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"Non Specific" Juxtacortical White Matter ?
All of my Google Searches related to my MRI report seem to point me to the MS Community here on MedHelp, so here I am! I posted this in the Neurology forum earlier, but it seems this might be a better suited forum?
A week ago, I was diagnosed with Optic Neuritis by an Opthamologist. Blurry spot in left eye, and headache on left side. My primary doc sent me for an MRI, and I just received the results. My doc's assistant said "There were nonspecific benign findings, and no findings of MS". She referred me to a neurologist who cannot see me for 3 weeks.
Of course, I want to know more before then, if I can. I do not have high BP, I will be turning 40 in 2 weeks, and have no family history of anything I know of.
The complete results are in the photo (it says the sizes are 1-2 mm, then 2-3mm), but the conclusions are:
1. Two small nonspecific right frontal juxtacortical white matter T2 hyperintense foci without enhancing mass lesion or acute intercranial pathology
2. No orbital pathology identified on standard whole brain images
I want to know what that MEANS. If you Google pieces of it, MS and other causes comes up .. so how could my doc say "no findings of MS"?
I am curious what the neurologist might do (further tests?) .. I am trying to manage expectations for my visit.From what I read, it often takes several neurologists before you find someone who takes you seriously. Hoping for some insight into these MRI results, and helpful questions to bring to my neurologist appt.
FYI - the headache has moved to the whole head, a lot of it in the back as if it's in a vice.
A week ago, I was diagnosed with Optic Neuritis by an Opthamologist. Blurry spot in left eye, and headache on left side. My primary doc sent me for an MRI, and I just received the results. My doc's assistant said "There were nonspecific benign findings, and no findings of MS". She referred me to a neurologist who cannot see me for 3 weeks.
Of course, I want to know more before then, if I can. I do not have high BP, I will be turning 40 in 2 weeks, and have no family history of anything I know of.
The complete results are in the photo (it says the sizes are 1-2 mm, then 2-3mm), but the conclusions are:
1. Two small nonspecific right frontal juxtacortical white matter T2 hyperintense foci without enhancing mass lesion or acute intercranial pathology
2. No orbital pathology identified on standard whole brain images
I want to know what that MEANS. If you Google pieces of it, MS and other causes comes up .. so how could my doc say "no findings of MS"?
I am curious what the neurologist might do (further tests?) .. I am trying to manage expectations for my visit.From what I read, it often takes several neurologists before you find someone who takes you seriously. Hoping for some insight into these MRI results, and helpful questions to bring to my neurologist appt.
FYI - the headache has moved to the whole head, a lot of it in the back as if it's in a vice.
Best Answer
COMMUNITY LEADER
2 Comments
Hi I was diagnosed in 2011 by a Neurologist in NC. There is an extra step that could verify the MS with the Lesions as I had a spinal fluid injection that proves that the T2 cells also show up in spine sooooo it was the I was diagnosed at 58yrs. old &n I am 65 now & received therapy at Chapel Hill Hospital in NC & so from I am stabilized but have Relasping/Remitting MS ! it is complicated & very tricky so perhaps to have peace of mind & total clarification you could have the spinal test b/c its important to know! Not knowing was torment! Good Luck!
Hi I was diagnosed in 2011 by a Neurologist in NC. There is an extra step that could verify the MS with the Lesions as I had a spinal fluid injection that proves that the T2 cells also show up in spine sooooo it was the I was diagnosed at 58yrs. old &n I am 65 now & received therapy at Chapel Hill Hospital in NC & so from I am stabilized but have Relasping/Remitting MS ! it is complicated & very tricky so perhaps to have peace of mind & total clarification you could have the spinal test b/c its important to know! Not knowing was torment! Good Luck!
Congratulations? Welcome to the club to which no one wants to belong :-)
As you said, now you have something to work with. It will likely take some time for reality to set in. You sounded as if you were pretty sure what you would hear today. So was I when I went in for the official declaration. Even so, it's a pretty big new reality and will take some time to fully digest. I saw a therapist for a year following my DX. It helped a lot!
As far as a separate Newbie thread, I don;t think there is one here. But there are lots of newbies here and in general you're in good company here!
Congratulations and I'm sorry :-)
Kyle
As you said, now you have something to work with. It will likely take some time for reality to set in. You sounded as if you were pretty sure what you would hear today. So was I when I went in for the official declaration. Even so, it's a pretty big new reality and will take some time to fully digest. I saw a therapist for a year following my DX. It helped a lot!
As far as a separate Newbie thread, I don;t think there is one here. But there are lots of newbies here and in general you're in good company here!
Congratulations and I'm sorry :-)
Kyle
So yes, she did give me a diagnosis of MS today. She said the lesions in my T-Spine were the telling signs, in conjuntion with my Optic Neuritis, numbness in arm (I assumed it was ergonomics since it comes and goes), and bright spots on brain.
We feel comfortable with this doc, with this clinic, and with her diagnosis. I'm still digesting. I think I will check things out here to see .. there must be a "newly diagnosed" forum or thread somewhere ..
We feel comfortable with this doc, with this clinic, and with her diagnosis. I'm still digesting. I think I will check things out here to see .. there must be a "newly diagnosed" forum or thread somewhere ..
Is this odd? I'm not scared of an MS diagnosis. I think the logic for me is, a diagnosis is SOMETHING TO WORK WITH, rather than a bunch of "maybe"s. I have to assume other people have felt the same way?
Anyway, from what I gather - and this is where my heart is - everything that has shown up has been pretty mild (2 or 3 suspected lesions on spinal cord, vs 40 or 50 that I've read in other people's) .. I feel like the Spinal Tap results will be a big piece of the puzzle .. if there are oligoclonal bands, then she'll probably lean toward MS, if not .. she may keep me as a "maybe".
I guess though, since I do not have debilitating symtoms, I'm "ok" with a diagnois at this time .. getting it earlier rather than later, I guess.
I have access to the patient portal through the MS Center, so I see results when they are posted; my LP results are out there, but I believe all pieces are not back yet. I see nothing about the "Bands" ..
-CSF Protein: 42 (standard range listed as <50)
-Neuromyelitis Optica AutoAb, IgG: Negative
-B. burgdorferi Abs, CSF w/ WB Confirm {I understand this is a Lyme test, being that I live in the US/Northeast}: <0.10 (standard range <=0.9)
- Glucose CSF: 59 (standard range 40-70)
- CSF Culture No Growth, No WBC's, No Organisms
- Angio Convert Enzyme, CSF: 3 (standard range <=15)
She did say that the LP/CSF results come back in stages, and one part takes longer than the others .. so I assume the part that counts/test for those oligoclonal bands is not back.
So .. I feel prepared for the nuro appt next wed, better understanding of MRI results to ask good questions. Thanks again for all of the insight!
Anyway, from what I gather - and this is where my heart is - everything that has shown up has been pretty mild (2 or 3 suspected lesions on spinal cord, vs 40 or 50 that I've read in other people's) .. I feel like the Spinal Tap results will be a big piece of the puzzle .. if there are oligoclonal bands, then she'll probably lean toward MS, if not .. she may keep me as a "maybe".
I guess though, since I do not have debilitating symtoms, I'm "ok" with a diagnois at this time .. getting it earlier rather than later, I guess.
I have access to the patient portal through the MS Center, so I see results when they are posted; my LP results are out there, but I believe all pieces are not back yet. I see nothing about the "Bands" ..
-CSF Protein: 42 (standard range listed as <50)
-Neuromyelitis Optica AutoAb, IgG: Negative
-B. burgdorferi Abs, CSF w/ WB Confirm {I understand this is a Lyme test, being that I live in the US/Northeast}: <0.10 (standard range <=0.9)
- Glucose CSF: 59 (standard range 40-70)
- CSF Culture No Growth, No WBC's, No Organisms
- Angio Convert Enzyme, CSF: 3 (standard range <=15)
She did say that the LP/CSF results come back in stages, and one part takes longer than the others .. so I assume the part that counts/test for those oligoclonal bands is not back.
So .. I feel prepared for the nuro appt next wed, better understanding of MRI results to ask good questions. Thanks again for all of the insight!
COMMUNITY LEADER
IF i'm reading all of this right which i'm possibly not, what i've noted is that your most resent brain MRI (possibly done with MS protocol?) has additionally picked up a lesion in the 'Corpus Callosum' and if that was added to the 'juxtacortical' lesion that was found originally, that would make a lesion found in 2 locations of the brain that are associated with MS.
You've spinal MRI has 'possibly' found 2 lesions in your spinal cord (T2/3 & T6), i'm not exactly sure if that is what its saying but this comment "These findings are concerning for demyelinating disease/MS." would only make sense if it's talking about lesions, so i suspect it is.
It will be really interesting what the MS neuro has to say, about your brain and spinal results, i'm definitely thinking you might be even more 'suggestive' of MS, if you do have both brain and spinal cord lesions, as well as Optic Nuritis.
There are MS mimics to rule out but the evidence reduces a lot of the other possible alternative dx, eg Vit B deficiency does mimic some MS sx's but wouldn't produce the same evidence you've got, so it's an unlikely cause. I suspect you won't be getting all your answers on your next appt, but your probably a little less unimpressive, if i'm right about what your MRI's have found. Yes, definitely something that needs to be followed up on and monitored!
Cheers...........JJ
ps let us know how you get on, and if you have any questions please ask away :0)
You've spinal MRI has 'possibly' found 2 lesions in your spinal cord (T2/3 & T6), i'm not exactly sure if that is what its saying but this comment "These findings are concerning for demyelinating disease/MS." would only make sense if it's talking about lesions, so i suspect it is.
It will be really interesting what the MS neuro has to say, about your brain and spinal results, i'm definitely thinking you might be even more 'suggestive' of MS, if you do have both brain and spinal cord lesions, as well as Optic Nuritis.
There are MS mimics to rule out but the evidence reduces a lot of the other possible alternative dx, eg Vit B deficiency does mimic some MS sx's but wouldn't produce the same evidence you've got, so it's an unlikely cause. I suspect you won't be getting all your answers on your next appt, but your probably a little less unimpressive, if i'm right about what your MRI's have found. Yes, definitely something that needs to be followed up on and monitored!
Cheers...........JJ
ps let us know how you get on, and if you have any questions please ask away :0)
One more piece of info .. In the actual report (not just the impression) there were two other things I noticed:
BRAIN
(remember, they had my MRI from last month from another facility to compare this to)
Foci of T2 prolongation involving the periventricular subcortical white matter are non specific (that part sounds like the original report) ,, there is one very small focus of increased FLAIR signal in the anterior body of corpus callosum on the right side which is not definitively seen prior, this may be related to the exam technique
So that tells me that there was an increased "bright spot" from my original MRI, but they are writing it off to imaging technique .. especially since it did not make it to the IMPRESSION notes.
I'm really interested in the Thoracic findings .. *IF* my spinal tap comes back clean, one question I have for the doc is, are the findings in my T-spine something that many people could have but never know about, or do those findings mean there is SOMETHING there that needs to be followed up on
BRAIN
(remember, they had my MRI from last month from another facility to compare this to)
Foci of T2 prolongation involving the periventricular subcortical white matter are non specific (that part sounds like the original report) ,, there is one very small focus of increased FLAIR signal in the anterior body of corpus callosum on the right side which is not definitively seen prior, this may be related to the exam technique
So that tells me that there was an increased "bright spot" from my original MRI, but they are writing it off to imaging technique .. especially since it did not make it to the IMPRESSION notes.
I'm really interested in the Thoracic findings .. *IF* my spinal tap comes back clean, one question I have for the doc is, are the findings in my T-spine something that many people could have but never know about, or do those findings mean there is SOMETHING there that needs to be followed up on
Spinal Tap was this morning, waiting 2 weeks for results.
Doc said my blood work came back fine, except B12 is on low side (I had Gastric Bypass surgery in 2008, this is not surprising)
I have the MRI report, she did not review iwth me today, will review in 2 weeks.
.....................................................
IMPRESSION:
Small, scattered nonspecific subcortical foci of increased T2 and FLAIR signal are noted in the cerebral white matter as detailed above. No acute brain pathology, or lesion enhancement.
No evidence of demyeliniating disease or pathology within the cervical spinal cord. There is minor disc bulging at C5-C6, no significant spinal or foraminal stenosis.
At the T3-4 level, there is a small disc osteophyte complex with indents the spinal cord, small focus of increased T2 signal within the central, ventral aspect of the cord is noted at this point. This could reflect focal myelopathic signal change secondary to the disc osteophyte complex.
At the T2/3 level, there is potential small focus of increased T2 signal in the right dorsal superficial lateral cord. Additionally, at the mid T6 level, there is high T2 signal within the cord without evidence of external compression. There is no pathologic enhancement of the thoracic spinal cord, lepomeninges or vertebrae. These findings are concerning for demyelinating disease/MS.
............................................................
Sooo .. that's a lot to read, and I only understand a little, really looking forward to my appointment in 2 weeks.
Things that look not so bad: words like "small", "no evidence in cervical spinal cord", "potential" .. in other words, looks like my C-Spine is clear (besides a minor disc bulge) and anything else is either small, or not specific.
Things that look worrisome: The last sentence of the impression, but I do not know what that means. Also, at the mid T6 level, there is 'high' T2 signal within the cord without evidence of external compression .. what does THAT mean?
I'd love some input - and any advice going into my appointment in 2 weeks? Reminder, the neurologist is specific to an MS clinic, so that's good.
Doc said my blood work came back fine, except B12 is on low side (I had Gastric Bypass surgery in 2008, this is not surprising)
I have the MRI report, she did not review iwth me today, will review in 2 weeks.
.....................................................
IMPRESSION:
Small, scattered nonspecific subcortical foci of increased T2 and FLAIR signal are noted in the cerebral white matter as detailed above. No acute brain pathology, or lesion enhancement.
No evidence of demyeliniating disease or pathology within the cervical spinal cord. There is minor disc bulging at C5-C6, no significant spinal or foraminal stenosis.
At the T3-4 level, there is a small disc osteophyte complex with indents the spinal cord, small focus of increased T2 signal within the central, ventral aspect of the cord is noted at this point. This could reflect focal myelopathic signal change secondary to the disc osteophyte complex.
At the T2/3 level, there is potential small focus of increased T2 signal in the right dorsal superficial lateral cord. Additionally, at the mid T6 level, there is high T2 signal within the cord without evidence of external compression. There is no pathologic enhancement of the thoracic spinal cord, lepomeninges or vertebrae. These findings are concerning for demyelinating disease/MS.
............................................................
Sooo .. that's a lot to read, and I only understand a little, really looking forward to my appointment in 2 weeks.
Things that look not so bad: words like "small", "no evidence in cervical spinal cord", "potential" .. in other words, looks like my C-Spine is clear (besides a minor disc bulge) and anything else is either small, or not specific.
Things that look worrisome: The last sentence of the impression, but I do not know what that means. Also, at the mid T6 level, there is 'high' T2 signal within the cord without evidence of external compression .. what does THAT mean?
I'd love some input - and any advice going into my appointment in 2 weeks? Reminder, the neurologist is specific to an MS clinic, so that's good.
Hi All,
Just an update from me .. I saw the Neuro at the Yale Division of MS and Immunology .. she reviewed my MRI images (done elsewhere) and did an exam .. she said she is "unimpressed" with my symptoms, meaning nothing is GLARING in any certain direction.
The white matter on my MRI was what she called "Unidentified Bright Objects", which often can be nothing. My Optic Neuritis was a mild case, according to her imterpretation of my describing the symptoms. I have had tingling in my right arm, which I have attributed to ergonomics.
However - since I have had several "muddy" symptoms, she ordered the following tests to look for any lesions:
- Repeat Brain MRI (on her machine, which is better apparently)
- C-Spine MRI
- Thoracic MRI
- Spinal Tap
I had the triple-MRI last week, and the Spinal Tap is this Wednesday .. then we'll see if anything is there.
I've been keeping a log of any symptoms or issues (for example, I've had floaters in my eyes, which I understand can be normal for anyone .. regardless, writing it down) .. I've had a lot of tingling, cold feeling, aching in my right arm and wrist which again I think is ergonomics, but just in case ..
So we'll see what comes of the tests.
Just an update from me .. I saw the Neuro at the Yale Division of MS and Immunology .. she reviewed my MRI images (done elsewhere) and did an exam .. she said she is "unimpressed" with my symptoms, meaning nothing is GLARING in any certain direction.
The white matter on my MRI was what she called "Unidentified Bright Objects", which often can be nothing. My Optic Neuritis was a mild case, according to her imterpretation of my describing the symptoms. I have had tingling in my right arm, which I have attributed to ergonomics.
However - since I have had several "muddy" symptoms, she ordered the following tests to look for any lesions:
- Repeat Brain MRI (on her machine, which is better apparently)
- C-Spine MRI
- Thoracic MRI
- Spinal Tap
I had the triple-MRI last week, and the Spinal Tap is this Wednesday .. then we'll see if anything is there.
I've been keeping a log of any symptoms or issues (for example, I've had floaters in my eyes, which I understand can be normal for anyone .. regardless, writing it down) .. I've had a lot of tingling, cold feeling, aching in my right arm and wrist which again I think is ergonomics, but just in case ..
So we'll see what comes of the tests.
COMMUNITY LEADER
Hey Lori,
So you've just had another baby a few months ago, congrats!
'If' this actually does turn out to be MS, you'll find it's very common to relapse within around 4 months after giving birth, the immune system behaves during the pregnancy but goes into over drive after delivery, and setting off a relapse.
Let us know how you get on!
Cheers.........JJ
So you've just had another baby a few months ago, congrats!
'If' this actually does turn out to be MS, you'll find it's very common to relapse within around 4 months after giving birth, the immune system behaves during the pregnancy but goes into over drive after delivery, and setting off a relapse.
Let us know how you get on!
Cheers.........JJ
I hereby declare I love this community. So many online are there to rile people up, and everything I've read (including outside my posts) is simple validation, empathy, and support. That's my way of saying Thank You.
I fully intend, TODAY, to follow up on these headaches - it might entail walking into an ER because I can't imagine my doc can do anything if she's already written the neuro referral. Doubt the ER can diagnose the big pic, but any test or veal they do will be more facts for my file. My FEAR is they will do a spinal. I have a huge anxiety factor around spinal anything. I always have (I had cortisone shots and an epidural with my first baby) then with my second baby, just 5 mo ago, I needed a csection - they tried the spinal block 6 times and couldn't get it in, so under general anesthesia I went. Last night I was wondering if that little episode caused any of this. (I plan to order the surgical notes).
As for any other symptoms ... I have some tingling and numbness in my right arm that I've attributed to ergonomic issues but who knows? Also had Iritis and Shingles .. all pieces of the puzzle.
The great thing about Yale is the division I am going to is "MS and Immunology" --- so if its something else that's auto-immune they can figure which it might me.
Thanks again ... Sincerely.
-Lori
I fully intend, TODAY, to follow up on these headaches - it might entail walking into an ER because I can't imagine my doc can do anything if she's already written the neuro referral. Doubt the ER can diagnose the big pic, but any test or veal they do will be more facts for my file. My FEAR is they will do a spinal. I have a huge anxiety factor around spinal anything. I always have (I had cortisone shots and an epidural with my first baby) then with my second baby, just 5 mo ago, I needed a csection - they tried the spinal block 6 times and couldn't get it in, so under general anesthesia I went. Last night I was wondering if that little episode caused any of this. (I plan to order the surgical notes).
As for any other symptoms ... I have some tingling and numbness in my right arm that I've attributed to ergonomic issues but who knows? Also had Iritis and Shingles .. all pieces of the puzzle.
The great thing about Yale is the division I am going to is "MS and Immunology" --- so if its something else that's auto-immune they can figure which it might me.
Thanks again ... Sincerely.
-Lori
I also have juxta cortical lesions, and one periventricular (and something in my internal capsule). I have had four specialists now say my mri doesn't look like ms despite meeting MRI portion of McDonald criteria according to the radiologist. Lesions are far too tiny and insignificant to be causing my symptoms -- not wanted back at ms clinic number one because of this. (One of them is 5x7mm.
Thankfully, ms clinic number 2 is taking my history and presentation a little more seriously. I'm glad you were able to get into the Yale Clinic -- just wanted to encourage you that if you do get turfed, it doesn't hurt to get a second opinion. I had given up after the first clinic -- I could tell the specialist was thinking I was malingering or making it all up. Terrible feeling :-(. This process stinks.
Thankfully, ms clinic number 2 is taking my history and presentation a little more seriously. I'm glad you were able to get into the Yale Clinic -- just wanted to encourage you that if you do get turfed, it doesn't hurt to get a second opinion. I had given up after the first clinic -- I could tell the specialist was thinking I was malingering or making it all up. Terrible feeling :-(. This process stinks.
Hi, just a quickie from me, JJ said most of it. The clincher (almost) here is the "juxtacortical" location of the lesions. There aren't a lot of disease processes that cause juxtacortical lesions. these are lesions that span from the subcortical white matter across the line into the gray matter. Their presence is a strong indication to think about MS. As JJ noted above that is one of the specific locations that have a high association to MS. I think the remark that these lesions are non-specific is hysterical. I guess they don't come pre-labeled as "MS" or "Not-MS". Alas.
Again, reinforcing JJ, the presence of MS in a female of your age should lead one to consider Optic Neuritis immediately. That in combination with lesions found on MRI should have led to an instant referral to an MS center. As she said, few primary physicians and fewer PA's are equipped to diagnose MS. The fact that there is no lesion in the orbit (eye socket) or apparently in the optic nerve leading into the eye doesn't mean anything at all. You have inflammation of the optic nerve by physical exam and probably symptoms. It doesn't matter what the MRI shows.
I also have to wonder if the MRI was done using the MS MRI Protocol, which is designed to optimize visualization of any MS lesions.
A lot of words to say that I am glad to hear you are already on the way to an MS Clinic. Do you have any other symptoms?
Quix
Again, reinforcing JJ, the presence of MS in a female of your age should lead one to consider Optic Neuritis immediately. That in combination with lesions found on MRI should have led to an instant referral to an MS center. As she said, few primary physicians and fewer PA's are equipped to diagnose MS. The fact that there is no lesion in the orbit (eye socket) or apparently in the optic nerve leading into the eye doesn't mean anything at all. You have inflammation of the optic nerve by physical exam and probably symptoms. It doesn't matter what the MRI shows.
I also have to wonder if the MRI was done using the MS MRI Protocol, which is designed to optimize visualization of any MS lesions.
A lot of words to say that I am glad to hear you are already on the way to an MS Clinic. Do you have any other symptoms?
Quix
COMMUNITY LEADER
Thanks for the update, I don't know anything about Yale (i'm in Australia) sorry but it sounds promising and your probably going to be more confident in the out come, because of their 'amazing' reputation :o)
I can't offer any useful advice on the headache either, I just don't have a lot of experience with headaches, i seem to only get the ice pick pain in my eyeball and sinus type. A headache that's lasted weeks and isn't going away with over the counter paracetamol, really should be assessed by a dr, so if you haven't seen your GP about it, I think you probably should.
Cheers..........JJ
I can't offer any useful advice on the headache either, I just don't have a lot of experience with headaches, i seem to only get the ice pick pain in my eyeball and sinus type. A headache that's lasted weeks and isn't going away with over the counter paracetamol, really should be assessed by a dr, so if you haven't seen your GP about it, I think you probably should.
Cheers..........JJ
Just a follow up - I live in CT. I called the Yale Division of MS & Immunology .. they had me fax my data to them (MRI, labs, history) and they would see if they would accept me or refer me elsewhere. They accepted me and I will see them next week.
Meanwhile - my headache has been here for several weeks, it does not seem to be ON-related because it is over the entire back of head and goes down to create a stiff neck. I am glad I am seeing someone at Yale (their reputation is amazing) and I only have to wait 1 week, vs 2 weeks .. but I literally do not know how I will tolerate this headache for over a week.
Meanwhile - my headache has been here for several weeks, it does not seem to be ON-related because it is over the entire back of head and goes down to create a stiff neck. I am glad I am seeing someone at Yale (their reputation is amazing) and I only have to wait 1 week, vs 2 weeks .. but I literally do not know how I will tolerate this headache for over a week.
Thank you both for the quick responses! Days of Google searches and reading, and in these two posts I found answers that make sense, and therefore, some peace! I get that it's unknown .. I'm not terribly frightened of an MS diagnosis, what I cannot stand is the unknown. My GUT was telling me that my primary's answer didn't make sense ("no findings of MS") and I did not like their referral to a neurologist that is simply in the same practice as they are -- not because she knew of a neurologist she trusted. Turns out -- the neurologist they referred me to has only been practicing for 4 years.
My family knows a family who have 3 members with MS .. I put a call out to see who their neurologist is!
I have not had the opportunity yet to read the article you posted, but I certainly will. Thank you again!
~ Lori
My family knows a family who have 3 members with MS .. I put a call out to see who their neurologist is!
I have not had the opportunity yet to read the article you posted, but I certainly will. Thank you again!
~ Lori
Ditto what JJ says. I'd not finished your second paragraph before I was saying 'time to go to a neuro, not a primary care'. JJ's last paragraph hits the nail on the head. Get a copy of your MRI and to the pros. You may find this artile from our Health Pages of use. http://www.medhelp.org/health_pages/Multiple-Sclerosis/Doctor-Visit-PREP---Be-Prepared/show/156?cid=36
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I would be surprised if the doc's assistant or even a GP would actually have enough training and education in identifying MS to make that call, a lot of general neurologist don't know enough to dx, which is why we highly recommend seeing a neurologist who specialises in MS.
The ON link to MS is widely researched, and its one of the most common sx's that leads to a dx of MS, though it can also be a stand alone dx too. According to the Mcdonald criteria, you need at least one lesion in 2 or more locations that are associated with MS - periventicular, juxtacortical, infratentorial, spinal cord.
So if you have a dx of Optic neuritis (ON) which is associated with MS and MRI evidence of a lesion in a recognised MS location (juxtacortical), then it doesn't make any sense to tell someone they have "no findings of MS" when there is evidence to say's otherwise. That doesn't mean that you do have MS (!), there is a lot more to it but I would think you have enough to warrant being assessed by an MS neurologist and at least monitored.
If you look in our health pages there is one on questions to ask and you'll find a lot of information online about the ON connection to MS, that might help you come up with some questions of your own. This is a good one to read...
http://emedicine.medscape.com/article/1214270-overview
MS is complicated to dx, so please don't get worried and jump on what it may be, because it just may not be too. Let us know how you get on with your neuro appt.
Cheers..........JJ