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MS diagnosis
MaryCz posted:
Can one have MS without visible lesions in CNS. My neuro says he can't rule out this dx because most of my symptoms fit but no lesions. I had LP that couldn't rule out MS. I don't know all LP results but I guess it wasn't definitive. Would a referral to an MS specialist be appropriate. There is a specialist here in Las Vegas, he has been here a year or 2 now. I am really confused and uncomfortable . I have been Dx'd with multiple autoimmune disorders but no one seems to agree. I would appreciate any help with this dilemma. Thanks in advance
hackwriter responded:
Dear MaryCz,

Yes, see an MS specialist. It is possible to have MS without having a definitive LP. An LP is performed along with a blood draw, and the number of oligoclonal bands are counted in both the blood serum and the spinal fluid. These o-bands signal the presence of inflammation. For an MS diagnosis, the neuro wants to see at least four more o-bands in the spinal fluid than those present in the blood serum. That would mean that there is inflammation present only within the CNS and that is a strong indication of MS. That said, 5-10% of MS patients have a negative LP and still go on to get the diagnosis. An MS diagnosis is the result of many different kinds of tests plus a clinical neurological exam and symptom history.

Regarding your negative MRIs: If you do have MS, lesions should appear in the brain or spine eventually. Unfortunately, few neurologists will give you an MS diagnosis without the presence of lesions, it's a vital part of the diagnostic criteria. It is possible that inflammation is occurring in the CNS and the is scarring too small and scattered to be picked up by an MRI. It's also possible that you have gray matter damage that a scan cannot detect. What's more, there are many diseases that share similar symptoms with MS and those need to be ruled out before MS would be named as the likely culprit.

Waiting for a diagnosis is maddening, scary, and confusing. But bear in mind that MS is very hard to diagnose and might take years to rule out or confirm. Neurologists have their work cut out for them.

So see that MS specialist and keep an open mind. It might turn out that you are suffering from another kind of autoimmune disorder or that you have more than one. Please do keep us updated on your progress.


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