MS

[adi123]

hi
m 27year old asian, diagnosed of MS two years back with symptoms of numbness in hands. MRI of cervical spine and  brain showed up lesions.my C-spine also shows bulge and dessication i ve symptoms of head spinning, pain in neck, imbalance currently which match with cervical spondylosis sympt. please let me know can i still be misdiagnosed of MS as i m skeptical of disease even now ,though my neuro is quite positive abt MS.plz help.

[JainMD]

Hi Adi,
How are you?
Why is the doctor confident of diagnosis?
What investigations have been done apart from MRI to say it is MS?
There are definitive guidelines followed worldwide for diagnosis of MS.
Also there are definitive lesions characteristic of MS on MRI.
Multiple sclerosis is a chronic remitting disorder characterized by multiple white lesions in the CNS separated by time and location. The most frequent presenting symptom is unilateral weakness or ataxia. Headache is common, ill defined paresthesias are noted, Visual symptoms like diplopia, blurred vision are also present initially.
MRI is the neuro-imaging of choice, small plaques of 3- 4mm can be identified, particularly those located in brain stem and spinal cord.
MS can cause changes in sensation, muscle weakness, abnormal muscle spasms, or difficulty in moving; difficulties with coordination and balance; problems in speech or swallowing, visual problems, fatigue and acute or chronic pain syndromes, bladder and bowel difficulties, cognitive impairment, or depression.
The initial attacks are often transient, mild and self-limited. The most common initial symptoms reported are: changes in sensation in the arms, legs or face (33%), complete or partial vision loss (optic neuritis) (16%), weakness (13%), double vision (7%), unsteadiness when walking (5%), and balance problems (3%); but many rare initial symptoms have been reported such as aphasia or psychosis.
Keep me informed.
Bye.

[Abhijeet Deshmukh, MD]

Hello.

It is true that your symptoms do match those of cervical spondylosis, but we need to still explain the brain lesions. Can you please narrate the MRI report here, if you have a copy ?

The brain lesions may not be of MS. There are certain MRI hyperintensities which are non-specific. And MS can not be diagnosed only on the MRI. Your clinical picture should match them. And certain laboratory tests also need to be done (spinal tap for IgG index).

Regards