PM Specialist suspected MS, but MRI may be negative?

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PM Specialist suspected MS, but MRI may be negative?

Postby kadedoll » Thu Feb 09, 2012 10:13 am

So, pardon the long intro. I'm a 25 year old female. Here is my back story;

About a month and a half ago, I experienced a sudden onset of some weird symptoms/pain. It started exclusively as neck/upper back pain & muscle spasms. Since then the symptoms have continued to worsen and develop. Here are the symptoms;
neck & upper back pain, muscle spasms in upper back, front of neck, and right leg/calf.
nausea, constant fatigue, intermittent numbness/burning/tingling in right forearm/hand/fingers. a "heavy" feeling in my arms and legs.. but mostly in the right arm & leg. weakness in arms and legs.. Legs always feel like they're going to give out.
dizziness, lightheaded, feeling like i'm going to fall, trouble concentrating, trouble finding the right word which results in stutter.
constant pressure on the back of my head/base of skull.. headaches there. buzzing there. ears are "clogged up."
a general "out of it" feeling. a "restless leg" feeling when sitting/laying down.. dominant in the right leg/foot, but in both.
"itchiness" in my legs mostly.. but no rashes/indications why.
sometimes my eyes feel like they won't focus or concentrate on an item.. they feel like they're bouncing around a bit.

I've had a cervical & spine mri previously for a suspected disc injury.. mri did show protrusion at c2-c3 and broad-based disc bulges in both neck and lumbar.. but nothing touching nerves/spine. so the pain management specialist said that wasn't the cause of my symptoms.

he ordered a brain mri. went to see him today but he didn't have the mri report yet.. he looked at the images himself, and said he didn't see anything "crazy." and that he would call me if the mri report saw anything. he doesn't suspect lymes. and didn't have any other offerings. he referred me to a neurologist, and I have EMG scheduled for next Friday.

My question is.. since he isn't a "ms specialist." if the mri doesn't show any obvious lesions, is MS still a possibility? The majority of the MRI was done WITHOUT contrast.. then they added in contrast for the last 10 minutes.

I did just schedule an appointment today with my eye doctor as well to see if he suspected anything with my "worsening" vision.. .. by worsening i mean the lack of focus, the bouncing around, the blurriness i see at times.

Any advice?
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Re: PM Specialist suspected MS, but MRI may be negative?

Postby MarkLavelle » Thu Feb 09, 2012 8:08 pm

A scan with 'contrast' (gadolinium) is almost always the last of a series of scans (T1, T2, ???), so it's not at all surprising that the majority of the scan time was without gadolinium.

If your MRIs don't show any lesions it won't mean you don't have MS, but it won't tell you much else, either...

Best of luck,
Mark

RRMS dx 3/3/11; Copaxone since 12/1/11
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Re: PM Specialist suspected MS, but MRI may be negative?

Postby Froggie » Thu Feb 09, 2012 9:19 pm

Unfortunately, MS can be very tricky to diagnose. I had optic neuritis about 10 years ago and my then ophthalmologist suspected it might be MS. I had a bunch of tests including MRI, lumbar puncture (spinal tap), and a ton of blood work. Everything came back negative. I was officially diagnosed in 2009 and likely had symptoms prior to it, though no one could pinpoint what was going on.

If you can, you may want to get a second opinion. Seeing a neurologist is a good idea in that if it's not MS, they may have a better idea of what's going on.

Hope all goes well- Froggie
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Re: PM Specialist suspected MS, but MRI may be negative?

Postby euphoniaa » Fri Feb 10, 2012 6:53 pm

Hi kadedoll, and welcome! I completely agree with Mark and Froggie's posts, but I wanted to say hello and add a couple of comments. Gadolinium is given just like Mark said - at the end of the main set of MRIs - but its pupose is to enhance any lesions that are "active" at the time. My very first brain MRIs were done with no gad at all, and still showed my brain was full of 'classic' MS lesions = instant dx. My next 2 sets of MRIs (1 yr & 2 yrs later) showed no noticeable change in lesions and NONE of them enhanced. Eight yrs later - those lesions are still there and they still don't light up. :smile:

And for those who don't already know this, EMGs are to test for peripheral nerve damage, and are not a specific test to dx MS. All neurological problems cause similar symptoms, so the trick is to narrow down the cause of yours. Since I have both central and peripheral nerve issues, my neuro admits that it's impossible to pin many of my symptoms on either the CNS or PNS alone.

But Froggie makes a good point:
If you can, you may want to get a second opinion. Seeing a neurologist is a good idea in that if it's not MS, they may have a better idea of what's going on.

And the eye doctor appointment is also a great idea.

Welcome again, make yourself at home, and keep us posted how things go for you!
Dx'd with MS & HNPP (hereditary peripheral neuropathy) 7/03 but must have had MS for 30 yrs before that. I've never taken meds for MS except 1 yr experiment on LDN. (I found diet, exercise, sleep, humor, music help me the most.)
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Re: PM Specialist suspected MS, but MRI may be negative?

Postby kadedoll » Fri Feb 10, 2012 7:33 pm

well, i received the brain mri report. I've been waiting for the doctor to call me to go over the results. When i called today, he said he was waiting to talk to the radiologist to get the "final report." But I picked up the report myself to see it. This was what was said.

INDINGS: The ventricles are normal in size. Single focal area of increased
T2 signal is noted in the right frontal lobe, sagittal FLAIR image #7. There
are
no extraaxial collections. There is mucoperiosteal thickening in bilateral
ethmoid and frontal sinuses. The orbits and globes are normal. The mastoid
air
cells and other paranasal sinuses are clear. There are normal vascular flow
voids of the major intracranial vessels. There is normal signal within the
bone
marrow. There are no abnormal areas of enhancement. There is no evidence
for cerebellar ectopia. Diffusion weighted imaging demonstrates no areas
of restricted diffusion to suggest acute ischemia.

IMPRESSION: Essentially unremarkable MRI of the brain. Minimal sinus
disease. Mild prominence of the pineal gland is noted, nonspecific. Consider
follow-up by MRI.


I'm mostly questioning the increased t2 signal.. on top of the pineal gland and the sinus disease, as I've never heard of any of it.. I"m not sure what it means.


I'm assuming it's pretty much good news. I don't see anything mentioned about lesions/ms/etc. So I'm assuming it's negative for MS.
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