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Work up finished for now, Neuro put me on surveillance

Dear all,

For the past month, I have posted little, but have been here to read a lot, and learned a lot. Thank you very much for all the collective wisdom you are sharing here.

Initial Symptoms:
- Intermittent Tingling/Numbness with fingers, hot feeling in palm (frequency: right hand once in a few days, left hand once in a month)
- Migratory, random vibration/buzzing sensation appearing and disappearing in small areas in both legs and feet.

Initial Tests:
- A horde of systemic tests normal (CBC, ANA, RF, TSH, Metabolic Panel, Lipid Panel, B12) ruling out R. Arthritis, Lupus, Hypo/Hyperthyroidism, electrolyte imbalance, B12 deficiency, etc.
- EMG/NCS of right hand normal.
- C-Spine MRI w/o contrast MRI where they looked for disc disease was normal. (Neuro said it is hard to pick up lesions on spine MRI, but nonetheless this MRI was OK for now, they did not order a w/ contrast for lesions).
- 2 non-specific lesions in Brain MRI (Impression from MS specialist: MRI shows two (~4mm) irregularly­ shaped T2 hyper-intensities, one adjacent to each posterior horn of the lateral ventricles. Not truly periventricular. Very nonspecific in appearance. No abnormal enhancement.)

With the Brain MRI, I was sent to a Neurologist evaluation by my Orthopedist. My Neuro (who is NOT an MS specialist) was so kind and understanding for my concerns and ordered an LP and a VEP.

Tests with Neuro:
- Clinical Neuro exam was normal.
- LP completely normal, no CSF unique O-Bands, IGG-index normal, no IGG elevation, Protein normal, no WBCs, etc. Also negative for Lyme Disease.
- VEP completely normal and symmetric for both eyes.

My Neuro is now putting me on a surveillance plan of MRIs (both Brain & Spine) every 6 months. I have gotten 2 opinions from well established MS specialists, both said my chances of having MS low at this point but they both agree with the surveillance plan. One said he wouldn't even do the LP and the VEP.

I like the interaction and understanding with my current Neuro and I decided stick with him for the surveillance. I can always switch to an MS Specialist if things start to lean towards there more heavily. But for now, I am convinced with the opinions I have gotten from them that my Neuro is not missing anything they would otherwise do.

This is not a question per se, but I wanted to share my current updates with you, as I told some of you that I will do so. But of course please let me know if you see any missing pieces in the picture above.
1 Responses
1831849 tn?1383231992
Hi Ted - Welcome out of the shadows :-)

It sounds to me you're on the right track.  At this point all you really can do is watch and wait. Having a neuro who is really entertaining the possibility of MS, and is willing to watch and wait with you, is great. If and when the time comes you can explore finding an MS specialist.

Let's hope the time never comes!

Kyle
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