if the mimics have been ruled out.
Would you be comfortable in telling us your whole story?
Quix
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