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Ringing in ears, burning/itching hands and feet, extreme tiredness

I have been seeing a neurologist since a bout of optic neuritis in 2014. I’ve had two MRI’s. The last one was in March, 2018. I have a three-year recall appointment with him next week. He has not officially diagnosed me with MS but I’ve recently obtained the report of my last MRI and I’m not sure if he’s been giving me the whole story. I do not have a copy of the MRI report from 2015.

MRI findings from 2018:
Slight interval enlargement of the previously demonstrated left posterior periventricular/perivenular lesion.
Approximately 5-10 subcortical and periventricular/perivenular lesions are otherwise stable.
Again demonstrated is a right cerebral peduncle lesion. No additional infratentorial lesion is seen.
Mild generalized cerebral atrophy is stable.
There has been development of right greater than left optic nerve atrophy.

So does this all mean I do indeed have MS but he needed:

“Evidence of damage “disseminated in space,” or found on two or more parts of the CNS” – and so far I only had the optic neuritis as a symptom?

In the last 3 years since my last MRI, I’ve experienced:

Increased ringing in ears although I have been experiencing this for the last 7 years
Burning/itching sensation in hands/feet – few episodes this past summer
Extreme tiredness – nodding off at work
Premature ventricular contractions since Fall, 2019. Holter monitor turned up nothing of significance.

1 Responses
987762 tn?1331027953
COMMUNITY LEADER
Hi and welcome

I would strongly suggest you get a sec0nd opinion with a neurologist who specialises in MS, if only for your own peace of mind if you are having doubts. A second opinion would likely provide you with a more definitive answer in regards to where you are in regards to already having MS or not....

Optic neuritis is one of the most common presenting clinical signs of MS,  and whilst the odds of developing MS over the preceding 5 to 10 years increase, it can definitely be a stand alone dx too.....its pretty standard to need 6mthly/12mthly/24mthly brain and spinal cord MRI's and even visual nerve conductor tests to track of any newly developing MS related diagnostics.    

Over the years the MS diagnostic criteria has been tweaked multiple times to make MS easier to dx much earlier but neurologist MS experience can still impact the outcome.

"“Evidence of damage “disseminated in space,” or found on two or more parts of the CNS” – and so far I only had the optic neuritis as a symptom?"

Optic neuritis (ON) is an objective clinical sign and definitely hard diagnostic evidence but symptoms are generally not seen as 'clinical' signs of an attack which is what 'evidence of damage' etc means. Below is a link to the basic diagnostic criteria, and you'll see somethings in your brain MRI report that is the same or similar.....  

https://www.researchgate.net/figure/2017-McDonald-Criteria-for-the-Diagnosis-of-Multiple-Sclerosis_tbl1_327945310

Have you ever had a spinal MRI?

Hope that is of some help....JJ
4 Comments
Thank you very much! Provides some further clarity. Wish it wasn't so hard to get diagnosed one way or the other. Hard to live in limbo.
And no, I haven't had a spinal MRI.
Generally when a neurological condition like MS is suspected, both brain and spinal MRI's are done, so if youve not had a spinal MRI i really think you should look into seeing an MS specialising neurologist.............JJ
oops: forgot to add...

"Multiple sclerosis lesions can occur anywhere in the CNS, and thus MRI of the cervical, thoracic and lumbar spine should be considered in patients with symptoms referable to these locations, and for detecting subclinical lesions (particularly in the spinal cord). Indeed, spinal cord assessment can be helpful in establishing dissemination in space when brain MRI findings are not conclusive and might provide significant prognostic information."
https://academic.oup.com/brain/article/142/7/1858/5519813
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