MS vs Microangiopathy

[onelly]

Please somebody help me, my husband's MRI showed more white spots than 4 years ago, they did the lumbar puncture then and it was negative, we just went for a second opinion today and the neurologist says they are microangiopathy lesions ????????????? I;m so confused he has weird sympotms worse than years ago. Memory loss, tingling on both arms, chronic fatigue, leg cramps. We are going back to the first neuro but until 3 weeks this is killing me, he is 40 years old. Is it possible to dx MS with a negative LP? or maybe his LP is positive now and we are wasting time?

[jensequitur]

I would say yes, that if the conditions are met to have another mini-stroke, then that could certainly occur.

[onelly]

We went to the Neuro and my husband had the Vision test that came back normal a little bit of weakness on the left side, but nothing major. They ordered the second spinal tap, he had the first one 7 years ago and it was negative. We saw two other Neuros and they said micro-strokes but what I don't understand why more lesions on the MRI than years ago? Can mini-strokes increase with the years? So hopefully this Monday we get an aswer this is killing me.

[sllowe]

Hi there,

Welcome. We have a great health page on this:

http://www.medhelp.org/health_pages/Multiple-Sclerosis/Can-you-Diagnose-MS-with-an-LP-that-is-Negative-for-O-bands/show/142?cid=36

Yes, lots of labs and a good clinical exam. I'm very glad they are continuing the workup. But, 2nd LP? If he just had one, they can call the lab and ask if there is extra CSF to test. Hope this Dr. is not hanging his hat on positive O-bands to dx. Hoping they are just looking in some other areas to rule in or out.

Thanks for joining us,
Shell

[jensequitur]

And don't forget that mini-strokes (small lesions in the brain caused by ruptured or blocked blood vessels) can cause similar problems.  MS is just damage to the nervous system, just like a stroke.  The difference is that strokes are usually a large problem with a large symptom (can't use the right hand, left side of the face doesn't work) while MS can be either large or small.

[Deb61]

Lab work is to rule out other causes for the symptoms and brain lesions.  Lupus, Sjogren's, Lyme disease, and antiphospholipid syndrome to name a few, should be ruled out.  I wonder why these tests weren't done so long ago.  This was one of the first things, besides the MRI, that was done for me.  I had about 15 vials of blood taken from me--no joke!  

It's also possible to have MS and a negative LP, as Mistylee pointed out.  She is also right that a diagnosis can take time.  I hope, though, that with these latest rounds of tests, that the cause for the symptoms will be identified.  

Deb

[onelly]

We went to see the Neuro last Wednesday and he said cannot rule out MS, he ordered an MRI of the spine that came back negative for plaques, also they are doing a vision test and possible a second LP, the first was 7 years ago and was negative.
We work in a hospital and we sent the MRI of the brain to a Neuro Radiologist out of town and the report says possible MS. What is next, labs?

[mistylee]

Yes its posible to DX MS with a negative LP.

I would definatly get a second opinion.  Did he have both a brain and spinal MRI?? If not then I would be pushing for a spinal MRI.

Also did he have a thourough neuro exam and what did it reveal??
You need to have a concise timeline with symptoms , when they occured and for how long etc as this is very important part of the DX process.

Also there are many MS mimics that need to be ruled out and most of these can be done with blood tests.

Also you may wish to read up on our Health pages ....top right....it can give you a lot of info and it is better to be armed with knowledge before your next neuro appt.

This DX process can be very long and many of us here are still undx. It has been 4 years for me so far.  I am waiting on test results from evoked potentials . This is another test that may be useful....especially visual evoked potentials.

Hope this has helped you some .  Wishing you and your hubby the best. Hope you get answers soon.

Mistylee