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clinical diagnosis
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clinical diagnosis

What does a clinical diagnosis mean????
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572651_tn?1333939396
In MS it would mean upon examination, the doctor found physical symptoms that would substantiate a diagnosis.This could include abnormal balance or reflex tests (or any of the many other neurological exam results).

In MS, just a clinical diagnosis is often not enough.  They will also want to see evidence from tests such as MRI or the lumbar puncture results.

Are you in the process of being diagnosed?

~Laura
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Hi, yes I am. I don't understand so much that is said, medical jargon. My neuro exam showed a dilated pupil not equally responsive to light in a darkened room, Romberg sign, not really able to go the heel toe walk, Hoffman sign in both hands and babinki in both feet. Had retrabulbar neuritis 14 years ago. Now have mild balance issues, weakness in one arm, tingling in legs, sharp shooting pains in head and eyes, twitches, numbness and need to wee alot, neck pain. Very tired constantly. 3 days ago had MRI with contrast of head and whole spine. Next week have VEP. Neuro thinks MS because of past history and symptoms now. I worry about MS or God forbid a brain tumour. Any advise?
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also tendon reflexes all brisk, what ever that means!!
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1831849_tn?1383231992
Hi Ghost - The things you describe in you most recent post would largely qualify as clinical findings, part of a neurological examination. They are also things which can suggest MS.

You MRI and VEP will add more info to the pile, in support of the clinical findings. Other supporting tests are blood tests to rule out MS mimics like Lyme disease and a lumbar puncture to to examine your cerebral spinal fluid (CSF).

The MS diagnostic process can be lengthy and frustrating. The length and level of frustration can be determined in part by your doc. Is your neuro an MS specialist?

Keep asking us, and your doc, questions :-)

Kyle
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I don't know if neuro is a specialist in MS. He said in his report that his provisional diagnosis is MS, and wants to see if the tests show more evidence. I have had blood taken, but not a lumbar picture. Problem is I am so tired, have been off work for 4  months now. Thank you so much for your response, it really helps.
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1831849_tn?1383231992
Have you received any treatment for your current symptoms? It is possible to treat them while you figure out the diagnosis. During my last relapse I could barely keep my eyes open and more than once tripped over my feet because I couldn't lift them properly when walking.

I got a 5 day course of IVSM, high dose intravenous steroids. That reduced the inflammation and my symptoms went away, including the tiredness.

Kyle

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No treatment yet. I was given anti depressents by G.P which did nothing. I wasn't depressed. I cried but didn't know why I was and got angry and again couldn't tell you why. Neuro said it might be the disease affecting the brain, therefore tablets would not help. I may not have MS, G.P and neuro seem sure I do. I just know something is wrong. My pupil is still dilated in dimmed light, previously it was dilated constantly. I'm sorry to go out, as you have MS and are dealing with it and are so kind. I'm just afraid, more that I don't know what's wrong. I live in Britain and here you get your results when you see the neuro for the follow up, which will be end of May. So ling to wait. Do you think it sounds like demeliating disease?
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1831849_tn?1383231992
As often as not, the diagnostic journey is more frightening than having the diagnosis :-) I know what's wrong with me and I can take all of the necessary steps to fight it.

No knowing, and having to wait until the end of May to learn more, is indeed a very scary thing. I'm not a doctor. What you describe could be caused by some form of demyelinating disease. It could also be caused by many other things. Is there anyway for you to get some kind of treatment while you wait to see the neuro?

Kyle
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I think maybe I will ring the neurologist and ask. I may even be lucky and get seen sooner. Thank you so very very much. Your kind words and support is greatly appreciated, your a star :)
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Are you able to ring the place that did your MRI and request a copy of the MRI results be sent to your GP, and then pick them up from there so you can get them sooner?  Getting hold of your results yourself and then having some time before you see the Neuro again might help you literally "get your head around" what's going on.

I was lucky enough to be able to get hold of my MRI results on Tuesday this way, and have a chat to my GP about them.  


Poppy
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I will do that, ask them to be sent to G.P. Thanks :)
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1218873_tn?1300094816
Hi I am in the UK too.

Do phone your neuro secretary and get the results of the scan it shouldn't take more than a week. Any problem getting your results contact PALS your hospital will have a number for them.

It is wise not to just wait as you can get over looked.

Twist
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Thank you twist. I have rang secretary just now but no answer. Left a message. Do I get the results over the phone, to G.P. Apparently not seeing neuro till end of may or June, the hospital seems to think that's acceptable. Where are you in Britain?
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I'm sorry to hear that your having such a hard time. Just wanted to let you know that your not a lone in the crying and the anger. I have had depression issues on and off for over ten years but this was different and once I started crying I. Couldn't. Stop. Plus little things would basically send me into a fit of rage. I just wanted to scream.

The constant fatigue the inability to come up with words and the forgetfullness didn't help. I atleast have a diagnosis so I'm sure that your issues aren't helping since you don't know and cant seem to get the answers without waitinng for long periods.

I finally founnd a book for people with Ms about mood swings depression and I believe anxiety. It may still help explain what's going on with your brain if you do have a demylating disease. It atleast helped me realize I wasn't as crazy as I felt.

I did start going to a psychiatrist he says I have bipolar ii disorder. I still don't know if I really do. In some ways it fits in other ways it doesn't. The meds help and that's all that I care about.

Just know that there are people that understand and know how miserable it can be. If you want to try to find the book let me know and I'll get the name of the book and author for you.

Just keep hanging in there it eventually will get better and everyone here is here for you. This is an absolutely amazing group of people! You'll be in my thoughts.

-britt
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Thank you Britt,
Yes you and I seem to have very similar cognitive issues and its really not nice, especially with all the other neurological symptoms too. I don't like being like thus, sometimes I feel so angry and have no idea why and my husband (who tries so hard to understand) takes the brunt of how I feel. My 7 yr old daughter said to me "I want my old mummy back". This broke my heart, but she is right, I am different. I can be so down, angry or crying for no reason. I try to mask it around them (I have a 6 yr old son too), but the crying which comes from no where, is so hard to control as I have no idea why im doing it. The book sounds great, I would like to buy it. To understand why would help, and knowing there are others like you, who get it really helps. Thank you so much :)
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It's. Not all in your head by patrician Farrell Phd. It has some other peoples stories of how they cope and she talks to some Ms experts. Even if it's not ms
I think it may help. If your as bad as I was I wouldn't read it in front of your children icried a lot when reading it. Also remember everyones disease is different so you may never get to the point where some of the people are.

I'm sorry to hear how it is affecting your family which in return is just going to make it harder on you. Hearing about your daughter breaks my heart. I don't have kids so I truely can only try to imagine how you feel.

A couple of more things....these two were some of the best things ive been told. First my mom told me after my dd I was going to have to mourn my old life because thing will never be the same. Second some one on here (I don't remember who) said something to the affect of because your a year and a half into ur life long disease you think you should have it figured it out?

Whatever u may or may not have your still greiving what u don't have right now. You also don't have a diagnosis so you aren't able to grasp what's going on. I hope that makes sense...someone always interrupts me when I try to post and I cant remember what I was trying to say.

If you need to talk you can always message me. I don't typically post that often but I'm always reaading the blocs.
-brit
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OMG....reading all the posts have me wondering about the depression I have been treated for the past 3 years. All I could do was cry uncontrollably, I was angry but did not know why, I mourned for my old life. I was told by a past doctor in the early 1990's I had what he thought was the beginnings of MS but I was not to worry about it because I did not have any major symptoms & may never get any. Tremors of the head, and now the arms & sometimes the legs, started out very minor but have continuously worsened. I can hardly write & usually have to type. I started keeping logs the past 3+ years....inputing how I am feeling, symptoms, what I do each day, B/P, temp, etc. I thought I was going crazy as more & more symptoms arose. I lost my job & insurance in early 2010 and went on disability. Just recently have started receiving SSMedicare Advantage Insurance. FINALLY.....I am able to go to a neurologist & maybe get some answers. Do I or Do I not have MS?? The painful torso hugs, the numbness, dizziness, constant pain (diabetic neuropothy/fibromyalgia/back-disc-stenosis), electrical shocks in some fingers & toes, depression, fogginess, exhaustion......too many to list. Due to a very, very limited income I could not investigate earlier if I had MS. My current GP agrees with my past GP. My neuro listed the reason for the MRI this past Weds as MS. Got a call from the doctor office on Friday with the results of the MRI--"no significant signs". Waiting for the insurance to OK a nerve conduction study. Neuro started me on Topomax (topamax) 100--may help with the tremors. Once I find out what something actually is, I deal very well with them.....it is the unknown that I have the problem with.

Sorry for the longwindedness of this note. Meant only to say reading all of your comments helped me to understand where my crying & anger might of been coming from. Another answer to a long list of questions. Thank You!
Beth
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I'm sorry to hear you still have no answers and im thinking of you.
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572651_tn?1333939396
MS and depression are often partners and hard to divorce.  Anger fits in there as well.

There are a couple different factors for the depression -

organic depression comes from the chemical and physical changes your brain and body go through with MS.  

Situational depression comes from living day in and out with a chronic disease, whether you are diagnosed or not. It is wearing to know that you have something amiss in your body that is beyond your control.

Wide emotional swings can come from the bouts of depression - either type.

There is also  a little studied MS symptom - pseudobulbar effect - which can create extreme mood swings.  Unexplained and/or inappropriate laughing and crying are some of the signs of this problems and it comes from a specific area of our brain being affected.  

Living with MS or trying to find answers for your health problems can be quite the roller coaster ride. Please be sure to talk to your specialists about these symptoms and what treatments might be available to you.
~Laura
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