3 months ago ,neuro said no MS, today he said it could be MS

[podpeople]

Hi:
In February I had an MRI and he said it's not MS. Today he said it could still be MS because I have white lesions on my brain. He said MS manifests itself in many ways and he is looking at my symptoms together with the MRI. I have to do an ncv test and probably a lumbar puncture. I thought they could tell by the MRI if you have MS. He also wants a repeat of blood test SPEP/IPEP (something to do with electrophoresis) to see if it got worse.

[22cyclist]

Hi:
In February I had an MRI and he said it's not MS. Today he said it could still be MS because I have white lesions on my brain. He said MS manifests itself in many ways and he is looking at my symptoms together with the MRI. I have to do an ncv test and probably a lumbar puncture. I thought they could tell by the MRI if you have MS. He also wants a repeat of blood test SPEP/IPEP (something to do with electrophoresis) to see if it got worse.

Sometimes lesions do not fall into the specific locations that "normal" MS lesions land, and are therefore deemed non-specific white matter lesions or changes on the MRI. If your physician sees a pattern between where your lesion is and a symptom you are having, he/she may think more about MS.

With an ambiguous MRI (One that doesn't say 5 lesions consistent with MS for example), the doc will try to collect more evidence so that he is sure about his diagnosis.

The NCV Nerve Conduction Velocity testing, in your case hopefully is talking about VEP, BAER, and SSEP. These tell about your central nervous system.

The SPEP blood test evidently showed some abnormality the first time you had it. This test evaluates some levels of albumin and globulins to recognize some diseases and conditions.

Because of an electrical field these proteins are split in the blood in different categories:

1. Albumin
2. Alpha-1 globulin
3. Alpha-2 globulin
4. Beta globulin
5. Gama globulin

Why it is ordered:
The doctor may recommend taking this test when the doctor analyzes symptoms suggesting multiple myeloma (a cancer that begins in plasma cells), amyloidosis (a disease in which an abnormal protein, amyloid, accumulates in tissues or organs), and macroglobulinemia (a plasma cell cancer). Several conditions and diseases might alter the normal amounts of the protein groups. Likewise, this blood test is very effective in finding out why a person has hypogammaglobulinemia (HGG). HGG refers to a condition when low levels of gamma globulin occur, allowing you to become more vulnerable to suffer from infections.

For the most part MS patient do not have an issue with their albumin, or globulin levels. Your doc may have found something in your blood drawing that could also be causing some of your problems. It is good they are repeating the test.

Best of luck on your journey. Let us know how it goes.

Lisa
Moderation Team

[Grace53a]

The NCV test (Nerve Conduction Velocity) is a much different test from the VEP, BAER, and SSEP. It is most often done along with the EMG (Electromyogram). It will aid your neurologist in either making a diagnosis and/or ruling out other disease processes.

Respectfully,
Grace

[podpeople]

Hi Lisa:
All my globulin and albumin were normal. It was the immunofixation serum which showed polyclonal gammopathy. Dr.spoke with a hematologist about results and he said he couldn't pinpoint the problem.
What is VEP/BAER/SSEP? He said he is doing the ncv test to find out if my neuropathy is from nerves or from the brain.
Thank you.

[podpeople]

Hello,
He said I don't need the emg test, only the nerve conductive test.

[22cyclist]

The VEP is a visual evoked potential that tells the physician if there has been any damage to the optic nerve.

The BAER is an evoked potential in which they put EEG probes on you and have you listen to a series of pings. This test tells the doctor if you have:
1. an ear problem (peripheral)
2. slowing of signal in your brainstem. (central)

The SSEP is an evoked potential in which you are lying flat and EEG probes are on your head, wrists, and inner legs above the ankles. You are given a mild sedative (Valium) because this test is painful. You are placed in a dark room and the test administrator gives you tiny zaps through those probes in your extremities. You hardly feel it, take a nap.

At the end, one or all of these tests will show if you have any slowing of processing signal which could be due to demyelination. These all assist the physician in making the diagnosis with your MRI.

Lisa
Moderation Team

[MSer102]

The VEP is a visual evoked potential that tells the physician if there has been any damage to the optic nerve.

The VEP tests from the eye all the way to the back of the brain so it does not test just the optic nerve. My neuro-ophthalmologist says that this is one of the things he has to explain to neurologists over and over. A VEP can be abnormal with a normal optic nerve if the damage is farther down the line in the brain. A VEP can't tell where the damage is so a physician can not tell from just a VEP if the damage is in the optic nerve.

[JerryD]

Again, I see talk of getting an LP but no talk of the simpler blood tests. Have you been tested for Lyme disease, vitamin D deficiency, vitamin B-12 deficiency and other deficiencies. Since you are being tested for 'Evoked Potentials' and Nerve Conduction, it is imperative to give the nerves the tools to work their best. And that fuel comes in the form of vitamins and minerals etc. Good luck

[podpeople]

Thank you to everyone for all the info.
I am not having an EVP test done, only a NCV test.
I was tested for Lyme,diabetes,lupus,RA, vitamin b 12 ,folic acid .the only problem was vitamin D which was an 8 and I got it up to 33. I am taking 5000 iu/day.

[MSer102]

I am not having an EVP test done, only a NCV test.

It sounds like the other poster got confused and thought that the NCV test is the same thing as the evoked potentials tests. Like Grace53a said the NCV is a different test - part of a different set of tests. It sounds like your doctor is trying to rule out problems in your peripheral nervous system before concentrating on your central nervous system and possibly MS.

[CaroleL]

Hello and Welcome Podpeople!

[podpeople]

Hello and Thank you!!!