How hard do I push?

[Lorimo1]

Neuro appt next week. Symptoms for 2 years. No lesions. If nerve test does not identify any specific issue, should I push for spinal tap? Or just stay in limbo land?

Lori

[gomer]

Lori....... That's a TUFFY?

I had a complete MS work-up. MRIs of brain & full spine, spinal tap, EVPs and tons of blood work etc.

MS is not an easy Dx........ Many other things have to be ruled out, its the nature of the MonSter.

Gomer

[sunshine008]

that is a hard decision, have you ruled out other auto immune diseases? that can help get closer to the dx without the spinal tap.

Just an idea.... I've had symptoms for alot of years and i suspected ms. yet i finally folded and went to a neuro.

the sooner you find out the sooner you can begin some type of therapy if you chose to.

good luck with the decision.

[Shashi]

Well, my thoughts are that you probably wouldn't be diagnosed with a positive spinal tap and negative MRIs anyway. So you may want to wait and see if any lesions pop up in the future before going through a spinal tap. (If you do have to have one, ask to have it done under flourscopy.) Have you been checked for any of the many MRI mimic conditions, such as Lyme disease, Sjogren's syndrome, Celiac disease, etc.?

[Redwings]

Hi Lori:
A spinal tap will still leave you in limbo. Negative (normal) results will certainly leave you there. Even abnormal results will leave you in limbo for two reasons:

1) Spinal tap results are not diagnostic for MS. Many conditions can cause abnormal results. None of the abnormalities are unique to MS.

2) The McDonald diagnostic criteria require at least one CNS lesion on MRI that is characteristic of MS.

In addition, to meet the criteria with only one lesion, there must be evidence of at least two attacks. (Neurological symptoms that onset after a car accident and continue may not meet this category.) With evidence of only one attack, there must be at least two lesions on MRI that are characteristic of MS and demonstrate dissemination in time and space.

Without lesions, your doctor can't make a diagnosis of MS that's in compliance with the McDonald criteria.

Since a spinal tap won't help you get a diagnosis, how hard you push for one depends only on how badly you want to know the results. A diagnosis of MS also requires that all other possible causes for symptoms be ruled out or accounted for. Your efforts will be better spent pushing to ensure that the testing for all other possible conditions is done before you get a spinal tap. A diagnosis of MS can be made without a spinal tap, but it can't (or shouldn't) be made without all of the other rule-outs.

[onlyairfare]

I've never had a spinal tap, but I still was diagnosed with MS.

And, the diagnosis was made without an MRI either, because I developed MS long before MRI was in common usage. It was the old-fashioned "lesions separated in time and space, with no other explanation."

I was never wanting to make the diagnosis anyway, since this was before there was treatment available, but I was not anxious to have a needle stuck in my back either.