Normal MRI without contrast

[rudyhorse]

Help!  I have numbness, tingling in my elbows to my hands and the bottoms of my feet, I fall and my right leg is rigid.  In addition, there is a loss of balance.  The Neurologist thought it would be a demelynating disease, and did and MRI.  Which was without contrast since I am allergic to the contrast dye, and it was normal.  The MRI only show " small region of encephalomalacia."  I have a lot of pain and am very frustrated.  Where to next?  Does this rule out MS or any suggestions?
THANK YOU

[Lulu54]

Hi Rudyhorse and welcome to the MS forum.  Has your neuro suggested any additional tests, such as a lumbar puncture (LP) to look at other markers. Not all MS patients show lesions on their MRI's and many more don't show up on the initial tests early on.    So a negative MRI does not necessarily rule out MS.  

If I'm understanding the use of contrast, it is essential.  The contrast will "light up" lesions that are newly formed (within 30-40 days or so) and help to establish a separation in time for the McDonald criteria.  If your lesions are visible, they will be seen with or without contrast.

It sounds to me like you are in limboland with so many other fine folkss here.  Be patient and keep looking for the answers to get you on the roadd to treatment.    I hope you'll come here often to learn more and ask all the questions you want.

my best, Lulu

[Heather3418]

Rudyhorse is allergic to contrast dye.  Even without contrast, if there are lesions there they can be seen.  A brain and spinal MRI is essential.  Rudy in your case, a spinal tap may clinch a diagnosis for you, since it will show active imflammation.

Boy it must be rough to be allergic to the contrast dye.  To know if you are in an active relapse, your Neuro will have to depend solely on the physical exam and history..

Welcome to the Forum.

Heather

[PastorDan]

These two nice ladies have given you some excellent advice, but I have a question: How do you know you are allergic to the gadolinium dye?  I ask only because I had an allergic reaction to a contrast agent once, but that particular agent is no longer in use.  If you're sure, then it is obviously something you're stuck with for a while, but if it was actually an allergy to a secondary ingredient in a particular manufacturer's formulation of the gadolinium-based product, you might have alternatives.  Wikipedia (always a source you'll need to verify, IMHO) lists six names with Gadolinium, and six with iron oxide, and also discusses manganese solutions.  It sounds, though, like they might not be as helpful in imaging for MS.  Something to ask about, anyway.

[Lulu54]

OOOPS! I caught that in the original post and I am so glad Heather poin ted out my err... I meant to include the word NOT  - the use of contrast is NOT ESSENTIAL ... I want to reassure you the MRI you get without contrast is sufficient.  Contrast only helps with the activity/age.   As I wrote, if visible lesions are present, they will be seen whether you have contrast or not.


Thanks Heather for catching that one.... once again the fingers fly without proofreading what I wrote...... :-)

[Heather3418]

I am the one that may be guilty of not reading posts here.  If I had read YOUR post more carefully, I would have seen that you forgot the add the word NOT.

Heather

[rudyhorse]

Wow!! What great help.  It really makes me feel better.  Yes I think they will do a lumbar puncture because the Neuro said "no needles yet" last time I was there.  However he also has done an emg on me so I thought he was talking about that, but now I am not so sure.  Also, I was unable to breath on the contrast, but that was 20 years ago, so I wanted to take a chance and try it but the Drs wouldn't.  Limboland is interesting isn't it.  But I feel better knowing others are with me, sorry you are there too, but I am not crazy.

A big hug to all of you because this really helped me and I haven't had anyone who really knows or understands.  Maybe they aren't in pain or limboland huh?
Thanks
Rudyhorse

[Lulu54]

Hi Rudyhorse,
Now that you know you are not alone on this journey I hope you will stop through often to share your questions and thoughts.  It can be pretty intimidating to do it on your own.

In the meantime be sure and read some of our health pages - written in common language by our own members- they contain a wealth of information that should be helpful to you,  They are located through the yellow icon at the top right side of this page.

Stay in touch,
Lulu

[Quixotic1]

I missed seeing what the MRI was of.  All of your symptoms are those of spinal cord dysfunction or of a systemic process like a deficiency or infection.  Have you had an MRI of your spinal cord?  Also, have you been checked for the mimics of MS, including B12 deficiency, other autoimmune diseases, and infections (especially of Lyme disease?)  Given your symptoms I would think a spinal MRI is mandatory.  And it should be on the highest resolution machine available to you - preferably a 3T.

And about the contrast.  20 years ago there weren't that many MRI machines around.  Could you have been having a CT scan which uses a different kind of contrast agent (and one which allergy to is much more common?)

If your neuro threw up his hands at a negative MRI and has no plans for more testing then you need a smarter neuro.  Tests that might be of use here would include a spinal cord MRI, testing for the mimics, and EMG/NCS, and Somatosensory Evoked potentials. If the history and exam are suggestive enough thought should be given to doing an LP.

What strength machine was your MRI done on?  You can call the department and ask.

No, you're definitely not crazy.  Did your neurologist do an extensive neuro exam head to toe testing literally dozens of things?  If not, another reason for getting a second view of things.  Before the MRI the neurologist needs to get a thorough history from you about how and when your symptoms appeared, your family history and then look at all of your nervous system.

Your symptoms are suggestive.  Did the tingling and pain in your hands and feet all begin together and are they the same on both sides?

Looking for your answers.

Quix

[PastorDan]

My soon-to-be-ex neuro did an exam that might have taken all of four minutes.  The physical therapist did a much more thorough exam.  Do we have something on health pages that might tell us what dozens of things you're thinking of?

[gapeach34]

I need some answers, my 16 yr old daughter started out with a headache 4 months ago on the left side of her head. The Doctors told us that she has migraine headaches he gave her some midrin for the headaches. The meds did not work. The headaches eaze up but did not go away completely. Then on January 31, 2009 the headaches came back really bad so bad that I had to rush her to the emergency room and she has had the same headache since. The Doctors change her meds to Tompax and Maxalt but that don't seem to be working. The doctor order a MRI on Feb 10, 2009 but have not heard from it yet. We went back to the military doctors but saw a different one this time. And we still could not get the results. But now my daughter is complaining of tingling and hurting in the face, legs, feet and waist down she's very weak, lay down at all times when home dont feel like getting up out of bed. I notice that her left eye lid droop a little and she says that she gets some blurred vision and sometimes the she sees a different color in her eyes. She has to have some kind of support when she walks.My daughter plays tennis, cheerleader and plays basketball very active in school now she dont function like the active teen she has always been. She has been keeping a journal on all of the different eposides.
I am a very concern mother and wish I could get some advice from someone. I know this is alot but someone please help