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Old 07-09-2012, 08:23 PM   #1
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McDonald's Criteria

I am in my 5th week since that morning of waking up to the numbness from waist down especially my feet. Since that I have had added symptoms such as eye pain in both eyes and a day where I had stabbing pains in my left eye. Fatigue, twitching (not new..maybe all my life), legs feel stiff when I walk. My thighs and legs are sensitive and I cannot stand my dress brushing against them so I relegate myself to wearing shorts at home.

Can someone please explain the McDonald's criteria for me taking it that I have had 1 episode/attack? Explain dissemination in time and space. I was never a dumb person but even before this attack I had difficulty comprehending that I even told my doctor I felt dumb. I was planning to go back to school then but that deterred me. I had chalked it up to being on a high dose of Xanax for 17 years (plus taking another benzo) and taking them since 1990 when I had a breakdown and developed panic disorder. My short term memory is a mess but I remember things clearly that from childhood and high school days that others marvel at such memory. I am so nervous and jittery and feel dizzy and disoriented at times. These are not new symptoms but are these symptoms of MS? Thank you.

 
Old 07-09-2012, 09:44 PM   #2
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Re: McDonald's Criteria

If you have had a "single attack" which presented with MS like symptoms, the neurologist would be looking at CIS (Clinical Isolated Syndrome) which is a term that has been used to describe a first neurologic episode that lasts at least 24 hours, and is caused by inflammation/demyelination in one or more sites in the central nervous system (CNS). The episode can be monofocal or multifocal. A monofocal episode is when the person experiences a single neurologic sign or symptom—for example, an attack of optic neuritis—that’s caused by a single lesion. A multifocal episode is when the person experiences more than one sign or symptom—for example, an attack of optic neuritis accompanied by weakness on one side—caused by lesions in more than one place.

To move into the "MS types" the neurologist will look for a second attack. The neurologist would also look for new lesions (or any lesions). The Revised McDonald Criteria uses two lesions in order to push a diagnosis of MS if the other tests concur.

Your life has been quite a stressful life and you have endured what many of us will never truly know. It is really difficult to look back and separate your traumatic life events into possible MS. An MS Specialist can sort this out to a degree.

When I was diagnosed, my neuro worked with me in looking back. I could only recall events when I was 14 yo and I still had shoes which provided evidence of foot drop. I may have had problems earlier, but there was no evidence. I would not have been able to separate events without my neuro's insight. Brain fog and cognitive difficulties can certainly plague you, but I would not worry about this. You just do the best you can and allow the doctors to do their work. If you cannot remember, no worries. When you can remember, write it down. It is like a puzzle; after a few pieces are joined, the whole picture becomes clearer!

Make sure you are looking at the 2010-2011 Revised McDonald Criteria which was updated from the 2005 version. In order to make a diagnosis of MS, the physician must:
1. Find evidence of damage in at least two separate areas of the central nervous system (CNS), which includes the brain, spinal cord and optic nerves AND
2. Find evidence that the damage occurred at least one month apart AND
3. Rule out all other possible diagnoses

If you have had attacks at least one month apart, you would satisfy this criteria. Writing in a journal will help you in knowing this which will aid the neuro in his review.

Have I confused you? I hope not. It is late and my brain fog is rolling in!
__________________
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MS onset circa 1977
Proud to be MED FREE!
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Old 07-10-2012, 04:30 AM   #3
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Re: McDonald's Criteria

Thanks MSJayHawk for your very detailed response. You did not confuse me at all although I find I do read things more than once. No active lesion was seen in my MRI with contrast but the more I read on here I get convinced it was an MS episode.

Looking back and blaming self does not help but I am doing that. A lot of symptoms I ignored as I had them from teenage years and especially at and after 30 when I had a massive nervous breakdown. I chalked up the burning sensations on my skin, the trembling especially when stressed and tired to stress and they may have been MS symptoms. Who knows? In fact I had a first nervous breakdown at 10 years old...so everything since that was just nerves. I have an appointment for September with the neurologist I saw in the hospital but I am not looking forward to seeing him as he wanted to send me home in emerg saying my neurological exam was normal. My PCP is sending a referral to the MS clinic 2 hours from me but their policy is they don't have to accept you. I don't know their criteria for acceptance and don't know how long that will take

Is it true that when you are diagnosed later in life it is worst and progression faster? I will be 52 soon. Thanks again.
P

 
Old 07-10-2012, 11:56 AM   #4
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Re: McDonald's Criteria

Quote:
Originally Posted by Preserved60 View Post
Is it true that when you are diagnosed later in life it is worst and progression faster? I will be 52 soon. Thanks again.
P
I certainly hope you will be accepted into their clinic. Your case may be challenging, but I think you can make it through the process. I will be praying for this for you.

I think that if you ignored your MS Symptoms for 30 years before you found out you had it, you will have lived 30 years med free.....would you be worse off? I doubt it. I say this because MS progresses differently for each MSer. In your own life you have overcome many traumatic events which would be difficult for everyone of us. Your survival and success in what you have overcome makes a missed diagnosis of MS rather unimportant, I think.

Had you been diagnosed before 1982, you would probably be med free because there were no meds back then. I will be 49 this year and I feel that I made the right choices by staying off meds and away from steroids.

I think that if you can learn to control your triggers and discover your triggers, you can live with MS without it overburdening your life. You cannot grieve over past mistakes or failures because those are in the past. Focus on today because tomorrow will arrive later with its own set of problems. I think your life experiences and the hurdles you have overcome speak volumes of what you can do. Against the odds, you have come far.

If you have an MS diagnosis tomorrow, it will not change a thing about who you are as a person. There is no MSer membership card, but you are not alone! Please do not dwell upon the "woulda, coulda, shoulda", look at each day as a new blessing. You have so many blessings that if you start counting them each day, you will find how blessed you really are!
__________________
MS diagnosed since October 3, 1982
MS onset circa 1977
Proud to be MED FREE!
Eternally blessed and eternally optimistic!<><

 
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