MS Help

My wife has been having what seems to be "typical" MS symptoms for the past few years. Started with what she considered a numbness in her arms, leg pain that felt like nerves in her calves .. Over the last year she has experienced facial numbness, weakness in her arms, loss of balance, has a hard time forming sentences or cant seem to get words out, numbness in feet, hands, back. A feeling across her mid section that feels like a tightening belt and painful to varying degrees. Baths and heat seem to exasperate the conditions.
She has had MRI's that come back normal. Nerve conduct tests- normal. Seen a few neurologists that after viewing MRI's and conducting standard tests (reflex, one foot in front of the other, follow the pen, hopping on one foot etc..) dismiss MS.
These "episodes" come and go (with the exception of the numbness and leg pains) and last for maybe a week or so at a time. She has breaks of upwards of two months between..

GP still feels its MS, but has tested for other possibilities such as viral infections, vitamin deficiencies, Lyme etc..
Were do we go from here? What else can be done to either confirm MS or what direction should be taken to "try" to get to the bottom of whats going on?        

[Christopher R Newey, DO]

Thanks for using the forum. I am happy to address your questions, and my answer will be based on the information you provided here. Please make sure you recognize that this forum is for educational purposes only, and it does not substitute for a formal office visit with a doctor.

Without the ability to examine and obtain a history, I can not tell you what the exact cause of the symptoms is. However I will try to provide you with some useful information.

Multiple sclerosis, or MS, is an inflammatory demyelinating disease that affects the central nervous system. To make the diagnosis there are specific criteria, in which objective neurologic findings are present affecting 2 or more locations in the nervous system in 2 or more episodes. In order to make this diagnosis, a detailed history and neurologic examination is required. MRIs of the brain and cervical cord are very helpful and needed as they help determining the presence of white matter lesions in 2 or more locations, however there are multiple conditions producing MRI changes that could be mistaken for MS, and the MRI should be reviewed properly and correlated to the symptoms. When the diagnosis is in doubt, a spinal tap or lumbar puncture (LP) to study the CSF is helpful, and if there is still some doubt, there are other tests such as evoked potentials that can help.

Your wife should continue working with her PCP and neurologist as there are additional testing that can be performed.

Thank you for this opportunity to answer your questions, I hope you find the information I have provided useful, good luck.