Contrast MRI

[Evalucia]

Hello Everyone!

I am currently being worked up for MS although no formal dx has been given.  (My neuro does send in my claims with a diagnosis code of MS to the insurance carrier, I do not know whether it is because he is leaning towards MS or because of lack of better codes.)  He had sent me for the contrast MRI to see if there were any active lesions, and if there were, then he would send me to the MS center for further workup.  

I received the report of my MRI with/out contrast.  The report read: "numerous stable foci of white matter signal abnormality, no abnormally enhancing lesions"  My lesions are mostly periventricular and subcortical.  This report did not mention the lesion of the corpus callosum which was found on my previous MR from a month ago.

Although the contrast did not show any active lesions, I am having the tingling, and loss of sensation, ear ringing, visual problems and so on.  Is it normal to have the symptoms but no enhancing lesion on contrast MRI?  Since my lesions did not light up, is it usual protocol to take the "wait and see" approach?  I see my neuro next week but I wanted to see what you guys thought.

Thanks!

[Evalucia]

Helly Kyle and thanks for responding :)  

The first mri which was without contrast read "Multiple foci of increased signal intensity within the subcortical and periventricular white matter with a single focus noted within the splenium of the corpus callosum is suspicious for inflammatory demyelinating disease"  And after this my neuro sent me for 2nd mri with contrast to check for active lesions.

I have had my symptoms come and go for many many years but every time I saw the doctor she would state that it was "stress", they never looked further into this so I basically tried to "ignore" my symptoms as well.  Since they would come and go I figured it was nothing serious until this time around they were very severe, to the point that I couldn't ignore them, that's when I decided to look further into it and of course, there were lesions found on my MRI.

I also went and got tested for Lyme and vitamin deficiencies just to rule any other condition that may mimic MS.  I haven't gotten the results as of yet.  I know that I will have to deal with whatever it is that ails me, in a way I am glad to know that it is not all in my head (no pun intended lol), it is just this waiting period is killing me.

How are you doing with the MS? and what DMD are you on if you don't mind my asking?

[kwarendorf]

Hi Evalucia -

Welcome to our MS chat fest...

You don't mention if there were any enhancing lesions found on your MRI from a month ago. Maybe because it was done without contrast?It doesn't really matter at this point.

Many of us have had MS for a significant period of time before we found out we had it. In my case it was 20 years :-) During the time between first appearance and diagnosis, MS marched on, however slowly. Little niggling things that we are hardly aware of can become part of our permanent MS landscape. Tinnitus (ear ringing) is one that you mentioned that I have 24/7.

The remitting part of Relapsing Remitting is not always 100%. We often don't go back to normal, but rather back to a new baseline, or new normal.  So it is entirely possible, if not likely, that you have no active lesions but ongoing symptoms.

Whether or not to take a wait and see approach, and the affirmative use of MS DX codes, is largely  up to the doc involved. It sounds like yours is being proactive. This is a good thing. I would want to see the MS specialist anyway. You have lesions, you have symptoms. What may be missing is a thorough clinical exam by a doc that specializes in MS.

The sooner you get to an MS diagnosis, if that's what ails you, the sooner you can start a plan on how you want to fight it, i.e. DMD.

Keep ups posted.

Kyle