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Should MRI be done with contrast?
seekingwisdom posted:
I have just started seeing a neurologist for multiple symptoms that are suspicious for MS. He ordered a MRI without contrast that was negative for lesions. He told me that I do not have MS since no lesions were seen, and agreed to do a nerve conduction study to double check. Should the MRI have been done with contrast to fully rule out lesions?
Rory26312 responded:
Hi seeking

The usual MRI protocol includes MRI's of the brain with and without contrast . The contrast is a Dye that shows active inflamation in lesions which can be the cause of a flair. one word of warning is that some people have an allergic reaction to it ,I am always asked if I have seafood allergy so I guess it is related to that in some way.

You say you have evoked potenial testing lined up and you probably should have an lumbar puncture as well.

All this may not lead to a diagnosis of MS but none of them can rule it out completely. My advice would be to find a neuro who specialises in MS or an MS care center for further testing as I would be worried about a neuro who rules out MS after one MRI.

Keep a symptom log and any triggers you notice such as heat cold stress and others.

Let us know how you are doing and any results you get, in the mean time feel free to seekwisdom here or better yet bring some we could all use it.

hackwriter responded:
Dear seeking,

A brain MRI with contrast might better reveal enhancing lesions. Usually, we have brain MRIs with and without contrast. However, a full diagnostic work-up should also include a spine MRI, a lumbar puncture, and evoked potentials.

A nerve conduction study is an EMG, which involves putting needles into certain muscles of the arm or leg to look for electrical conduction abnormalities in the peripheral nervous system. This is not a diagnostic test for MS, although it is often given to a patient who is being tested for MS. Neither a normal nor an abnormal EMG will rule out MS, since MS only affects the central nervous system. Evoked potentials, on the other hand, reveal abnormalities in the CNS that other MS diagnostic tests might miss. They test the time it takes for nerves to respond to stimulation for vision and hearing and do not involve needles.

Hope this helps.

rosherman replied to Rory26312's response:
Strange, as far as i know, there is not allergic reaction to gadolinium.
Rory26312 replied to rosherman's response:
Hi Rosherman

It is very rare and there seems to be different types of dyes involved but it does happen. If you enter gadolinium in the search this community at the top of this page you will see a previous disscussion we had on this topic.

Beccah replied to rosherman's response:
After multiple MRIs with contrast and no adverse reactions, immediately after the last one I had a rather nasty reaction to the gadolinium. Hives, rash, severe itching , body became very hot, nausea and vomiting. Trust me, a Big Mac tastes better going down.

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