question about MRI results

[polanwil]

Hi Have had symptoms in left leg for probably 5 years Had all normal test for hip or back prob nothing was ever found to explain. Two years ago had a very bad epsiod . leg burning tingling toes numb ,also horrible fatigue brain fog left arm feeling like band around it and electric feeling in fingers. Gp sent me for brain mri results multiple foci in both sides of brain .Impression could be ms or vascular or age. Went to Ms Nero did all blood work all came back good Had MRA of vascular al good Had LP came back normal symtoms gradaly got some better.
Had couple more bad spells sent for 2nd brain mri with and wthout says Multiple abnormal white matter whitin periventricular tracts predominantly symmetrical largest 9mm by 4.6mm in left frontal parietal consistent with ms . impressions diffuse demyelinating disease consistent with MS cant see ms nero till june 25 do you think he will diagnose now any replies app ty

[polanwil]

Hi Have had symptoms in left leg for probably 5 years Had all normal test for hip or back prob nothing was ever found to explain. Two years ago had a very bad epsiod . leg burning tingling toes numb ,also horrible fatigue brain fog left arm feeling like band around it and electric feeling in fingers. Gp sent me for brain mri results multiple foci in both sides of brain .Impression could be ms or vascular or age. Went to Ms Nero did all blood work all came back good Had MRA of vascular al good Had LP came back normal symtoms gradaly got some better.
Had couple more bad spells sent for 2nd brain mri with and wthout says Multiple abnormal white matter whitin periventricular tracts predominantly symmetrical largest 9mm by 4.6mm in left frontal parietal consistent with ms . impressions diffuse demyelinating disease consistent with MS cant see ms nero till june 25 do you think he will diagnose now any replies app ty

spine mri clear

[SNOOPY]

Hi polanwil and welcome to MSWorld.

cant see ms nero till june 25 do you think he will diagnose now

Maybe, maybe not.

The diagnostic criteria (McDonald Criteria) for Multiple Sclerosis is based on medical history, Neurologic exam and testing. There is no single test by it's self that can give a definite diagnosis. I know it will be difficult waiting until June 25th for an answer to your question

Information about diagnosing Multiple Sclerosis:
http://www.nationalmssociety.org/Sym.../Diagnosing-MS

Best wishes!

[polanwil]

Hi polanwil and welcome to MSWorld.



Maybe, maybe not.

The diagnostic criteria (McDonald Criteria) for Multiple Sclerosis is based on medical history, Neurologic exam and testing. There is no single test by it's self that can give a definite diagnosis. I know it will be difficult waiting until June 25th for an answer to your question

Information about diagnosing Multiple Sclerosis:
http://www.nationalmssociety.org/Sym.../Diagnosing-MS

Best wishes!

What worries me the most is my mother was also diagnosed in her 50s with MS I am 57 and have always been very health. My GP says disgustingly healthy for my age other than this

[jreagan70]

cant see ms nero till june 25 do you think he will diagnose now

Hi polanwil:
Without knowing your neuro (that's neuro, not nero), it isn't possible to say whether he will diagnose you now. For a variety of reasons, some neuros delay a diagnosis beyond the time other prudent practitioners would diagnose.

For more info about the McDonald diagnostic criteria for MS 2010 revision, try googling that term to find the actual scientific article that describes the 2010 criteria. I think the NMSS description and summary table leave a few details out.

The best you can do is to compare your own experience to the diagnostic criteria and then relate to what your neuro has told you.

As you go through the criteria, it isn't speculation or projection. It's a logical analysis of your situation. If you don't feel like doing it, you can of course wait until your neuro appointment in June. But if you're up to it:

The criteria call for MRI and other sign/symptom evidence separated in time and space. For separation in time, there must be a minimum of two episodes with onsets at least one month apart, that are consistent with a neurological demyelinating event. Vague and generic symptoms like fatigue and nonspecific pain don't count. Separation in space requires that the MRI and/or sign/symptom evidence affect two different body areas.

Although you called your thread "question about MRI results," you already have a professional answer to your question: "impressions diffuse demyelinating disease consistent with MS." That meets the criterion of consistent with a demyelinating event. "Diffuse" and "multiple" meet the criterion of separation in space. If the second MRI shows new and different lesions than the first MRI, it meets the criterion of separation in time.

Your symptoms of "leg burning tingling toes numb, and electric feeling in fingers" fall into the category of symptoms that can be caused by a demyelinating event, so they fit that criterion. They also meet the criterion of separation in space. (Although that wouldn't be necessary if your MRIs showed separation in space, it would count even if the MRIs didn't show that.)

Your symptoms also appear to meet the criterion of separation in time, with "two years ago had a very bad episode" and "had couple more bad spells." If the symptoms during all of your episodes were consistent with a demyelinating event, your symptoms fit the time criterion.

And depending on what blood tests your doctor did, you possibly meet the criterion for having ruled out other possible causes of your signs and symptoms.

If everything is as you described, you meet the symptom and MRI criteria for a diagnosis of MS, and prudent practitioners would probably diagnose you. But again, it isn't possible to know whether your neuro will. If your situation is different than you described, you'll have to go back and adjust your analysis accordingly.

If your neuro doesn't diagnose you, you'll have enough knowledge to ask him specifically why he doesn't feel like you meet the criteria for MS. There might be other things going on that you aren't aware of that could change the picture. And if he doesn't diagnose you, be sure to ask him what else he thinks could be causing your symptoms and the MRI the radiologist said is consistent with MS.

At this crossroad, it's really important that you get all of your questions answered before you leave the doctor's office.

[polanwil]

Thank you so much for taking the time to answers all of this. You have made it much more comprehensable I guess I just needed someone to spell it out for me and I totally understand it is ultimately up to the neuro lol not Nero to make the call. I guess I just wanted someone else's opinion. Again thank you

[polanwil]

moe confused

well had neuro visit today he came in to room saying (sorry I took so long but couldn't get computer program to work final got one lesion to show up ,but I don't think its ms I thought saw one Dawson finger but im not sure I coundt get it to enlarge ) I ask then what is it ? he said I don't know but it diff some kind of autoimmune after he did his exam he said well last visit your left leg reflexes were abnormol this time its worse Last visit the Babski reflex was only in left foot this time its in both I ask again ,and you are sure its not ms H said im sure

[22cyclist]

well had neuro visit today he came in to room saying (sorry I took so long but couldn't get computer program to work final got one lesion to show up ,but I don't think its ms I thought saw one Dawson finger but im not sure I coundt get it to enlarge ) I ask then what is it ? he said I don't know but it diff some kind of autoimmune after he did his exam he said well last visit your left leg reflexes were abnormol this time its worse Last visit the Babski reflex was only in left foot this time its in both I ask again ,and you are sure its not ms H said im sure

Seek out a second opinion. If you have had two episodes of tingling or numbness in a limb or torso, then go to a major hospital and see an MS Specialist. They will probably do another MRI, hopefully a 3T MRI to find all of your lesions and enhance the two that have already been seen. If you only had one, but two episode of tingling/numbness then you may be diagnosed with CIS depending on how your lesion looks. Because MS lesions look a certain way and are in certain places they can be distinguished from other types of lesions.

Good luck and let us know how it goes.

Lisa

[SNOOPY]

Hi polanwil,

he came in to room saying (sorry I took so long but couldn't get computer program to work final got one lesion to show up ,but I don't think its ms I thought saw one Dawson finger but im not sure I coundt get it to enlarge ) I ask then what is it ? he said I don't know

I ask again ,and you are sure its not ms H said im sure

I would strongly suggest you get a referral to a new Neurologist. Your Neurologist doesn't sound like he has it together and he may very well be missing something. If in fact you have Dawson's Fingers the only thing that causes that is Multiple Sclerosis.

[polanwil]

lisa im sorry if I didn't make my self clear but this guy is M.S. specialist and this is second mri of brain. it was on a 3t It says multiply lesion on both hemipheres white mtr perivetical consistant with M.S. impressions diffuse demyelinating de consistant with m.s. Spine and LP normal all blood work normal

[22cyclist]

lisa im sorry if I didn't make my self clear but this guy is M.S. specialist and this is second mri of brain. it was on a 3t It says multiply lesion on both hemipheres white mtr perivetical consistant with M.S. impressions diffuse demyelinating de consistant with m.s. Spine and LP normal all blood work normal

You definitely need a second opinion. If the radiologist read your lesions as consistent with MS, take that MRI and go to another neurologist and get a second opinion, because it is VERY likely that you DO have MS. Let us know how thing go, OK?

Lots of people have a clear spinal, especially early in their disease course, and many have a negative a CSF too throughout the

Go get a second opinion,

Lisa

[polanwil]

thank you all so much I just almost feel like I should just quit trying

[jreagan70]

thank you all so much I just almost feel like I should just quit trying

Don't quit trying. Quit your neurologist. For an "MS specialist" to not know what to do with your MRI is just bizarre.

To look for a new neuro, you can start with the website of The Consortium of Multiple Sclerosis Centers (www.mscare.org). On the left of the home page click Directories > MS Centers. You can then search for an MS center in your state.

[jreagan70]

For an "MS specialist" to not know what to do with your MRI is just bizarre.

By that I don't mean that he couldn't get the computer program to work. I mean that, even if he couldn't get the image to enlarge, he basically could see what your MRI looks like and should have a feel for what he was seeing. Adding to that the impression of the radiologist, his unsureness about what he was seeing is strange.

It's also strange that an MS specialist wouldn't know what other demyelinating disease could be causing your symptoms.

But his inability to make the computer program work brings up another issue. He should have reviewed the MRI when the report came to him -- before your appointment -- and should already have known everything about it before he walked in the door of the exam room. And he should have already developed a plan to further investigate other possibilities. To wait to look at it until you were in the office is just lazy and sloppy. Another reason to find a new MS specialist -- one who knows more about neuroimmunology.

[polanwil]

jreagan. Thank you I really don't think he ever read the report that was with the mri I also felt that it was very strange my DIL was with me and she asked him about the report and he would never answer her.