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1168317 tn?1330262837

neuro results

hi folks
hope you are all well
i have just got back from the neuro!!!!!!!
he shook my hand and we sat down and then he stated well im pleased your mri scan came back clear!!
now even though when i tested you in october you clearly had clinical signs and symptoms of ms........
however i am a strong believer that a clear mri means (no ms) so we can rule it out WTF!!! i thought to my self..
so now he says get on the bed and let me have another look at your reflexes !!!! and then performs another neurological exam.
again all the clinical signs still there to no surprsie to me ........
we sits back down and he says im going to book you in for a lumber puncture . how do you feel about one!!
i said i dont realy want one but will have one to help further testing to find out whats wrong
you clearly have something going on so i will be in touch with an appt thanks for coming............
WTF!!!!!!!!!!
any thought
confused bairdy!
12 Responses
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1094370 tn?1317134825
You know, when I went for my last neuro appt at UCSF, my doc said it's not MS but then after he said that, did a physical exam.  That did bother me.  I was thinking if it's not MS, then why are you giving me another physical exam....?

I also have hyper reflexes.  My left foot big toe was numb for 5 days last week.

Ugh...
Helpful - 0
1168317 tn?1330262837
thanks it makes sensewhen you think about it dont it.
i will read up on health pages but im not looking forward to it but if it helps get answers so be it.
regards bairdy
Helpful - 0
983008 tn?1329925830
Hi bairdy,

It sounds to me (and i'm no expert here) that he expected the mri to show lesions which would match his physical exam diagnosis, when your mri was clear but all your physical signs are still there he's decided to do the lumbar puncture to see if that backs it up or as my neuro said ''to nail the diagnosis''

have the LP, together with your symptoms history and physical exam results it'll support his diagnosis, don't worry too much about the LP but do read the health pages and take on board all the advice - it's good stuff

take care

Val
Helpful - 0
1168317 tn?1330262837
hi and thanks for the info
i am tottally confused at the mo when i saw him last in oct he said after the neuro exam that i have all the signs of ms with the clinical progression.
so had the scans and now this u turn but after another neuro exam said ok m
i will oredr a lumber puncher.
how can he rule out ms and then shortly after bring it back to the table.
he looked confused !!! think he thought the scan would show him proof.
he got a bit cross after he said clear mri scans mean no MS and i pointed out that he said my possitive hoffmans test and abnormal nuerolgy means deffinate a liesion on the spine in october !!!! WTF!!!!
i dont know what to do now im so confused ............
regards bairdy
Helpful - 0
1453990 tn?1329231426
O bands are actually unique IgG Antibodies that are in the brain but not in the blood.  It really has nothing to do with the number of times or virus that have breached the BBB.  It has to do with antibodies that are being synthesized in the CNS that are not being synthesized in the rest of the body.  You don't even need a virus to do this.  The term "Autoimmune" implies that there is the synthesis of antibodies without the normal challenge to an external pathogen.

I seem to have demyelinating events in the brain with ON and TN but at this point I have not synthesized unique antibodies in my CNS.  The doc says that 10-30% of MS patient's can have negative o-bands, depending on the lab.  If you have them, it supports the diagnosis of MS.  If you don't have them, it doesn't mean much.

Bob
Helpful - 0
572651 tn?1530999357
I'm so sorry this neuro now has you confused - it sounds like he is, too.  You don't have to have a positive MRI to get a dx.

You don't have to have a positive lumbar puncture (LP) to get a dx, either.

To back up here about the number of o-bands being equal to the number of times the blood brain barrier (BBB) has been breached - I wish it were that simple, but it is not the case.

If that were true, each time we have a virus and it breached the BBB , then we would have the same number of o-bands - the ones on the outside of the BBB and the ones on the inside of the BBB.  What they look for inj the spinal fluid from the LP is o-bands that are unique, meaning they are only found in the CSF and not in both locations.

I know this is a simple explanation, and I hope it helps to clear this confusion.  

If you want to know more about the LP and what it MIGHT show, check out the health page written by Quix a while back ....

http://www.medhelp.org/health_pages/Multiple-Sclerosis/Can-you-Diagnose-MS-with-an-LP-that-is-Negative-for-O-bands/show/142?cid=36

good luck, Bairdy.  I thnk your neuro is still on the right course with you.

Lulu
Helpful - 0
1168317 tn?1330262837
thanks for the response just a bit confused now as to what he is thinking???
regards bairdy
Helpful - 0
338416 tn?1420045702
A lumbar puncture will show how many times the blood-brain barrier has been breached.  It takes the antibodies that exist in your spinal fluid and separates them out into what are called o-bands.  O stands for oligoclonal.  I had five o-bands, which means I've had five viruses go through the blood-brain barrier.

MRI is much beloved by neurologists, but it doesn't show the whole picture.  Neurologists rely way too much on the MRI and not enough on clinical sign.

My first question would be what strength was the MRI.  You can call the clinic where you had it done and ask what strength their machine was.  A .7T MRI is almost useless.  A 1.5T MRI is what I was diagnosed on - for the brain, it's adequate.  A 3T machine is optimal, especially for imaging the spine.
Helpful - 0
645390 tn?1338555377
Hi Bairdy,

Well, hmm, that is frustrating.  I wanted to let you know I heard a speaker this week, who is a leading MS specialist at the Mellon Center @ the Cleveland Clinic.

It struck me that he said you can have MS, with a negative MRI, negative LP, negative VEP and other things I cant remember.  If you have a abnormal neuro exam and the history, you can be DX with MS.

Just wanted to let you know.  My MS doc doesnt do LP's.  She feels there is too much of a false negative and doesn't rely on them.  FYI.

Michelle
Helpful - 0
1394601 tn?1328032308
He could be looking for many things in the puncture....an infection, cancer, bleeding, pressure in the cerebospinal fluid....Who knows....
Helpful - 0
1168317 tn?1330262837
hi thanks for the response
the mri i had done was of the head and c spine but dont know what strengh machine???
i presumed he thought ms was back on the table even thjough he just ruled it out . lol..
i dont know what else a lumber puncture would prove in my case?????
regards bairdy
Helpful - 0
1394601 tn?1328032308
MRI of what?  Both brain and spine?  Was the spine done on a 3tMRI?  What are they looking for in the lumber puncture?  Those are the questions I would have asked.
Helpful - 0
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