yabby02 wrote:I was referred to a neurologist recently, and the first thing he wanted to do was an MRI to "rule out MS" because my symptoms were all over the place. Things that have been ongoing for years now. To name a few:
intense tingling in my left arm when I use it
pain from left hip down throughout the leg; it gets tired very easily and sometimes I trip a little
some weakness in hands
poor memory
speech issues, like the wrong words come out or they get jumbled around
fatigue
stiffness
headaches
Anyway, I did the MRI (brain only, with and without contrast) and it came back normal. So he's moving on to some nerve conduction test or an Electromyography (not sure which, or if they're the same?) ... I think, assuming that there's no MS because of the clear MRI.
I don't want to seem like I'm looking for problems where there aren't any, but at the same time I want to be thorough. The pain in my hips and leg has been worse this week, so I'm wondering if I should call and push for the spinal MRI??
I don't know where to go from here, and I'm not the type to just sit back and let the doctors do it all. Sometimes that works against me
but I like to be informed, and prepared.
Welcome to ThisIsMS, yabby02.
MS is a diagnosis of exclusion, made when other more likely possibilities have been ruled out. There is no
one definitive test for MS – certainly not an MRI.
Knowing this, I can't understand your neurologist, who, as "the
first thing he wanted to do" was 'rule out MS' with an MRI– this is not possible. This is not to say that you
don't have MS, but only that other conditions need to be investigated first.
Numbness/tingling/pain in the legs and arms (which I find in your list of symptoms) is the textbook definition of "peripheral neuropathy." This is a common symptom in
many conditions. In investigating the cause of peripheral neuropathy, the University of Chicago suggests the following:
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
Please note that the first blood test the U of Chicago suggests is for vitamin B12. Screening to rule out a B12 deficiency cannot be the serum B12 test alone; a serum homocysteine test and a serum (or urinary) methylmalonic acid test should also be done to confirm or rule out a B12 deficiency in the blood.
There have been several malpractice cases won (for several million dollars each!) when doctors did not look for vitamin B 12 deficiencies and patients went on to develop irreversible neurologic damage.
To answer your specific question, "should I call and push for the spinal MRI?"… My opinion is that more information about the situation is always good. But an MRI, brain or spine, cannot give a definitive diagnosis of MS. Even in many people who ultimately get the MS diagnosis, initial MRIs can be "normal." I myself had three initial MRIs that were "normal."
I get a good quality, phosphorylated B-complex and I take twice the recommended amount ... I can tell I feel better mentally when I take it, but it's never done much for the pain.
