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Old 07-12-2013, 11:47 AM   #1
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Question

Is it possible to have MS without having lesions show on your MRI? I have had an MRI on my brain with and without contrast. There were lesions but according to the report they were not consistent with lesions of MS. I had an MRI done on my spine but those results have not been read to me. I have a horrible neurologist, as I have had to deal with military doctors and tricare. I am visiting family in another state to see a better doctor, who seems to think I could have MS, even with out lesions showing up. She said its not very common but that it does happen. I have almost every symptom of MS, and after my last "episode" of whatever is wrong with me, my right leg never fully recovered. I was left with a slight tremor when I walk, and it took close to six weeks to be able to walk at all with out a walker. The doctors I have been dealing with have done no blood work to check for lime disease, or any other disease, when I was admitted into the hospital they did not repeat the mri of my spine, they have not tried a spinal tap, steroids, or physical therapy. I know I need to switch neurologists when I get back home, but I am lost. I don't have a clue as to where to start, because there are so many different neurologists with different specialties. I can't drive for six months from the time I was hospitalized because they don't know what is wrong with me, but they also aren't doing anything to figure it out. Sorry I just kinda vented...but the point was can you have MS with out having lesions show up on your MRI? Trying to figure out if I should take this DR. seriously or now.

 
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Old 07-12-2013, 12:14 PM   #2
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Re: Question

Welcome Ashley.

While there are lesions consistent with MS, this is not 100% accurate. The revised McDonald Criteria needs at least 2 lesions and other criteria in order to render a diagnosis OF MS.

A spinal tap, while encouraged, is not a requirement for MS. It is not a specific test for MS.

At this time, I think you need to seek out a qualified MS Specialist. The fact that no blood tests have been run and your MRi appears to have been read by a radiologist, it is too early to discuss MS. MS mimicries number over 400 and you need to eliminate all of those diseases before you can get to MS.

I would 'dump' your doctor, take your medical records, and see an MS Specialist. In the long term you will spend less time in limbo land with no answers. The MS Specialist will point you to another specialist if your test results point that direction. You do not need to have to linger in a state as you now find yourself.

I am glad you found us; I hope that you do not have MS, but until you know, please hang with us and you need not feel alone!
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Last edited by MSJayhawk; 07-12-2013 at 12:17 PM. Reason: typo

 
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Old 07-12-2013, 01:39 PM   #3
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Re: Question

Just to make sure I am understanding you correctly... you can not have MS with out having lesions. The new doctor I am seeing is an MS specialist. According to her it is very rare but can happen. She was going to start from the beginning with lab work that hasn't been done and go through my medical records.

QUOTE=MSJayhawk;5198759] Welcome Ashley.

While there are lesions consistent with MS, this is not 100% accurate. The revised McDonald Criteria needs at least 2 lesions and other criteria in order to render a diagnosis OF MS.

A spinal tap, while encouraged, is not a requirement for MS. It is not a specific test for MS.

At this time, I think you need to seek out a qualified MS Specialist. The fact that no blood tests have been run and your MRi appears to have been read by a radiologist, it is too early to discuss MS. MS mimicries number over 400 and you need to eliminate all of those diseases before you can get to MS.

I would 'dump' your doctor, take your medical records, and see an MS Specialist. In the long term you will spend less time in limbo land with no answers. The MS Specialist will point you to another specialist if your test results point that direction. You do not need to have to linger in a state as you now find yourself.

I am glad you found us; I hope that you do not have MS, but until you know, please hang with us and you need not feel alone! [/QUOTE]

 
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Old 07-12-2013, 01:42 PM   #4
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Re: Question

Ashley,

If you are with an MS Specialist, you should be fine. If the doctor is following the Revised McDonald Criteria, I do not see how a diagnosis of MS could be reached without lesions because it requires at least 2 lesions. You might ask this directly to the MS Specialist. Is MS the doctors only specialty?

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Old 07-12-2013, 01:49 PM   #5
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Re: Question

Ashley,

Just to add to my information for you, a normal MRI of the brain does not rule out the possibility of MS and an MRI also does not always mean MS. About 5% of people who are confirmed to have MS do not initially have brain lesions on MRI. However, the longer a person goes without brain or spinal cord lesions on MRI, the more important it becomes to look for other possible diagnoses. You may be diagnosed with MS, but an official diagnosis which follows the Revised McDonald Criteria might be delayed until your lesions can be counted. You might need an MRI regularly until the lesions can be seen. Not all lesions are going to follow the "textbook".
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Old 07-12-2013, 02:24 PM   #6
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Re: Question

I also want to add what your doctor may mean is that its possible to have MS, and the lesions NOT YET show up on the MRI.....you cannot have a diagnosis of MS without lesions- however, its possible in the beginning stages of the disease that the lesions are not big enough to show up at this time. Its also possible for the lesions to show up on the lower spine area (uncommon, but possible). There is no way you will get a diagnosis of MS without meeting the McDonald criteria, however- and that needs 2 separate incidents as well as 2 lesions consistent with MS .

Nikki
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Old 07-13-2013, 11:04 AM   #7
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Re: Question

Quote:
Originally Posted by MSNik View Post
I also want to add what your doctor may mean is that its possible to have MS, and the lesions NOT YET show up on the MRI.....you cannot have a diagnosis of MS without lesions- however, its possible in the beginning stages of the disease that the lesions are not big enough to show up at this time. Its also possible for the lesions to show up on the lower spine area (uncommon, but possible). There is no way you will get a diagnosis of MS without meeting the McDonald criteria, however- and that needs 2 separate incidents as well as 2 lesions consistent with MS .

Nikki
i agree with Nikki. also different mri facilities have different resolutions. by chance i did my brain mri with two different facilities. the private hospital had almost double resolution, and it showed a spot that was not seen in the other mri. i m not saying this to make you worried, rather i want to say there are numerous possibilities, and if there is no specific lesion seen yet, there is also a very high chance that you wont ever have that. hope for the best - good for you to visit family and see the new doctor while you are there! : )

 
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