MS Diagnosis (2nd Opinion)

[Burns2589]

My name is Don.  Last year at age 46, I was referred to a Neurologist due to numbness and tingling in my entire left arm.  After several tests and after revewiing my lumbard puncture results, my Neurologist informed me that I had MS and recommended me to start Rebif immeditely.  Since 01 July 2007, I have been on Rebif (44 mcg, 3 times per week).  Over the past year, I have had a few new symptoms such as burning and sharp pains in my left leg.  Also, when I have situations that increase my stress or anxiety, my entire body vibrates like a tuning fork (wierd feeling).
My question to you is, do you concur with the diagnosis of MS?  Below is a summary of the results from the MS tests I took last year inlcuding the results of the lumbard puncture (CSF analysis).  The only thing that jumps up to me is the oligoclonal banding.  PLease advise.  Thank you.

TEST RESULTS:
1.NCV:  Performed on 10 April 2007; normal nerve conduction study form the left upper extremity.

2. C-Spine MRI:  Performed on 10 April 2007 with sagittal T1, T2 and inversion recovery and axial T2 weighted images.  Vertebral body stature, alignment and marrow are within normal limits.  There’s no significant degenerative disc disease, herniation or degenerative stenosis with patency of the central canal and foramen all adequate.  No cord compression is seen, and there is no intrinsic signal abnormality in the spinal cord.  

3. Brain MRI:  Performed on 10 April 2007 with sagittal and axial T1 and axial T2, FLAIR and diffusion weighted sequences.  Based on this, additional contrast-enhanced axial and coronal T1 weighted-images were obtained.  There is a number of relatively small but fairly classic periventricular and subcortical white matter lesions predominantly in the frontal regions with the largest lesions approaching 8 mm in the frontal regions.  There are at least nine lesions.   There is sparing of the frontal posterior fossa.  The ventricles are normal.  After giving contrast, none of the lesions presumed to primary demyelinating disease show abnormal enhancement, but there is an incidental enhancing left frontal venous angioma.

4. Vision Evoked:  Performed on 10 April 2007.  Significant weakness in left optical nerve.

5. Cerebrospinal Fluid (CSF) Analysis:  Performed on 14 April 2007

MS Panel                                                                                   Reference Ranges
Glucose                                    60                                     40-70 mg/dl
Total Protein                              41                                     15-45 md/dl
WBC                                          8 H (high, abnormal)             0-5 mm3
RBC                                           0                                         0-0 mm3
Lymphocytes                             89%
Monocytes                                11%
Crptococal Antigen, CSF            Negative                               Negative
Oligoclonal banding, CSF           12 bands
Oligoclonal banding, Serum          3 bands
Oligoclonal banding, Interp.    9 H (high, abnormal)                    <4
IgG Index, CSF                           0.81                                     <=0.85
IgG, CSF                                    5.05                                     <=8.1 mm/dL
Albumin, CSF                            25.50                                     <=27.0 mg/dL
IgG/Albumin, CSF                        0.20                                     <=0.21
Synthesis Rate, CSF                   9.89                                     <=12
IgG, Serum                                   988                                     600-1500 mg/dL
Albumin, Serum                          4030                                    3200-4800 mg/dL
IgG/Albumin, Serrum                     0.2                                     <=0.4
Myelin Basic Protein                      0.3                                     < 1.5ng/mL

[Burns2589]

Yes . . . the first tests done (which I failed to mention) after my MRI was blood test to check for Lyme Disease.  The results were negative.

   -Don

[dannig]

Have you been tested for Lymes disease?

Danni

[slightlybroken]

Hi Don

According to your results you do meet the criteria from what I understand. I'm not a doc either nor do I have a DX but your evidence follows it perfectly. The doctors go by the McDonald criteria to DX MS. You have involvement of 2 parts out of three of you CNS (your brain and your optical nerve). Your lesions in your brain are of good size for MS also. Your LP shows that it has crossed the blood brain barrier because of the banding so from what I can see, I would concur with the DX.

Hope This Helps..Take Care

[Burns2589]

No . . .  I have not required any solu-medrol infusions.  My Neurologist has stated that I have RRMS, but was concern about my HIGH oligoclonal bands.  He also seems to really worried about my vision which so far I have only been dealing with normal bi-focal issues.  While my sensation problems with my left arem is continuous everyday, the new symptoms arise only periodically depending on my daily stress or anxiety level.  Sor far, I have simply manage to get through each episode so far.

- Don

[young at heart]

I HAVE SECONDARY PRIMARY MS, REBIF IS TO TREAT RELAPSING AND REMITTING.AT THE PRESNT TIME,YES I DO FEEL THE REBIF HAS HELPED,EVEN THOUGH ITS NOT APPROVED FOR SPMS.

THE DISEASE MODIFYING MEDS ARE TO SLOW THE PROGRESSION.MRI'S ARE THE TRUE ANSWER.

WITH MS,WE ARE GONNA HAVE SYMPTOMS,THERES MAINTENANCE MEDS TO HELP DAILY FOR THE SYMPTOMS.

SINCE STARTING THE REBIF HAVE YOU HAD ANY RELAPSES THAT HAVE REQUIRED SOLU-MEDROL INFUSIONS?

T-LYNN

[Burns2589]

Hi Lynn,
Thank for the response and the welcome.  Do you beleive Rebif has helped you?

-Don

[young at heart]

WELCOME TO OUR CYBER FAMILY.

SORRY MS HAS BROUGHT YOU HERE,BUT GLAD YOU HAVE JOINED US.

YES,MS SEEMS TO BE A HIGH PROBABILITY.

I ALSO TAKE REBIF.

WITH MS SYMPTOMS COME AND GO AND ANXIETY AND STRESS CAN ADD TO PRESENT SYMPTOMS OR BRING OUT UNDERLYING ONES.

I'M NOT A DR.,JUST ANOTHER MSER.IF YOU HAVE YOUR DOUBTS,SEE A MS SPECIALIST.

CONTACTING YOUR LOCAL MS SOCIETY CHAPTER,THEY CAN REFER YOU TO A MS SPECIALIST.

AGAIN WELCOME

T-LYNN