Confused about Test Results

    
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Posted by CCF Neuro MD# on February 22, 1998 at 14:51:45:

In Reply to: Re: Re: Confused about Test Results posted by Paula Crane on February 21, 1998 at 15:53:20:

: : : I am confused about how MS is definitely ruled out. I had the conception that MS could be ruled out with negative brain/spinal MRI's, negative evoked potentials, and a negative spinal tap. Am I right? What other etiologies are considered after MS is ruled out? I have "MS-like" symptoms and all my tests are negative. My neurological exam was also normal. Lyme, ANA antibodies etc. were also negative. Do I still have to worry that I have MS even though my tests were all negative? I appreciate your response.
  : ==========================================================================
  : It is very difficult to give an absolute answer to a question like this, answers
  :  can only be expressed in terms of probabilities.
  : I would be interested to know what your  MS-like symptoms were, since the
  : possible range of symptoms is very broad and many other disorders can overlap
  : in terms of individual symptoms.
  : I would also be interested to know if the normal neurological examination occurred
  : during or after your symptoms.
  : If you had a normal exam ,and all of those normal tests at the time of your
  : symptoms MS would be very unlikely, but it is not possible to say that the
  : diagnosis has been absolutely outruled especially whwn typical symptoms are being
  : encountered.
  : It would appear however, on the basis of the extensive testing that you have had that it
  : is not sufficiently likely to worry unduly about the posibility.
  : The other possibilities explored would be the ones that appear to have been
  : looked into already, vasculitis, Lyme disease and post-viral syndrome.
  Thanks for getting back to me. Yes, my normal neurological exam occurred during my symptoms which included, vertigo, paresthesias of the arms and legs. I didn't have any vertigo when I had my spinal tap; however I still the tingling in my arms and legs.
  What is vasculitis and how is it ruled out? Can it cause vetigo and paresthesias? Thanks
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Vasculitis is inflammation of blood vessels, it can occurr anywhere in the
body including in the brain and since blood vessels are found everywhere
it can affect any part of thr brain causing any possible symptom,
including vertigo and parestherias.
Vasculitis is diagnosed by means of blood tests which detect abnormal
antobodies in the blood (ANA ), by MRI scans which will show areas of inflammation
around the effected blood vessel, and ultimately if necessary a lesion
which is visible on a scan may be biopsied.
Vasculitis in the brain is usually associated with inflammation in other
areas like the skin  or joints, lupus is a typical example.
The fact that you have a normal ANA and normal MRI would make this
diagnosis unlikely in your case.