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lumbar puncture

Why are some people diagnoised without a lumbar puncture? I was diagnoised by MRI of brain and spine and visual evoked potential. VEP was abnormal ant brain had lesions mainly in the mid brain and one lesion on spine. Just curious! ?
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739070 tn?1338603402
Hi ghost,

A lumbar puncture is not necessary for a diagnosis of MS and sometimes the lumbar puncture is normal even if one does have MS. That was the case with me.

A lumbar puncture is not a defintive test since a "negative" lumbar puncture doesn't rule out MS but strongly positive results might be what is needed to confirm the diagnosis in some people.

Hope this helps.

Ren
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Avatar universal
Good question! I think because the McDonald criteria only requires ithe LP when the MRI is inconclusive. If you have at least 2 lesions, 2 attacks and dissemination in space and time, that is all that is required for dx.

I did have the LP which led to my dx but I think it had a lot to do with the fact that I don't think my neuro like MRI's.

I have only had a head scan at this point without contrast and no VEP done.  He gave me the choice to wait a year and thenget anither MRI or do the LP.  Needless to say I was not willing to wait.
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Avatar universal
Thanks for responding :) im still learning.
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1979418 tn?1432135441

The LP can also clear up when there is question between CNS Lyme and MS.  My first neuro swore I had CNS lyme which would present much the same as MS including lesions, apparently lyme loves nerve matter too....

The LP was just the definitive factor, it came back negative for all indications of lyme DNA, but positive for protein markers as well as the o-bands.  

I still think if we had not had horses, the first neuro would not have been so hell bent that it 'had' to be lyme.   My primary had put MS on the table within weeks of starting the process, but it took about 5 months or so to get the MS / Lyme quandary cleared up.  

If you don't need the LP, I would not suggest having it...  was not the worst thing in the world, but the headache after was a killer....

Jen
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Avatar universal
I have been diagnoised by second relapse, abnormal neuro exam, abnormal VEP and about 6 or 7 lesions on my brain and 1 lesion on my spine. I am now on Avonex, fighting this horrid disease. Thanks for all your help :)
Helpful - 0
5485096 tn?1375574235
Ghost... I am the same as you.
Lesions on brain.. One in c spine... First attack was ON.. Second symptom with proof is lhermettis sign.
I go back to neuro August and I will fight not to have a lumbar simply bc it is not needed in my opinion (there is enough evidence) and the only reason he needs it is to build his case for future law suits (IMO) lol
Now that being said I was all for the extra MRI of c pine etc... But I am not letting them do a painful lumbar for no reason.

They like to protect themselves against wrong diagnosis.... Think about the 50k a year our drug plans pay for a wrong diagnosis... Neuro has his back up docs he can't be held accountable.

I hope my doc does not go there ... Fingers crossed.
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Avatar universal
I agree with you, there should be no need for an invasive procedure if all the other signs are there. Good luck :)
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1831849 tn?1383228392
Done by the right hands, LP's are not painful. I've had 3, done by 2 different docs, in the last 2 years and there were no side effects associated with any of them.

Kyle
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5485096 tn?1375574235
I think it is the thought of it that bothers me... :/

I have had 2 epidural for labour but was in so much pain I don't remember much... I had a headache after the first one only. Not bad though.
I think epi would be close to the same as LP?
Helpful - 0
1979418 tn?1432135441

The thought and worry is worse then the procedure...  

Epi vs LP...  well consider you're not in labor bent or hunched over to get stuck, makes it much easier!!!!   :)

A neuro did mine and did a local, I really did not have pain or anything.  The headache I got is cause I am notorious for not drinking enough, so biggest advice - drink plenty before and after....    The LP itself is not horrible, but I still wish it on one if its not absolutely needed!!

Jen
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Avatar universal
I agree with you, there should be no need for an invasive procedure if all the other signs are there. Good luck :)
Helpful - 0
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