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Does this match MS? What is usually next step?

42 yo female with facial numbness, vision blurring, numb feet and hands;  Brain MRI: No swelling or acute territorial infarct (no blockages) No acute intracranial hemmorage (no bleeding on brain) No ventriculomegaly No effacement of cisterns and CP angles. (no reduction of ....) Not a cranial nerve concern Not a tumor of brain  Not something in any of the structures Not craniocervical junction

Blood work has eliminated lupus, B12 deficiency, arthritis, diabetes, lyme disease, and was good.  Just got results on Friday after July 4.  Have nerve conduction scheduled and awaiting MRI of spine. Is this typical for checking for MS?
states Demyelinating process such as MS is not excluded. Recommend clinical correlation.
punctate FLAIR and T2 hyperintensities in white matter in right frontal lobe;
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20803600 tn?1546262537
Typically MS diagnosis comes after other problems have been ruled out, and sepera free e, distinct episodes of symptoms are medically documented, with correlated findings on MRI of white matter lesions, and possibly MRI of spine looking for lesions within spinal column.
Seems to me your doctors are following the right tract in getting you a proper diagnosis and treatment.
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987762 tn?1331027953
COMMUNITY LEADER
Hi and welcome to the MS community,

Technically IF the types of symptoms and or symptom pattern and or medical history  the patient has experienced is suggestive of a neurological condition like MS, the types of tests typically done is a clinical neurological assessment, full blood tests, both brain and spinal MRI's preferably using MS protocol, Lumbar puncture (LP), and a Visual Evoked Potential (VEP) if visually suggestive symptoms are included in the patients symptom pattern but there is no single test, symptom, or physical finding which confirms a person has MS.

A diagnosis may not always be made solely on the basis of MRI because a normal MRI doesn’t absolutely rule out multiple sclerosis either, and whilst the latest version of the MS Mcdonald criteria makes it possible to be dxed with just one MRI now when it comes to  a neurological condition like MS to be at the top of a patients causation list, it's their collective abnormal diagnostic evidence that puts MS at the top and the diagnostic evidence can not be a more suggestive or consistent with any alternative medical condition...

Q: "Is this typical for checking for MS?
states Demyelinating process such as MS is not excluded. Recommend clinical correlation. punctate FLAIR and T2 hyperintensities in white matter in right frontal lobe;"

A: statements in your MRI report similar to  'Demyelination process such as MS is not excluded. Recommended clinical correlation' is pretty standard and it often includes other types of possible causes too eg migraine, diabetes, hypertension, cardiovascular disease etc

"punctate FLAIR and T2 hyperintensities in white matter in right frontal lobe;"

Punctate is typically used when there are multiple tiny tiny, 1-2 mm or even smaller, um think microscopic dot or pinprik sized unidentifiable white matter hyper-intensities (lesions), FLAIR and T2 is just the sequence used that picked them up, T2-FLAIR stands for T2-weighted-Fluid-Attenuated Inversion Recovery.

You mentioned you have "numb feet and hands" and bilateral both upper and lower wouldn't be a typical symptom pattern suggestive of MS, it's usually more suggestive of a peripheral nervous system issue so if your scheduled to have a spinal MRI and nerve conducter tests it's possible they will help point towards what it is your dealing with.

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