BOB - where in the world did you get the idea that
"For the most part, "Clinically Definite MS" is "Probable MS" until proven by histopathology."
If histology (looking at the tissue by microscope) has NEVER been a criteria in determining MS. Yes, MS has been both proved and disproved at autopsy, but that is not a consideration in the diagnosis of MS.
Clinically Definite MS is Clinically Definite MS. Period. This means that the needed criteria for diagnosing MS using the History and Physical Exam, plus any labs or testing (ParaClinical) is satisfied for making a firm diagnosis.
You statement or quote (if that is what it is) basically states that EVERYONE with a diagnosis of MS really can only be said to have Probable MS unless they are dead and the brain has been looked at or they have had a brain biopsy. That's absurd!
There is even some doubt with histology. I have seen experts be absoutely sure about the same tissue sample and have opposite diagnoses.
On the other hand I have to absolutely agree that it is foolish and uninformed to see a patient in flare and expect that an MRI will show perfect changes with each lesion representing the new symptoms. That is the whole idea behind the Health Page:
Now I think you have misinterpreted the comment about the doctor waiting for a new flare or new MRI lesions. If the doctor is now looking for new lesions, then he is looking for evidence that Jibs disease hase disseminated in Time. A new flare would show the same thing. If the new flare showed different symptoms then the Time requirement would be fulfilled.
Jibs - you have had Trigeminal Neuralgia and now motor spasms of the thumb (silly, ALL spasms are motor), but I meant to distinguish the spasms from sensory symptoms. So you have had symptoms that show Dissemination (spread) over Time and Space. These are two requirements for MS. Are you saying you have no CNS lesions on MRI? You could be treated NOW with a DMD if the reasonable mimics of MS have been excluded under the guidelines of a CIS - Clinically Isolated Syndrome.
Do you have MRI lesions already?