Question about MRIs

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Question about MRIs

Postby mcames12 » Mon Apr 28, 2014 11:27 am

Hi, all,

I'm at a point where I'm very confused about MRIs and how reliable they are. I'm hearing conflicting things on the Internet and from my doctors.

Some background -- I've been dealing with symptoms for over a year. Started with pins and needles in left arm, followed a few months later by numbness in left leg. Also intermittent facial tingling on left side. Went to top neurologist in CT a few months into symptoms and she ordered brain/spine MRI on 3T. Both normal. All bloodwork normal. Symptoms got better for a while, then twitching started in left arm. Noticed buzzing in left leg. Kept going back to neurologist, who said must be stress-related, as my exams are perfectly normal. Symptoms got worse recently -- twitching became numbness/pain in left arm and left leg has felt heavy and I've also got nerve pain down my thigh. Also noticed symptoms starting on right side. My right arm occasionally feels like it's burning. Also had tingling tongue/throat for the last few weeks. Called neurologist back and she said emphatically, "Michele, you don't have MS. The 3T machines are so strong that we have to convince people that what they're seeing on the scan isn't MS, they are that sensitive." She insists this is stress or hormone-related. Went to neurologist #2. He said the same thing -- no need to repeat MRI -- thinks it's either stress or viral attack on my nerves. He said this even after I had a bout of eye pain a few weeks ago -- which I thought might be optic neuritis -- but an eye exam revealed nothing wrong with my optic nerve. GP says I should trust what my neurologists are saying. Even visited a chiropractor who specializes in nerve issues who says Functional Nerve Disorder.

Can all these doctors be wrong? My husband thinks I'm obsessed with MS, and maybe I've done too much reading and need to step away from the forums for a while. But I feel like if everything's been ruled out...what's left?

I just need another opinion -- do I trust these two neurologists (both have experience with MS although aren't specialists), who say they would see *something* on exam that would indicate MS by now (my reflexes are normal and no other "signs" of MS on exam) and seem to think the MRI should be trusted (actually I had two -- one in 2011 and in 2013 -- back in 2011 I had some tingling on left arm and dizziness). Or do I see yet another neurologist? I can't see an MS specialist around here unless I'm diagnosed.

Thanks for your help -- I'm at the end of my rope!

Michele
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Re: Question about MRIs

Postby lyndacarol » Mon Apr 28, 2014 3:18 pm

Welcome to ThisIsMS, Michele (mcames12).

"Pins and needles in left arm, numbness in left leg" is the definition of peripheral neuropathy. The University of Chicago offers the following guidelines for investigating peripheral neuropathy:

http://peripheralneuropathycenter.uchic ... #bloodtest

Blood tests

Blood tests are commonly employed to check for vitamin deficiencies, toxic elements and evidence of an abnormal immune response.

Depending on your individual situation, your doctor may request certain laboratory tests to identify potentially treatable causes for neuropathy. These include tests for:
Vitamin B12 and folate levels
Thyroid, liver and kidney functions
Vasculitis evaluation
Oral glucose tolerance test
Antibodies to nerve components (e.g., anti-MAG antibody)
Antibodies related to celiac disease
Lyme disease
HIV/AIDS
Hepatitis C and B

You stated, "All bloodwork normal;" I hope your blood work included the tests listed above. Your GP can order any of these tests.

Your symptoms are similar to those of vitamin B12 deficiency, which is the first test on the U of Chicago list. I certainly hope you have been tested for a B12 deficiency. You may find the following video interesting:.

"Everything You Want Your Doctor to Know about Vitamin B12"

http://www.youtube.com/watch?v=BvEizypoyO0

I highly recommend this 50-minute documentary from the filmmaker Elissa Leonard, featuring Sally Pacholok, RN, BSN & her husband Jeffrey Stuart, D.O. (authors of the book, Could It Be B12? An Epidemic of Misdiagnoses); Lawrence Solomon, M.D., hematologist with Yale Medical School; Ralph Green, M.D., hematologist at UC Davis; and Donald Jacobsen, PhD, at the Cleveland Clinic (Homocysteine Research Lab).

@1:23 "The neurological manifestations well precede the hematological manifestations."

And, in my opinion, even many doctors can be wrong.
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Re: Question about MRIs

Postby CaliReader » Mon Apr 28, 2014 9:11 pm

I know it is miserable to live with uncertainty.

Unfortunately, the sensory symptoms of pain, numbness and tingling really can be made worse by worrying about them. They can also be caused by a variety of things from diabetes to stress. Without mri or lumbar puncture evidence, your neuro won't know the difference. The good news is that if this is ms, the available statistics suggest an easier course for the disease if it starts with only sensation symptoms.

I have ms and I live with pain, numbness and tingling. I take enough medicine at night to let me sleep, but still allow me to think in the morning. You could ask for a lumbar puncture or an OCT scan from your eye doctor. But if it's only tingling. you might be better off letting it rest for a year.
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Re: Question about MRIs

Postby centenarian100 » Mon Apr 28, 2014 9:21 pm

Doctors can't explain every symptoms every patient has.

Medical science is simply imperfect, regardless of the quality of the physician.

It's fairly unlikely to be peripheral neuropathy if your reflexes are truly normal, but you can certainly do the blood tests that lyn suggests.

I would advise that you stop reading about MS. It sounds like you want MS. Trust me...it's better to have undiagnosed vague symptoms that to actually have multiple sclerosis. Trust me.
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Re: Question about MRIs

Postby mcames12 » Tue Apr 29, 2014 4:09 am

Thank you all very much. I will double check to make sure I've had all those blood tests done. I believe I was tested for peripheral neuropathy, as I had nerve conduction studies done, which was normal.

My real question (which got buried, I apologize) is this: is there a difference between a 3T MRI and other MRI's? My doctors all seem to believe that there is no way these high powered machines will miss lesions, even early in the disease.

Thanks!
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Re: Question about MRIs

Postby mamarama » Mon May 12, 2014 9:39 pm

YES there is a difference. A 3T will have spatial resolution as good as 1mm^3, while the 1.5T will have resolution of around 3-3.5 mm for T1 scans, over 5-6mm for FLAIRS.

If you have had a 3T and it is clean, you are safe. Especially if they used a contrast.
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