MS and MRI's

    
      Re: MS and MRI's
    


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Posted by CCF Neuro MD on August 13, 1997 at 20:10:35:

In Reply to: MS and MRI's posted by Janet MacKinnon on July 17, 1997 at 22:05:45:

: I just received the results of my last MRI.  The neuro that there was no
  new lesions and that this MRI was better that the one I had in 10/96.  
  That MRI showed 8 lesion spread out in my spianl cord and brain.
  I was Dx with probable MS, based on MRI and symptoms as well as what the
  neuro found when she examed me.  My qestion is since there were no new
  lesions on this MRI and some of the lesions may have faded does that change the
  Dx.  I have not a attack since March or April.  I still do have MS symptoms
  at times.  Also I have almost daily at what I think is called L'Hermittes sign
  I hope the Dx. will change.  Could this happen
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Dear Janet:
The question you ask is a common one in view of the complexity of the diagnosis of MS, or rather, the certainty with which such a diagnosis is made at a point in time with the available data. I invite you to go over some of our previous answers addressing questions like yours. Below is one (dated 7/2/97) that I felt was highly pertinent:
  The diagnosis of MS is based on a combination of findings - historical (what you tell the doctor), physical (what signs the doctor finds on examining you), imaging (MRI), electrophysiological (evoked potentials), and CSF (spinal tap). No feature in itself is sufficient to make the diagnosis of definite MS. When there is a combination of features suggestive of MS, but not meeting the full diagnostic criteria, the patient is labelled as having probable MS. As time passes, this patient may develop a new exacerbation or typical neurological deficit. This may occur days, months, or even several years after his/her earlier event(s). At that point, the patient may meet the full diagnostic criteria of MS and may, thereafter, be labelled as clinically definite MS.  While a fairly large proportion of patients with probable MS, even a majority, become clinically definite MS over the next several years, a significant number do not. They may not have any subsequent exacerbations, or may be diagnosed with another disease that may have mimicked MS. I hope this clarifies some of your questions and concerns.
  If you live near the Cleveland area, and in case you desire a second opinion and want further explanation of these issues, you could call up [phone] or [phone] for an appointment to see a neurologist specializing in MS (Drs. Rudick, Kinkel, Cohen or Guttman) at the Mellen Center for MS affiliated to the Cleveland Clinic.
  This information is provided for general medical educational purposes only. Please consult your physician for diagnostic and treatment options of your specific medical condition.