Spine MRI next? Confused

[sparkles9708]

Hello,
I have had a brain MRI, VEP, EMG with nerve conduction velocity. Originally he said the brain MRI showed lesions consistent with vasculitis or he would be concerned with MS if I was having MS like symptoms, but then he asked me but your not are you I said no because my symptoms seemed more consistent with migraines.

Well the past couple months I have had several falls and then last month one day I took several steps and my left leg gave out on me. I made my way towards a chair and rested for about 45 minutes and while it was still weak, it was functional enough to use it to make my way to the shuttle to get back to my car.

Now since I saw the neuro for that incident he wants a full spine MRI and a VNG. All he said was "Your young and I just want to make sure we don't miss anything including MS or anything like that." Did we not do that with the VEP and the Brain MRI you are now calling "normal"? I am confused? I would just like the falls to stop and the leg weakness issue to not ever happen again.

[rayray12345]

MS

i have leg weakness. I have a leasion on my spine the mri picked up. They thought MS but after many test diagnosis was TRANSVERSE MYELITIS..

[Alicious]

Transverse myelitis can occur with MS--it did for me, anyhow. Hopefully they can get to the root of your issue, rayray.

Sparkles, I did a cervical spine MRI before a brain one, based on my symptoms. The brain one was abnormal, but migraines were listed in the differential diagnosis. The c-spine scan showed more than one lesion, however, and voila! MS.

OK, it's more complicated than that, but I think with the falling and the weakness another MRI is in your best interests. Lesions anywhere are bad news, but if you are getting them in your spinal cord, you need to know so you can start treatment.

So, I'm definitely not wishing MS on you; I am, however, hoping that the MRI gives some clarity as to whether or not it really could be MS, or maybe a much more boring spinal issue--or helps the neurologist walk another path to figure out what is happening.

It doesn;t sound to me like your neuro is caling your brain MRI normal; it sounds like he or she is saying that it doesn;t look like MS, as best as they can tell, and if you have no MS-like symptoms, it is likely not MS. Now that you have weakness and falling, however, it's time to dig deeper. That's my take anyhow.

[sparkles9708]

Thank you rayray and alicious for your feedback, and help, initially my symptoms were more vision related and other symptoms not the weakness/ several falls in a month issue.

I may now have a different reason for the falls, about 30 minutes into the VNG the tech asked me how long I had been having the dizziness and asked if I had seen An ENT specialist yet. I was still at work but 30minutes after the test my primary called I'm guessing the number left to call is their referring service.

I have a history of migraines and I know my primary even said in people with a history of migraines radiologists tend to read it as demyelinating disease. We will see what the 26th brings even though the lumbar spine results won't be ready yet, it's the day before. Whatever happens happens, at least he does seem to be listening and trying to figure things out

[sparkles9708]

update

So the good news is the MRI of the spine came out clear and the neuro pretty much said he didn't see anything on the VNG that was significant, then asked me a few questions immediately it must be BPPV. Literally handed me a piece of paper with the vestibular exercises to do at home and that was about it. I woke up after doing those the next day with two severe dizzy spells.

The next week I call my primary because I almost had to miss work and the nystagmus was really bad, so she suggested vestibular rehab mainly for diagnostic purposes. Physical therapist decides its not BPPV and I did have some balance issues.

I go to my primary last week for strep throat and notices my pupils are unequal sizes. She even made the comment "and yet your scans all came out clear". Alot of my symptoms didn't appear until after December, after the brain MRI. My boyfriend got really mad because I didn't mention that day that my little toe is now moving on its own occasionally. I don't know if its spasming or whats going on.

I love my primary because after 4 weeks of PT I do feel like it has helped with the dizziness/balance issues, but I don't know that further testing is necessary since everything has pretty much came out clear and the Brain MRI was just done 6 months ago. Anyone have any suggestions on what to do?

[hunterd]

keep a journal of what happens and when. Also call your neurologist every time something "different or odd" happens. It is also good that you are primary Dr. is involved also.just because your MR I is clear does not mean that you will not be experiencing symptoms. My MRI has remained unchanged for years, but new things have happened. My best advice is to keep a thorough journal. Good luck to you

[22cyclist]

It would be a good idea for you to see an ophthalmologist (an MD eye doctor) since you have been noted to have unequal pupils. They can also see your nystagmus if you have any. You need to get to one ASAP. This will also help along your diagnostic process.

If they find anything in your eye exam you will be referred back to your neurologist for possibly another brain MRI, and maybe a spine MRI, or a brain and a spinal tap. It depends. If they see something in your brain MRI, and they can after only 6 months, then the spine may be unnecessary. Google the Revised McDonald Criteria for the diagnostic process.

Best of luck. Let us know how it goes.

Lisa

[suziq38]

I was told by my doctor that while these tests certainly help, but MS is a clinical diagnosis.
There are approximately 5% of the population who test negative (spine MRI's, brain MRI, blood tests, lumbar puncture, and evoked response (eye) test) on all tests still have MS.
I hope that you don't, but it is still a possibility.
Time will tell.