Why no definite MS diagnosis?

[Morningstar208]

I am a 60 year old woman who presented with left sided numbness,
balance instability, clumsiness,foot drop.  Neuro did MS workup, first in March 2005 (MRI positive) and second one in December 2005.  Radiologist read positive for MS (based on diagnostic criteria) plus one small stroke both MRI's. March 2005 lumbar puncture negative and EVP negative. No change in MRI from March 05 to Dec. 05.  No black holes. Differential diagnosis both times from neuro small vessel ischemia. Both MRI's positive for optic neuritis on right side.  Leg weakness(sometimes severe) since October 2005.Rapid decline in ability to walk except for short distances. Minimal blurred vision. Neuro is hesitant to diagnose MS because of age.  Said if 25, definite MS diagnosis. Have ruled out DDD as culprit (neurosurgical consult) Ruled out neuropathy and ALS.
Have appointment at major university with specialist in April.
Should I push for a definite diagnosis to receive treatment before this progresses?  Understand reluctance to diagnose this disease in older person.  If it walks like a duck...Advice please!. My stress level is off the charts. Thanks!

[CCF-Neuro-M.D.-PW]

Unfortunately I cannot make a clinical diagnosis over the internet. You are correct though in pursing an accurate diagnosis at a major center - one must be confident of the diagnosis before initiating treatment (in most circumstances) as the treatment is expensive and has side effects which could be deleterious to your health. If the diagnosis is MS, then treatment may reduce or slow the course of the disease.

There are several mimics of MS which are sometimes hard to seperate out. MS may still be possible in an older person (rarely we see an MRI scan in an older person that suggests MS, when they have had no symptoms reported in their whole life, MS can be clinically silent for long periods of time, and the severity of the disease varies widely). But especially in an older person, the mimics of MS such as vascular disease, vasculitis, Lyme, sarcoid among others should be looked into before a diagnosis is made.

Good luck

[Pinky61]

I really feel like there is too much emphasis on demographics in the medical profession. I'm 25 and was recently diagnosed with MS following a single episode of numbness that came after I had a very nasty bout of tonsillitis. The MRI was positive but I have normal CSF and visual evoked potentials. They won't even consider post-infectious myelitis because of my age. I've also starting getting rashes and fevers but the neurologists don't care. So if you want a MS diagnosis, come to Houston. They'll diagnose you with it whether or not it makes sense.

PS- Sorry if I sound nasty. I'm just bitter about the treatment I've gotten. I really hope things work out for you.

[bengalcats]

I have a friend who was dx at 61 yrs old for MS and her Dr said she would most likely die from other causes and not the ms, said that by the time it would get that bad she wouldnt be around.I am 45 and feel i have ms but my drs say I do not. Just what exactly did your MRi say? Mine said that i have a few small t-2 bright signal foci in the subcortal white matter, when i asked if it meant ms they said no. I have had symptoms for 15 or more years such as tingling in my arms and legs, weird, very weird feelings in my brain, like something is short circuiting, tingling in my bladder, vaginal numbness and a host of other weird things, I am not so sure I want to know if it is MS because I would not take the medicine, i read that it is toxic and can cause other ms symptoms to get worse so untill things get bad I am going to stop searching but I am always willing to share stories with others, it really helps.Keep pushing if you really want to know.

[bengalcats]

what kind of balance and clumbsieness are you experiencing?

[bengalcats]

if you had the spinal tap then i doubt you have ms, it is supossed to be a good way to find out if you have it, and what ever makes a dr think someone is to old to get ms, heck 60 year old ladies are having babies for their kids who cant have any!

[kf kf]

have your doctors considered lupus?