This Is MS Multiple Sclerosis Knowledge & Support Community

Hello All,

I have been reading many of the posts here and I now understand why MS is so confusing and hard to diagnose. I for one am confused at the moment. I went to neurologist who specializes in MS. On the first visit he gave me an "80% dx of MS" based on clinical evaluation, my history ove the last 18 years and new MRI results and suggested I start DMD's. I am just wondering if someone could comment on my MRI results and if they think the results show extreme progression of MS or relatively little. So here goes. First is the brain MRI followed by the cervical spine. The thoracic spine is not included as it was "clear". FYI: I do have symptoms such as tingling, numbness in left hand and left leg, and I stumble from time to time. Symptoms vary from day to day from almost none to very annoying and have been present for about two months. When sleeping I have no symptoms. My leg starts to tingle as soon as I start walking. I am not fatigued. If you take the time to read this - thank you. I am filled with anxiety right now and its causing me to obsess over every little sensation I have.

BRAIN MRI
TECHNIQUE: The MRI was done using 1.5 Tesla high field strength short bore magnet. T1,
proton weighted and FLAIR sequences are used. Images are obtained in the sagittal, axial and
coronal projections.
~0 01/0 01
FINDINGS: The posterior fossa demonstrates the fourth ventricle to be midline. No cerebellar
masses are seen. The cerebellopontine angles are clear. No infarcts or hemorrhage are seen. The
acoustic nerves are normal. The brain stem and pons also demonstrate no abnormalities.
The pituitary is normal. The suprasellar cistern is clear. The optic chiasm and optic nerves
demonstrate no abnormalities. Normal ventricles and cortical sulci. No evidence of hemorrhage,
edema or masses in the brain.
The FLAIR sequences demonstrate three nodules of demyelinization in the posterior left parietal and
one in the occipital left deep white matter. These are too few to be called demye/inizating disease at
this time. The demye/inizating disease usually has at least a dozen nodular areas of demyelinization
in the hemispheres. So, these could be degenerative gliosis nodules. No subdural collections.
IMPRESSION:
THERE ARE THREE NODULES OF DEMYELINIZATION NOTICED IN THE DEEP WHITE
MATTER OF THE POSTERIOR LEFT PARIETAL AND OCCIPITAL DEEP WHITE MATTER
WHICH IS NOT DIAGNOSTIC OF DEMYELINIZATING DISEASE. THESE COULD BE
DEGENERATIVE GLIOSIS.
ltAM.: _

CERVICAL SPINE - RADIOLOGISTS IMPRESSION ONLY -
SMALL CENTRAL PROTRUSION OF DISCS C6/7. IT DOES AFFECT NEURAL FORAMINA.
C5/C6 DEMONSTRATES NARROWING OF THE LEFT NEURAL FORAMEN BY BONY OVERGROWTH. THERE ARE THREE AREAS OF DEMYLENIZATION INTHE SPINAL CORD. THE LARGEST ONE IS POSTERIOR TO THE BODY OF C4. IT EXTENDS FOR 14 X 5 MM. IT IS SEEN ON THE LEFT SIDE OF THE SPINAL CORD.

tingnum,
There is still more testing that should be done to get a positive dx of MS. There is the Visual Evoked Response test ( VER ) and several others. There is some 'criteria' that has been developed to help doctors diagnose MS through the use of inclusion and exclusion of certain bodily functions. You haven't mentioned anything about fine motor impairment or cognitive fogginess.
I would get my doctor to test vitamin D and B-12 levels. You may be surprised what you find. Good luck

Thank you for your reply. I did test for b12 and was normal. I do know that I am very sensitive to b12 deficiency even if it is slight. Upon my dx, I started getting b12 shots. One of my most annoying symptoms disappeared - a simultaneous pain in two separate parts of my body (left hand and left rib cage) which would last no more than a second and felt like I was being jabbed with a hot needle. Very intense and painful and it occurred often even when I was sleeping.

I did not mention that I have had Lhermittes sign since approximately 1990 (but no other symptoms - until 1998). In 1998 I had a horrible, unbearable pain appear in the middle of the night (right arm, shoulder and chest) that caused me to go to the emrgency room. The pain dsiappeared in 30 minutes. However, I was left extremely fatigued for months and had muscle twitches in my left hand and arm for about 10 months. I had an MRI that showed two points of demyelination in my brain.My GP sent me to the Rocky Mountain MS center. Then I went through the tests you mentioned as well as a lumbar puncture and all were negative. After 10 months the demyelination disappeared. It was the opinion of the MS center that I did NOT have MS and my symptoms might have been caused by a bug bite of some kind or a virus. Now flash forward to 2012. Intrmittent balance problems, tingling in left leg. Stumbling. No foggines or fatigue. But, the MRI does show the demyelination mentioned in my first post (can that be caused by anything else??). My current neuro gave me an 80% dx of MS based on my past history and current MRI and symtpoms. I am still unsure but I sure do not feel like my old self. Left leg feels like it moves slower than the right. On/off tingling and numbness.

I wonder if anyone else has had MRI showing demyelination and if it was caused by something other than MS?

Thanks again for you reply.

i did - it was b12 deficiency. and, the 'normal' range is a far cry from 'healthy optimal'. what was your b12 result, iima?