Possible MS

[patientx]

I have a detailed question, so please bear with me.  I am a 37 y/o male. otherwise in good health.  About 3 months ago, I starting experiencing strange neurological symptoms, starting with numbness in the soles of both feet.  Over the next 3 weeks, this progressed to numbness and tingling in various parts of the body, a strange cold shock feeling that would come and go in various parts of the body, lasting a second, and burning in my left arm that lasted a few hours.  Also had a strange sensation in my legs, where tapping either one would produce a reverberating feeling in the lower part of my body.  My PCP ordered blood tests, including Lyme, that came back ok, and an MRI.  The MRI (with contrast) showed several focal FLAIR white matter hyperintensities on the brain (none on the c-spine).  The largest is 12x10mm and in the right frontal subcortical white matter.  There is also one in the right lateral aspect of the pons.  Went to see a neurologist; based on his office exam and negative VEP (also no vision problems or eye pain), he does not think MS.  He feels it is some form of viral myelitis.  Recommended a 2nd MRI in 2 months to see if lesions are progressing.  I decided against LP at this point.  In the meantime, my PCP ordered a lyme test from Igenex, which showed positive for 31 and 41 bands on the IgM test.  My PCP believes it is Lyme based on this test, and prescribed 6 months of Ceftin, Biaxin, and Plaquenil.
My questions are these.  What are the chances this is myelitis like neuro suggests, or does this seem more like MS?  I live in Maryland and could go to the MS clinics at Johns Hopkins or University of MD; at what point do I consider this?  Also, I know there is considerable controversy with Igenex, but my PCP trusts them.  Do I start taking the antibiotics on the chance that it is Lyme, especially with a 2nd MRI coming up, where I could see if they are having an effect?  Thanks for your help.

[patientx]

No, I was never in the military.

[Jennyb67]

Were you ever in the military in the desert? Several of my commrades coming back are developing MS.

[DrNoopurMD]

Hi,

MS is very difficult to diagnose in the early stages. The diagnosis is based on clinical evaluation, bright spots indicating demyelination on MRI, CSF examination showing chronic inflammation.
I would suggest you to start the antibiotic course for lyme disease and see if it helps. Since antibiotics work very well in lyme disease especially if started early.