Can you still have MS even though the neuro exam is neg?

[Lucky13chrissy]

After suffering for years with depression, anxiety, fatigue, which has become severe and almost debilitating the last few months, recent pain especially in my legs and back, blurred vision, tingling feeling in my limbs and numerous other symptoms.  Family doc ordered a bunch of tests that came back neg except for the MRI which was abnormal.  So he sent me to a neuro doc which was really rude, didnt want to hear anything aboit how I was feeling, he seemed very rushed.  Neuro exam was negative.  My mri showed white spots/lesions in my brain.  The MRI impression was: "periventricular white matter signal abnormalities with demyelinating process remaining a consideration"  the neuro diagnosed me with Fibro (duh I've had it for years) he said the spots are from my age and fibro, I'm 43.  I should add I had a mri done 3 years ago and had same interpretation but my old family doc never brought it to my attention. So to conclude, I had these same white spots 3 years ago, they are unchanged but still there.  Neuro exam was normal but I have numerous symptoms of MS.  I feel awful and can hardly function, all I want is to be diagnosed correctly so I can get on the right meds to make me feel better.  Any help would be greatly appreciated.

Chrissy

[Poppy7402]

The neuro exam can be normal initially, even though you still have MS but over time would definitely become abnormal.  It really depends what part of the body is affected in the beginning as to what the Neuro exam shows.  Mine was normal for the first three years of 'problems' but is now highly abnormal.

[HVAC]

Neurological exams are pretty accurate with out it being abnormal I do not think any neurologist will diagnose MS. Neurologists are like Sheldon Cooper on Big Bang. They are very smart and look at clinical findings more than listening to patients. I have seen over a dozen and only one has been warm and friendly. I had to cancer doctors who were dismissive too. You have to find the right doctor to work with.

Alex

[supermum_ms]

Hi and welcome,

Over the years we have heard from a lot of patients who've experienced rude and dismissive attitudes by neurologists, it's even happened to diagnosed MSers and undx patience who do have the suggestive/consistent neurologically abnormal clinical signs, MRI's,VEP etc it's never good to be on the receiving end but it might help a little bit to know your not alone.....

Q: Can you still have MS even though the neuro exam is neg?

A: I'm assuming you mean 'can you still have MS if your neurological exam is normal', technically the answer would be yes but a neurological condition like MS is a 'less likely' causation for symptoms of both upper and lower limb weakness, paresthesia -tingling, numbness,  burning etc when the clinical signs are not abnormal and showing up all the expected corresponding or corroborating neurological abnormalities.  

Ischemic white matter signal abnormalities ie tiny (1-3mm) non specific ischemic brain lesions are a normal part of aging but your about 20 years too young for them to be just 'normal' age related ones but you do have a medical history of Fibromyalgia so your MRI findings 'could be' normal for someone in their 40s with an 'accurate' diagnosed history of Fibro.....accurate because fibromyalgia is still misunderstood and misdiagnosed, if correct though, you are 2-7 times more likely to additionally have other medical issues too....

"Patients with fibromyalgia were 2.14 to 7.05 times more likely to have one or more of the following comorbid conditions: depression, anxiety, headache, irritable bowel syndrome, chronic fatigue syndrome, systemic lupus erythematosus, and rheumatoid arthritis."
http://journals.lww.com/jclinrheum/Abstract/2006/06000/The_Incidence_of_Fibromyalgia_and_Its_Associated.5.aspx  

This is a very simple but very good explanation of Fibromyalgia: https://www.ncbi.nlm.nih.gov/pubmed/27583567
http://www.spine-health.com/video/video-what-fibromyalgia  

What i would recommend is that you seek the opinion of a Fibromyalgia specialist, for not only confirmation that the dx is correct but most importantly so that you can get the support and understanding from a dr that wouldn't be dismissive or treat you badly, it will also allow you consider better treatment options for your specific combined medical issues......I'd focus on getting better help for the conditions you know about and could explain your symptoms, rather than continuing to be concerned about a neurological condition like MS when its honestly a less likely explanation.

Hope that helps..........JJ