Can You Can Have MS without MRI Lesions?

[Quixotic1]

I know we have covered this before, and I really should spend more time on the National MS Society site, but this is a quote from the NMSS Sourcebook on MRI's.  It says everything so much more succinctly than I do when I'm "winging it."

"Diagnosis
Because MRI is particularly useful in detecting central nervous system demyelination, it is a powerful tool in helping to establish the diagnosis of MS. It should be remembered, however, that approximately 5% of patients with clinically definite MS do not show lesions on MRI, and the absence of demyelination on MRI does not rule out MS. Also, since many lesions seen on MRI may be in so-called "silent" areas of the brain, it is not always possible to make a specific correlation between what is seen on the MRI scan and the patient's clinical signs and symptoms. In addition, with advancing age (probably over age 50), there are often small areas seen on MRI in healthy people that resemble MS but are actually related to the aging process, and are of no clinical significance."

http://www.nationalmssociety.org/site/PageServer?pagename=HOM_LIB_sourcebook_mri

Guys, not to restate the obvious but this is 1 out of every 20!!!  I'll keep looking, but even my MS Neuro, whom I consider very smart, felt that MS was ruled out by normal MRI's.  I need to understand whether the 5% got diagnosed because they presented so classically - maybe with Optic Neuritis, more than one clear attack, a very positive LP, and a tatoo on their forehead that says, "I have MS!"

Quix

[immisceo]

Hi Andi! This is a very old thread. Quix isn't very active in the community anymore (though as you state, her wisdom and helpfulness are still VERY apparent here). It's very possible that you will get more response if you copy and paste exactly what you've written here as a brand new thread/question.

First of all, I'm sorry you've joined our club. The time immediately post-diagnosis is frenetic and not a time I personally look back on with any fondness. But it gets better! You're probably absolutely hoovering up information right now, and it can take a while to be able to discern the good from the bad, the trustworthy from the bunk.

To that end, a healthy diet is a great thing for anyone with MS. In fact, it's a great thing for anyone period. However, there is zero evidence that it will alter the disease course itself. Stress-reduction, exercise, eating right... these are all wonderful and things we should all aim for in the interest of our overall well-being. But again, none of the above will change the course of the disease.

The use of disease modifying drugs is a highly personal choice, but one best made on factual information not fear. All drugs have side effects. If a drug has an effect, it will have a potential side-effect. In the interest of patient information, all side-effects reported prior to a drug's approval must be listed. This can provide a very skewed image of what the side effects will be for the average person.

There are over 10 approved DMDs, along with drugs currently being trialled, and a couple of off-label options that are evidence and science-based. In other words, a patient is not stuck with one they try and don't respond well to.

I guess it comes down to a gamble. Do you bet that a drug's theoretical side effects are worse than the disease continuing unchecked. It's probably already obvious, but I quickly opted for combating my MS after I was diagnosed 4.5 years ago. Whatever my disease looks like in 10 years, I won't have to live with any 'if only I'd...'

[Andipw3]

Hi,
My name is andrea. In my research I see you on many threads. You seem very informed and helpful.
I was just diagnosed with MS a couple of days ago. I'm still trying to let it resignate.
I seem to be on the mild side of things. I'm no stranger to headaches/ hormonal migraines. What set things off was that in addition to a case of optical neuritis, fatigue, sometimes my toes curling, occasional twitches, light headedness.
I'm not one to run to the doc whenever I don't feel well, but this seemed different and I felt something was going on. I was under a lot of stress with a funeral, and tried to push it off to stress. However , the suggestion of an MRI was given by my Opthomologist. So.. I did. Through my GP. Showed "scattered lesions" and I think demylation . One lesion enhanced.So off I went to an MS neurologist.
I have a dr.  as a MS neurologist . Excellent credentials. He ran Another brain MRI with the spinal MRI. Using the T3 . Compared 1 st MRI of the brain. Showed an additional ( albeit small) enhanced lesion. Spinal was negative.
First of all.. Could it be anything else? (Prob not. ) What terrifies me are the meds. I can't do it. It gives me such anxiety to put such brutal drugs in me that have such awful side effects. I feel fine except occasionally fatigued.  I just today noticed a little numbness in my right finger. But pretty much gone now?! Weird since I don't have spinal lesions right? The brain doesn't control the arms/ legs/ torso? Being things are so mild, and I'm turning 46 this year,
I want to manage this with a paleo type diet/ vitamins/ excercise/ stress reduction. Isn't it possible with reducing food items that can cause inflamation prevent progression as well? Has there been any success stories with a more natural approach?
I'm really struggling and I meet with the neurologist in 2 weeks. He of course wants to treat. He's very sweet, but I know he's pro drugs. Like most doctors.
Any advise?
Thx so much.
- andi

[Alleybolton]

Hi there

I wondered if anyone can help me I've been diagnosed with optic neuritis with Holmes adie pupil and vermiform iris.   I have been having pain in my eye, blurring, black spots and going partially blind...dizzy spells, fainting episodes headaches and nausea. My pmh includes IBS and ?TiA as I had numbness and tingling in my hands arms and face. I am waiting on an appointment with an eye surgeon, but the symptoms are just getting worse, if I go to the hospital they just send me home again....not sure what to do!

Any advise would be greatly appreciated

[lfileccia]

I have been having symptoms now for about a year.  I have legs burning, tingling, back pain (hugs) like someone is squeezing the air out from me from my back.  I have nerve damage from my toes to my finger tips, I was told I have O.N in my left eye but today was told by another doctor that I don't but something is wrong with me and they just don't know what it is.  standing still I topple over, walking I trip, I can't think straight, I'm forgetting so much, and my vision is decreasing quickly.  I work at a hospital and am finding it difficult to perform my duties!  I have a uncle and cousin whom have MS, my MRI on brain and spine came back negative, had a nerve conduction test, not peripheral, so its sensorial, blood work came back all ok..I want a spinal tap but my neurologist doesn't think anything is wrong!  Im loosing my mind...thanks for listening-Lauri

[Dstein62]

My husband started having weakness and numbness in his left leg and left arm then gets lightheaded like he is going to pass out last for about 15min then he is ok again then has another spell off and on. He has like 4 or 5 spells a day for a few days then none for a couple days then more spells again. He has had all work ups and not heart related. He just had a Mri but looked normal only one small 3milameter spot on left side so dr said not ms but is referring us to neurologist have to wait 6 weeks to get in. These spells are hard to work in factory with. Just worried

[SarahL2491]

If you have previous MRIs, the hospital where they were done would have copies.