MRI results- does this confirm MS? - Multiple Sclerosis Message Board

umo · 01-10-2008, 08:50 PM

Hi all, (sorry this is so long)

I have been lurking and reading all the wonderful support and information you all provide to each other. I was wondering if anyone had a clue what all the below info means. I was in a car accident in 08/07 and in 11/07 I had MRIs of the brain and c-spine done for leg pain and vertigo.

Results: The brain MRI was fine. The c-spine showed a C5-C6 lesion that I have had since I was 18 and "in retrospect" an additional C4 lesion was spotted that was on a previous MRI in 2004 but missed.

I saw the head of Neurology/MS Center at UPMC who ran a bunch of blood tests including the one for Devic's to rule that out. A few weeks after I saw him, I had really bad pains in my legs (almost felt like I had shin splints in both entire legs) and my PCP wrote out a script for me for a medrol dose pack and percocet on Christmas Eve. When I called my neuro to see if my recent blood tests came back showing why this was happening, the girl there called back and said he wanted me to have another c-spine and thoracic MRI. I picked up the results yesterday and they said:

1. No significant change in the cord lesions at C4 and C5-6. These do not occupy more than 2/3rds of the volume of the cord. There is a new lesion at C3, which is right lateral.
2. Differential considerations include and most likely demyelination/multiple sclerosis. No cord edema enhancement to suggest myelitis or tumor. This is not a syrinx.
3. At C5-C7, there is spinal and foraminal stenosis, which is moderate in nature and is also unchanged.

In the findings he mentions the C5-6 level has a 1 cm lesion and the C4 lesion is 6 mm. He says on the axial gradient images, there is felt to be a new small area of increased signal intensity at the C3 vertebral body level. No enhancement after IV contrast administration .

I should also mention that I currently take Plaquenil (which has hugely helped me for the past 2 1/2 years) for what my Rheumatologist calls an "atypical mixed connective tissue disease" meaning something autoimmune but not anything they can specifically say. I am still waiting for the Devic's test and haven't heard from my neuro so assume he is doing the same (may not be back until the end of the month). Do I have MS? I am so confused and just want an answer. Any thoughts or opinions would be most welcome......thanks for listening and I hope I can be of some support to you all in the near future.
Christine

GothicRosie · 01-10-2008, 09:33 PM

Christine,
You will need more than a MRI to diagnose MS. Did your neuro do a spinal tap (Lumbar Puncture)? There will be indicators in that fluid that will help them diagnose you as well.

The National MS Society has more information on how this is diagnosed. Try looking them up...I tried putting the link here but this site blanked it out...sigh.

Your scan results look like they may have found new activity but it did not enhance with the contrast...meaning it is not active. "He says on the axial gradient images, there is felt to be a new small area of increased signal intensity at the C3 vertebral body level. No enhancement after IV contrast administration." To me the MRI results read that the radiologist feels you may not have ms...but the new activity indicates something is going on...that does not mean you do not have it. I'm no expert so I suggest you confer with your neuro about the results...ask for a plain English explanation of the results.

I personally have a clear MRI but a diagnosis because I had 2 clinically presenting attacks separated by time. The McDonald criteria (revised in 2005) set a check list for doctors to follow in diagnosing ms. Since it presents differently for everyone...

Here is the McDonald criteria: [url]http://www.msif.org/document.rm?id=311[/url]

You may or may not have ms. Keep in mind that there are other neurological disorders out there that have similar symptoms and most doctors tend to be conservative in their diagnosing people with incurable degenerative diseases.

Keep notes about your symptoms, a calendar with daily notes on any new things is a good thing to keep...it helps me when I have appointments with my neuro so I can remember to ask him questions about what is going on with me.

Sounds like you are on the right path to diagnosis though in seeing the head of Neurology/MS Center at UPMC. Good luck and keep us updated on your progress.

Cheers,
rosie

duttin · 01-11-2008, 08:21 AM

Christine,

Welcome,glad You Decided To Post.

With Devics Disease Comes Optical Neuritis Have You Experienced This?

You Are In Good Hands With The Center You Are Being Treated At.

By No Means Am I Dr.but The Mri's Could Be Suggestive Of Ms,but Other Test Need To Ran,the Devics Is A Great One,but A Lp And Theres Evoked Potenials.

Remember Ms Is Livable And Theres Gonna Be Some Bad Days.i Can Relate To The Leg Pain.

Keep Positive And Remember We Are Here For You And You Don't Have To Go Through This Process Alone.

T

Bearygood · 01-11-2008, 10:43 AM

Hi, Christine. First of all, the good news is that it seems that your neurologist is doing all the right things.

IMO, your results do not rule out MS and it specifically says that the findings are consistent with demyelination. A majority of what is first indicated as a "demyelinating disease" turn out to be MS. That said, there are some other demyelinating disorders, of which Devics is one. The reason they're testing you for Devic's is because in that disorder, lesions commonly appear on the spine and not the brain. Like Duttin said, eye conditions (Optic Neuritis being one) are also common in Devics.

The updated (2005) McDonald criteria is what most doctors use to support an MS dx. Not everyone needs an LP to dxed but it can be helpful in hard to dx cases although do note that not everyone with MS will have a positive LP. Re: brain lesions (or any other lesions for that matter), they can take a very long time to show up (a friend of mine would add "if at all" here!).

Good luck to you and keep us posted!

umo · 01-11-2008, 11:41 AM

Thanks so much for your responses! I am kind of freaking out today because I had a lot of tingling and buzzing everywhere last night (no big thing- happens often) but when I woke up I noticed that my jaw and ears (both sides but worse on the right) and some of my right cheek feel funny - not quite numb as I still can feel things but almost "tight" like my skin was being stretched and taut if that makes any sense (sort of like when you have a beauty mask on your face and it dries and your skin feels tight). I haven't had any new numb symptoms since my first episode 20 years ago so this is making me really nervous. I just left a message on the machine of my neuro's assistant- God only knows when I will hear back. Is this a familliar symptom to any of you? Is there a name for it?

Also, my neuro did not do a lumbar puncture as he said he didn't want to put me through that unless he had to. Still waiting for the devic's test (it was done 12/2!) and my biggest fear is that I have devic's and these symptoms suddenly after all this time is a rapid decline that you can have w/devic's. I'm sorry- I don't mean to be whiny- I usually take all the burning, tingling, buzzing, neurological symptoms and pain in stride but this for some reason is freaking me out......thanks for listening.....hope you all are doing well today.
Christine