normal neurological exam and mri is it still possible to have ms

[susu32]

Hi everyone I've not been diagnosed with ms but suspect I may have it. I have a few questions for those who have had an ms diagnosis. Did any of you have clear exams and mri's in the early days? And would an abnormal exam/ reflexes etc only be abnoromal while having symptoms/relaps? X  

[Mindysue1026]

Thank you and sorry it took a while to text it so it is probably very confusing. I will try and break it down and post thank you again prayers for you and all who suffer from this.

[Sailorsong]

First off many people with MS have a hard time reading large blocks of text, including myself.  If you re-post this as a new post with the text broken up into smaller paragraphs you will get more responses to it.  Many of the pwMS on this forum are more knowledgeable about MS and the mimics than I am.  Because it is hard for pwMS to read large blocks of text a lot of them will just skip your post.

I did read all of your post even though it took me many tries to get the gist of what you were saying. There were several things that suggest something is going on Neurologically, but nothing that shouted out this could be MS that I could see.  But as I said earlier your post was difficult for me to read.

I would suggest that you see a Neurologist and bring the MRI you have had done earlier with you to the appointment. That way if the Neuro does order a new MRI he will be able to compare it with the old one.

Dennis

[Mindysue1026]

I feel like the pupil thing was my first thought that maybe those people was right and my friends dr says there were lesions ( he didn't make a big but again he was cancer dr he just told that and said to tell me to keep a dairy - which never works for long - once I feel better there's so much to catch up on. Also wanted to say I have had seizure tests and needles stuck in my left arm several treatments tried - nothing's changed it or stops the pain.

[Mindysue1026]

Sailor song - I hope you get to see this
I have suspicions that I have MS
Been told by people with it who know me that my symptoms seem close to have it checked out. Working on getting insurance back then checking into but not trying to look a fool as I go in I've been researching and reading comments everyone on blogs and so on. Let me say I was in a horrible accident in 97 I was 24 then 40 now - broke neck, shattered left shoulder, broke 5 ribs one punctured a lung. After the wreck I remember it being a big deal that my right pupil was bigger then the other. (At one point my dad said they even questioned if I broke my neck at all) a about year after I started having This pain in *** around my tailbone I go to doctor because I had once had a cyst there that popped so think a ditto situation was about to happen I went to dr. To see nothing was discovered. I now I think back to just stumbling into the wall trying to clear a door ( just thought oh I'm clumsy) about a month later I started have migraines with over the top pain in upper legs and butt area I do have nausea sometimes with them but never really to sensitive to light or sound. When I try to stand up I'm hunched over and have passed out (just secs and I know it happening and tell people the room is going black) sometimes it's like the edges of my eyes are kaleidoscopeing the images. I get burning sensations in arms and legs I've even thought blood clot at times it hurts so bad and I've thought someone burned me with a cig once (like my coat was on fire) even after seeing it wasn't I double checked. A friend of mine is a nurse for a cancer dr. She had my head MRI checked by him he said there were serval lesions (did not get spine done still just relating any issues to wreck and dismissing some as nothing but me being off or clumsy) I often spit food out saying it expanded as I chewed and couldn't swallow it & I catch myself holding drinks , jello pudding things of the nature in mouth for long periods of time( now wondering if it's a swallowing issue not that I'm crazy) I often trip over my own feet and when I'm in pain I feel the urge to wiggle my legs to ease the pain(maybe pins and needles feeling like legs falling asleep and I got to move them) I've always said my migraines was really some kind of nerve damage but as always they go through everything else first - thinking back now I think a few dr may have thought this by their questions - I've never lost bladder control yet but when in pain I feel like I got to go so bad and never go but don't have urinary or bladder infections. I also feel there are times I can't breathe right and after testing the dr told my dad it's in my head - this was years ago after the wreck and still nothing shows. Also these issues do subside I guess I should say and not all happen every time I have an episode but in general they do. I have had to use walkers and canes and a bedside toilet because I could barely move. I know a wreck won't cause MS but have stress things bring out the symptoms.
My eyes sometimes seem blurry thinking it my glasses I wipe them no help so then I try rubbing my eyes nope that don't stop it either. Also I get up feeling fine a couple hours into my the pain starts no matter what I'm doing 4-5 days (on average / been times I go days without symptoms) a week. I have said as I get older I'm either a bigger baby or these things are progressing (just thinking pinched nerve and I a big baby really) I also had a cyst form at the base of my neck and shoulders right on my spine(not sure that means anything) and also I've slowly lost weight - was a size 14/16 now a 3 without dieting at all) something I read makes me think it's related not sure
I could've have missed something and know tons of things have these symptoms but what do you think?

[Sulig1956]

You can check my message just written and compare. I also have it hard at times when speaking not able to think of the main word in a sentence or put the wrong word in. M.S is difficult at times to diagnose. Best to you and hope you find your diagnosis soon.

[Sulig1956]

You can check my message just written and compare. I also have it hard at times when speaking not able to think of the main word in a sentence or put the wrong word in. M.S is difficult at times to diagnose. Best to you and hope you find your diagnosis soon.

[kwarendorf]

I'm not sure exactly what he meant, but last month my neuro said I "was better" than the last time he saw me. This was immediately after the neuro exam. I was personally unaware of any changes, good or bad :-)

Kyle

[Sailorsong]

Clinical signs don't always remain when you are having a good day from my experience. For many years I have had foot drop on my right side, but my Neuros never saw it during the clinical exams. But finally a couple of years ago I happened to be having a bad day during one exam. My right foot was turning inward and the foot drop was very visible so the Neuro immediately sent me to the Prosthetic department to get an AFO since it was so pronounced. My Neuros have also only seen my unequal pupils one time.

But I must also add that even when I was having a good day my exam wasn't completely normal. I always have numb feet during the exams. But I think that is because it is permanent damage. My Neuro confirmed this by doing the test while I had my eyes closed.

But despite this I do agree with Kyle that MS is probably a lower possibility than other causes.

Dennis

[Sulig1956]

M.S is a difficult  to diagnose. I agree with Dennis. When my last child was born when I was 38 I decided to take a walk with her. Was not far from the house I stop for a minute  and all of a sudden I couldn't feel any muscles in my legs though I was standing fine. Lasted a few minutes and it left and I walked fine. I blamed it on possible from a nerve from a c-section.When she was 3 I had these not normal headaches. That's what he was treating them as. No diagnosis at that time. It left with no treatment help. Two years later I was out one day and had double vision. Some tremors. Went to my medical doctor and he ran some bloodwork and a MRI. Went back to doctor and as he was walking in, he was looking at my chart He said you don't have Lou Gehrings. You have M.S. Shock and left. No questions. Sending me to neurology. Problems were far and near and thought to go at a later time. Tremors, double vision and another episode of leg muscles and one morning waking up couldn't pick feet up and scooted to BR.Short time back to normal. Only happened 3-4 times. Decided to go to neurology. Had spinal tap and bloodwork. During spinal tap legs went into jumping around and the two people said people that do that have M.S. Doctor wasn't helpful. Waited a little while and then started having spasms in legs also. Tremors in hands and body.Those symptoms continued. Muscles in legs with no feeling happened about 5 times then left. I had about five times while walking up stairs made me stop because my brain wouldn't tell me to step. Well to shorten this one day I had double vision all day long. Next day I became so fatigue. Had to lay down. This started a horrible year of muscle spasms the split second of waking up with spasm in thighs that felt like basketballs. Sometimes burning. Spasms in calves. Hand tremors and severe body tremors. Double vision and at times  couldn't even begin to close my eye lids. Horrible head pain from rumbling when closing my eyes blinking. There were other things as going unconscious. To be diagnose with seizures.Walking problems with gait.Couldn't even get to a neurologist.  Never had a severe problem like that anymore. Tremors gone, just hands and arm. Most symptoms on right side. Episodes start in Fall. A few times a couple of times off and on in year. Rumbling and another noise in head. Now it is believe I have a nerve damage in R eye. Now records to show optic neuritis. Low vitamin B12 and vitamin D for a while. Heat intolerance and paralysis, pins and needles and goes on for a long time. Only thing in spinal taps is high protein that keeps going up. This neurologist for 5 years.. All the other diseases cleared. Now hoping with the R nerve eye damage ( Causing rumbling and feels like it is rumbling my brain with another noise at same time.)and optic neuritis there is the diagnosis of M.S. Unbearable I tell you. This neurologist found 10 plus lesions on brain.Yes it is hell. Sorry so long. It shows how it can be to get a diagnosis. Though the doctor has been expecting M.S she told me she couldn't treat me till she found those little rings. I am in hope these eyes that also hurt will help. Thanks for reading and hope it helps someone.

[Sulig1956]

Another thing was carpul tunnel in both arms and something else can't remember right now with that test. Being sent to a neuro psychologist for testing.

[essdipity]

Tests that MS neuros perform during a complete exam include reflexes, strength, balance, eye movements, walking speed---what am I forgetting, folks? A thorough exam takes a good 30 minutes, so I must be forgetting things.

These things often don't correlate to symptoms, and pretty much remain constant or get worse over time. I strongly doubt they get better. So regardless of particular symptoms the patient mentions, if the neuro finds an abnormality it will stay that way, and not remit just because symptoms do.

Anyone disagree?

[supermum_ms]

Hi and welcome,

I agree with Kyle, it's not likely to be MS if you don't have any clinical signs or MRI lesions to indicate MS is a possibility. MS is still suppose to be a clinical dx and it is possible for clinical signs of lesions, to show in the patient before they are detected on an MRI, and it's also possible for lesions to be detected on an MRI and the patient not have any sx's. Having normal test results in both, would definitely put MS low on your list of possible causes, imho.

Keep in mind that most of the sx's listed for MS are not exclusive to MS and because the sx's are also associated with a lot of conditions (we call them MS mimics) statistically it's actually more likely to be one of the mimics, than it is MS. I think of sx's as being either primary or secondary, primary are the big indicators the cause is 'more likely' a neurological condition like MS, things like naystagmus, Optic Neuritis, positive Romberg, hyperreflex, clonus etc
  
Secondary to me are sx's that don't particularly indicate neurological eg sensory - pins and needles/numbness, spasm/fasciculations, pain, bladder/bowel, blurred vision etc, because these issues could be caused by so many 'other' conditions too ie vit deficientcy, virus, hypoglycaemia, IBS, anxiety, degenerative disc disease, diabetes, myopia etc etc

Your last question is difficult to answer with a definite yes or no response, it can depend but i think in general most sx's caused by brain and or spinal cord lesions (MS) usually do leave behind a clinical sign, even when your not in relapse, so i'd expect some abnormal signs to still be evident.    

Hope that helps you a little :D

Cheers........JJ

[susu32]

Hi Kyle thank you so much for reply. I have been examined by by 3 nuerologist and all of them looked at mri of brain neck and lumber 1.5t mri. Not sure if they used ms protocol or not. But each time I had an appointment my symptoms were not so bad so wondering if they could have missed something. In my post 'hashimotos or ms' is a detailed list of my symptoms nothing else seems to fit, I'm feeling so down with these horrible symtoms over the last 16 months! Xx

[kwarendorf]

Hi Susu- Welcome to our little group!

While it is possible to have MS in spite of  clear MRI's, and less so a clean clinical exam, it's not likely to have MS when both are clear. A lot would depend on who was conducting the clinical exam.

An MS specialist will be able to detect things that a GP or general neurologist might miss. It would also depend on whether or not the MRI was done using the MS protocol. Also, you did not mention whether or not you had an MRI of your spine. This would be needed to help rule MS in or out.

What makes you suspect you have MS?

Kyle