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MRI questions and diagnosis questions

Posted: Fri Feb 03, 2012 9:00 am
by kdlalib
Three years ago I had my first possible MS "attack" with evidence of spots or lesions in my brain during 2 separate MRIs. My first MRI had 1 spot and my second MRI had 3 more spots. Because there was less than a month gap, the neurologist considered it the same attack. The neurologist said I had "possible MS." A few months went by and I developed bladder symptoms. The neuro said he expected to see a new lesion, but I had the brain and spine MRI and there was no change. I still had the four spots, but no new lesions were seen. The neuro did a follow-up MRIs at 6 months, and 1 year. My original spotswere still there, but I didn't have any new spots. Two years passed with no symptoms.

A month and a half ago my symptoms restarted but worsened in severity. I had tingling, numbness and weakness on both my left side and now my right side as well. It extended down from one side of my face down the neck and through the arm. Occasionally, it traveled into my leg. I also had burning and electrical shock sensations in my fingertips. I went back to the neurologist and my neuro exam showed evidence of changes in sensation and sensory abnormalities. I also had a positive l'hermittes sign, which is a new symptom for me. I didn't have this during my first attack. The neuro ordered a new brain and c-spine MRI which I'm having tonight.

A week after the abnormal neuro exam, a neuro-opthamologist diagnosed me with retrobulbar optic neuritis in my right eye. I had blurring, mild vision loss, color desaturation, pain upon eye movement, and flashing lights upon eye movement. During the exam, the neuro-opthamologist said my left optic nerve had pallor and that I might have had a mild bout of optic neuritis in my left eye at a previous time.

My sensory attack seems to be ending. The numbness, tingling, burning etc. is lessening in severity and frequency. I still have l'hermitte's sign but the resultant electric shock is milder than it was before. I have some muscle jerking on both sides (also a new symptom) and still have optic neuritis though my eye pain has decreased.

Using the McDonald Criteria for diagnosis, do I now meet the requirements to convert from possible MS to clinically definite MS? Since I already had one attack and now have optic neuritis does that fulfill the dissemination in time and space criteria? Or, does the neuro have to see new lesions on the brain and c-spine MRI to make the diagnosis? If I have optic neuritis, doesn't that mean I do have a new lesion, it just won't show on today's MRI because it's only a brain MRI and not an optical MRI? Will I even show new lesions if my attack is ending? I worry because I had that bladder attack, but no new lesions appeared then. I don't want this to happen again. Living in limbo stinks and I just want an answer, so I can be done with the waiting.