This Is MS Multiple Sclerosis Knowledge & Support Community

My blood tests are fine, my sleep study results were fine and my nerve conduction test was good. All I have are symptoms, prominent ventricles for age and white matter volume loss unusual for age. My doctor ordered a lumbar puncture next because my insurance denied the MRI with contrast. My neurologist told me that MRI with contrast won't find lesion and is only used for cancer or other masses. Should I believe her or is she just buying time to fight with the insurance company? I suspect they haven't done a peer to peer review like they were supposed to and they are just taking this route to make it look like they are taking action. The MRI with contrast was order in July. What do you guys/gals think?

dpcorona wrote:My blood tests are fine, my sleep study results were fine and my nerve conduction test was good. All I have are symptoms, prominent ventricles for age and white matter volume loss unusual for age. My doctor ordered a lumbar puncture next because my insurance denied the MRI with contrast. My neurologist told me that MRI with contrast won't find lesion and is only used for cancer or other masses. Should I believe her or is she just buying time to fight with the insurance company? I suspect they haven't done a peer to peer review like they were supposed to and they are just taking this route to make it look like they are taking action. The MRI with contrast was order in July. What do you guys/gals think?

I am unclear about your last question… On what subject exactly are you seeking our opinions?

I do not understand your situation; do you have a list of all your symptoms? Your "blood tests are fine," but which blood tests were done? I have never heard of a neurologist saying that MRI "is only used for cancer or other masses." Lesions can be found in patients who have migraine headaches, B12 deficiency,… Lots of conditions, including MS. I venture to say that most of us people with MS who have had MRIs have had MRIs with contrast. I think you need doctors who are more open with you.

I encourage you to ask for your own copy of all test results. "Fine"and "good" are not adequate.

These are my opinions.

I assumed she ordered the typical blood tests to rule out other conditions. As for the sleep study, I was told they found nothing significant. I wanted to know if I should believe what she said about the MRI with contrast. My symptoms are typical - paresthsia, spasticity, fatigue and heat sensitivity. I was diagnosed with Transverse Myelitis in 2004. The non-contrast mri showed prominent lateral ventricles and diffuse white matter volume loss. I'm not buying the contrast mri line and wondered if people here would with their unique experiences.

dpcorona wrote:I assumed she ordered the typical blood tests to rule out other conditions. As for the sleep study, I was told they found nothing significant. I wanted to know if I should believe what she said about the MRI with contrast. My symptoms are typical - paresthsia, spasticity, fatigue and heat sensitivity. I was diagnosed with Transverse Myelitis in 2004. The non-contrast mri showed prominent lateral ventricles and diffuse white matter volume loss. I'm not buying the contrast mri line and wondered if people here would with their unique experiences.

Hi Daniel,

You might compare the tests she ordered to the suggestions from the University of Chicago (peripheral neuropathy is paresthesia in the extremities):

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 still encourage you to request copies of your test results – then you will know exactly which tests were ordered and the actual number result. [By the way, if a complete blood count (CBC) was done, check the MCV (mean corpuscular volume) value and where it falls in the standard range – near the high end?]

If I am reading these results I got online correctly, they did a CRP, ANA, CBC, ESR, Folate, TSH High Sensitivity, Comprehensive Metabolic Panel and Vitamin B1 Lc/Ms/Ms. My MCV is 89 and the range is 78-100 fL. The only results that were high were my Glucose at 125 with normal being 65-99 fasting and Anion Gap 20 with a range of 4-18. The Glucose and Anion Gap were no surprise because I am a type 2 diabetic. I was diagnosed two years ago with an A1C of 8.1 as my all time high. In the last three blood draws, taken every 3 months, my A1C has been has been between 6.1 and 6.3. I don't want to post every number because that's boring but if some wants to suggest I check a specific result please let me know.

dpcorona wrote:If I am reading these results I got online correctly, they did a CRP, ANA, CBC, ESR, Folate, TSH High Sensitivity, Comprehensive Metabolic Panel and Vitamin B1 Lc/Ms/Ms. My MCV is 89 and the range is 78-100 fL. The only results that were high were my Glucose at 125 with normal being 65-99 fasting and Anion Gap 20 with a range of 4-18. The Glucose and Anion Gap were no surprise because I am a type 2 diabetic. I was diagnosed two years ago with an A1C of 8.1 as my all time high. In the last three blood draws, taken every 3 months, my A1C has been has been between 6.1 and 6.3. I don't want to post every number because that's boring but if some wants to suggest I check a specific result please let me know.

You are correct: she did order tests to begin to rule out other conditions. I was a little surprised at your mention of a test for "Vitamin B-1" – I would've expected a test for serum B12. The MCV value appears to be spot on. Two years after a diagnosis of diabetes, you are, no doubt, well aware of the meaning of those related numbers.

You seem to be in good hands with your doctor. Perhaps you just need more discussion with her about an MRI… with contrast or without contrast – that is the question. I think most people with an MS diagnosis often have MRIs with contrast (Certainly that was my experience.). With your diagnosis of transverse myelitis, the practice may be different.

dpcorona wrote:My blood tests are fine, my sleep study results were fine and my nerve conduction test was good. All I have are symptoms, prominent ventricles for age and white matter volume loss unusual for age. My doctor ordered a lumbar puncture next because my insurance denied the MRI with contrast. My neurologist told me that MRI with contrast won't find lesion and is only used for cancer or other masses. Should I believe her or is she just buying time to fight with the insurance company? I suspect they haven't done a peer to peer review like they were supposed to and they are just taking this route to make it look like they are taking action. The MRI with contrast was order in July. What do you guys/gals think?

It sounds like you had an MRI without contrast, is that correct? If you didn't have lesions, then there's not much point in doing an MRI with contrast as the gadolinium contrast is used to distinguish active lesions from inactive lesions.

Do active lesions show up on MRI without contrast?

Ignore that last question. I read active lesions can be missed if they are too small or haven't done enough damage.