LP after 5 lesions...WHY?

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LP after 5 lesions...WHY?

Postby wildandfree26 » Wed Aug 31, 2016 7:47 am

So I got my second MRI back and they found 5 lesions….the neuro said some of these are “classic MS” and others are not. My first MRI only had one….however now the radiologist said he could point the 5 out on that one too. The neuro said they had changed some(this was 8 months ago)
All my bloodwork to rule out anything else came back negative.
NOW she wants to do a LP….I guess I will do it, but what I am confused about is if there are classic MS lesions and I have symptoms why do I even have to do the LP?
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Re: LP after 5 lesions...WHY?

Postby Snoopy » Wed Aug 31, 2016 9:52 am

wildandfree26 wrote:
NOW she wants to do a LP….I guess I will do it, but what I am confused about is if there are classic MS lesions and I have symptoms why do I even have to do the LP?


There is no single test by it's self that can give a diagnosis of MS, this includes the MRI. The LP, if positive with o-bands but not in serum can help support a diagnosis of MS. There is also no symptom/symptoms that are unique to MS. MS is a diagnosis of exclusion, all other possible causes for a person's symptoms need to be ruled in/out.
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Re: LP after 5 lesions...WHY?

Postby wildandfree26 » Wed Aug 31, 2016 10:35 am

thanks for your reply. I totally understand that. But I thought LPs were required when you have multiple lesions on the scan?
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Re: LP after 5 lesions...WHY?

Postby NHE » Wed Aug 31, 2016 6:54 pm

Hi Wildandfree,
Regarding spinal taps, it might be helpful to read the following post about needle bevel orientation when doing the tap. post196861.html?hilit=spinal%20tap#p196861 Having the needle bevel oriented parallel to the long axis of the spinal cord will help to minimize damage to the cord and help reduce the risk of getting the post tap headache which can be fairly debilitating. In addition, when your doctors tell you to lie down for a while afterwards, do so even if you feel fine immediately afterwards.
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Re: LP after 5 lesions...WHY?

Postby Snoopy » Thu Sep 01, 2016 4:58 am

wildandfree26 wrote: But I thought LPs were required when you have multiple lesions on the scan?


The LP is an invasive procedure and is usually a last test. The LP may or may not be helpful There are those with MS who either didn't have a LP or it was negative. Of those that received a diagnosis of MS and had a LP, 90-95 percent will be positive for o-bands.

The number of lesions does not make a LP a required test. Your Neurologist is trying to get more medical information that might help in a diagnosis of something, be it MS or something else. The LP is used in the diagnostic process for many different conditions.

I was diagnosed a very long time ago and the diagnostic criteria was different. I had a negative MRI and a boat load of tests, the LP was literally the last test for me and it came back positive for o-bands.
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Re: LP after 5 lesions...WHY?

Postby wildandfree26 » Thu Sep 01, 2016 10:29 am

So do you know if you have to have the LP during a flair up? or will it yield the same results regardless of when it is done?

I just hear about people who are diagnosed with MS with just MRIs so I was confused....
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Re: LP after 5 lesions...WHY?

Postby Snoopy » Thu Sep 01, 2016 11:14 am

wildandfree26 wrote:So do you know if you have to have the LP during a flair up? or will it yield the same results regardless of when it is done?


A LP can be done at anytime. It "might" have a better chance of showing "something" if a person was currently in an exacerbation (relapse, attack, flare-up) but, once a person has o-bands they will always have them (per my neurologist). O-bands in MS indicates the shedding of Myelin (demyelination). Multiple Sclerosis is a demyelinating disease. But as I stated before not everyone who is diagnosed with MS has had a LP or a positive LP.

I just hear about people who are diagnosed with MS with just MRIs so I was confused....


I would suspect there was more to a person's diagnosis other than MRI results or at least I hope so. Unfortunately, a misdiagnosis of MS can happen, I have seen this time after time within the 12 years I have been around MS forums. There are different reasons a person may have brain lesions and not related to MS. Symptoms can have many different causes and none are exclusive/unique to MS.
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Re: LP after 5 lesions...WHY?

Postby wildandfree26 » Thu Sep 01, 2016 12:02 pm

thank you. You seem super knowledgeable so I appreciate it. For a young person, besides Migraines, what else do you know can cause lesions in the same area MS lesions would be found?
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