should I push?

[sarahbstevens]

I'm wondering if I should push for a diagnoses. For years now I have experienced tingling in my hands and face which has been written off to anxiety at every appointment. But last October I developed a strong vibration through my entire body when I would bend my head forward. If I did it over and over it would seem to weaken but did not fully go away for over a month. I also have lost all sex drive, developed memory problems, and from time to time I have muscle weakness so bad that I can't lift my son. Once I described all of this to the neuro he ordered an MRI of my brain and neck. The neck showed a slightly bulging disk but the brain showed "Punctate foci of T2/flair signal hyperintensity in the deep white matter of both frontal lobes, nonspecific. No acute intracranial abnormality." I had my follow up MRI last week and will meet with neuro Friday. He said he will do a spinal tap if I want to get a diagnoses. Should I do it?

[lyndacarol]

I'm wondering if I should push for a diagnoses. For years now I have experienced tingling in my hands and face which has been written off to anxiety at every appointment. But last October I developed a strong vibration through my entire body when I would bend my head forward. If I did it over and over it would seem to weaken but did not fully go away for over a month. I also have lost all sex drive, developed memory problems, and from time to time I have muscle weakness so bad that I can't lift my son. Once I described all of this to the neuro he ordered an MRI of my brain and neck. The neck showed a slightly bulging disk but the brain showed "Punctate foci of T2/flair signal hyperintensity in the deep white matter of both frontal lobes, nonspecific. No acute intracranial abnormality." I had my follow up MRI last week and will meet with neuro Friday. He said he will do a spinal tap if I want to get a diagnoses. Should I do it?

Welcome to ThisIsMS, sarahbstevens.

Every member here at ThisIsMS probably has his own unique answer to your question. In my opinion, the investigation is more important right now than what the ultimate diagnosis is. I fear that the neuro will only see the problem/solution in his specialty of neurology (when it might be in another area). I have read: "doctors are experts in, and only test for, those parts of the body in which they specialize."

Since the first symptom you describe is "tingling in my hands," and this is the definition of "peripheral neuropathy," which is a common symptom in many conditions, I hope your GP or neuro has investigated and ruled out the other more likely causes, as suggested by the University of Chicago in the following (Please request your own copies of any test results – it is useful to know the actual number results.):

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

I suspect the sensation you experienced "when I would bend my head forward" was "l'Hermitte's syndrome, "which is also not exclusive to MS. In fact, there is no test (not even a spinal tap) or image that is specific to MS – MS is a diagnosis of exclusion, made when the other, more likely possibilities have been ruled out.

I have never had a spinal tap; it is my understanding that many doctors today are getting away from doing them.

Please be aware that in testing for B12 (as is the first area suggested by the University of Chicago): the outdated, unreliable "serum B12" is not adequate alone to identify a deficiency. Initial screening should also include at least a serum homocysteine test and a serum (or urinary, which is cheaper and considered more accurate by many experts) methylmalonic acid test.

Rather than the "serum B12," the newer, more accurate HoloTranscobalamin (a.k.a. HoloTc) is preferable – but is not yet available everywhere.

As for your question about a spinal tap," Should I do it?"… Discuss the necessity with your GP or even a second neurologist.