Lumbar Puncture

[Boudreaux]

Will a lumbar puncture show indications of MS while in remission?

VA wants me to do another lumbar puncture to confirm dx. I'm not interested in going through that headache again.

[Daisycat]

I am really curious with this myself. I tried to find stuff online but after this past week I think I need a short break from my buddy dr google.


This was was something I was going to ask my new neurologist... so I’ll know in a month if no one else here knows.

[Temagami]

I´d ask if in addition to the bands they are also going to check for Nfl- MSers have a higher content and it relates to relapse/remission.

[Jules A]

I'd find out what exactly their purpose is, in many cases a LP isn't even needed for initial diagnosis. I didn't have one. It was my understanding at that time the LP can assist with confirming the diagnosis but can also be unremarkable when you in fact have MS. The only neuro still doing them routinely around here is about 100 years old so there's that.

Are they looking to rule out or identify a different condition?

[SNOOPY]

Hi Boudreaux.

I had a LP years ago as part of my diagnostic process. My Neurologist said we had a better chance of the LP "showing something" since I was still in (bad) shape.

Once my LP came back positive for o-bands and I received my diagnosis he told me once you have o-bands you will always have them. I have never had another LP and have no intention on ever having one again to find out if I still have o-bands

I was told a positive LP (o-bands) indicates active demyelination, the shedding of myelin.

[Boudreaux]

I'd find out what exactly their purpose is, in many cases a LP isn't even needed for initial diagnosis. I didn't have one. It was my understanding at that time the LP can assist with confirming the diagnosis but can also be unremarkable when you in fact have MS. The only neuro still doing them routinely around here is about 100 years old so there's that.

Are they looking to rule out or identify a different condition?

I was diagnosed by civilian doctors shortly after discharge and they were able to use my records (when dealing with the VA always bring a hard copy of your documents, DO NOT expect them to pass along needed info). There were questions with the original spinal so they say they need to rule out other possibilities but I believe it may be more like to disconnect my service connection. Who knows. My MRI's tell the tale.

[pennstater]

I also didn't need a spinal tap for diagnosis. Review the MS criteria for diagnosis and ask them why needed. Especially a 2nd time.

It seems to me that general neuros still seem to rely on the spinal tap as part of a diagnosis vs MS specialists and general neuros that see a lot of MS patients. One of the ways I research neuros is that if not part of the Touch protocol that allows them to prescribe Tysabri, then they don't see enough MS patients (since willing to eliminate one of the more effective potential treatment options).

[Boudreaux]

I definitely meet the dissemination in time criteria now but probably not at initial diagnosis. Thing is this Neuro at the VA didn't care that I had 3 sets of imaging with me taken over the last few years and didn't want to look at them. No biggie to me (right now anyway) I still function quite well and can out perform "healthy" people all day long, hold a job with insurance so my private care Neuro is my primary care giver and the VA is just something I'm glad I have for whatever the future may bring.

I really feel for the Vets coming home from the sandbox that are not getting the proper treatment. It's actually quite sad how some physicians in the VA treat the heroes.