Spinal Tap taken during remission

[annemariecurran]

If a spinal tap is taken during a 'remission' will it still indicate immunse system activity in the Central Nervous System?
If a 'cerebral small vessel ischaemia' shows on an MRI can of a 53 year old would this suggest perhaps MS?

[Cleveland Clinic, MD]

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 your doctor.

CSF analysis can continue to be abnormal and show evidence of inflammation even during a remission from MS symptoms, however, several studies have shown that during remission, the quantity of inflammatory markers (like immunoglobulins) can be less than during active disease phase, usually due to the effect of immunosuppressive therapy with steroids or other immune therapies.

Small vessel disease is more commonly seen in patients who have risk factors for developing vascular disease (the main risk factors include age, high blood pressure, diabetes, high cholesterol and smoking). it is due to occlusion of very small arteries of the brain. There is no direct correlation between this process and MS but sometimes it not easy to differentiate on MRI between small vessel disease and MS demyelinating lesions. in these situations we have to look at the whole picture which includes the patient's symptoms, the clinical course, results of other testing, etc. to reach the correct diagnosis.

Thanks for using the forum. Good luck

[annemariecurran]

How does my neurologists interpretation of my MRI scan indicating small vessel ischaemia square with the fact I am a 53 year old female, height 5ft 4 ins, weight 138lbs, who has never smoked, has never had high blood pressure and am not diabec. I am having real problems getting what I feel may be remitting\relapsing (not really remitting any longer) MS diagnosed. Any justification for the small vessel ischeamia diagnosis that you could imagine, given the above extra information on my health?
Thanks for reply to date as it has been most helpful.