Hi and welcome,
You asked if it is possible to have both MS and a pinched nerve and the answer would have to be yes, simply because MS doesn't prevent anyone from having additional medical issues or diseases.
I'm going to assume your question has something to do with you not having been diagnosed with MS even though your brain MRI showed you have "more than 10 lesions on my brain highly indicative of MS" and having been diagnosed with a pinched Lumber nerve because your spinal MRI showed you have some structural spinal issues ( herniated disc, a bulging disc, spinal stenosis etc) with L4-L5 nerve entrapment.
Your L4-L5 nerve entrapment wouldn't account for all your mentioned symptoms, a pinched nerve at the L5 level of the spine is almost always associated with symptoms known as sciatica, the sciatic nerve becomes vulnerable to compression and can produce unilateral or bilateral symptoms in the lower body eg pain, shooting pain, tingling, numbness or muscle weakness so unless you have additional structural disc issues higher up your cervical spine too, a peripheral nerve related condition wouldn't be able to account for all the symptoms you've experienced....
BUT MS still can't be taken off your potential causes list if you unquestionably have MRI lesions suggestive-consistent with a neurological conditions like MS. exactly what specific evidence you have that would make the brain lesions "highly indicative of MS" is significant to whether or not an alternative condition is more or less likely than MS eg if any lite up with contrast, shape ie ovaloid, Dawson's fingers, size, specific locations ie juxtacortical, perventricular, infratentorial, spinal cord etc
I hope that helps......JJ
Unfortunately your brain MRI results significantly limit the types of conditions that can cause the different types of findings your MRI is showing, conditions like MS will be very high on your list because some of your results are more commonly associated with MS...
"Multiple sclerosis (MS) is a chronic central nervous system (CNS) disease that affects at least 2.5 million people world-wide. Longitudinal MRI studies show that MS is a dynamic disease in which lesions appear and disappear.
About 80% of the newly formed T2-hyperintense lesions appear hypointense on T1-weighted images. About 40% of these lesions remain hypointense over many months to years and are generally referred to as persistent black holes that represent severe, irreversible tissue damage.1
The correlation between the persistent T1-hypointense lesion volume and EDSS is not always consistent.2 It is not known why certain T2-lesions or portions of T2-lesions convert to persistent T1-hypointense lesions."
I typically advice anyone not diagnosed with this type of MRI evidence to make an appointment with an MS specialising neurologist because they are more up to date with all things relating to MS and it's mimics but your already doing that next week......don't be surprised if your MS neuro sends you for a lot more tests (eg more brain and spinal MRI's, Visual evoked potential (VEP), Lumber puncture (LP) etc etc) before you get a more concrete idea of what it is that your dealing with.
Going through the diagnostic process can be scary and very confusing, it's always better if you have someone with you to support you and pay attention to what the neurologist is saying because it can be a lot to take in.....breath, try to stay calm and take one step at a time!
Ask any question and i'll do my best to give you a straight answer.....JJ
Hey Mandi, just checking in to see how you are doing.....JJ
Well i definitely didn't see that dx coming, Radio Isolated syndrome (RIS) is in a lot of ways as controversial as Benign MS so it's not surprising you've found the information to be conflicting and your dx confusing...
Technically the term radiologically isolated syndrome (RIS) was created in 2009 and in the last couple of years the dx of RIS is becoming more common, it is used to define a rare subgroup of patients who have demyelinating lesions highly suggestive of multiple sclerosis (MS) but they have 'no' clinical symptoms or signs suggestive of a demyelinating disorder.
RIS is still not considered a distinct type of MS, approx one third convert to MS within 5 years of being dx-ed, typically clinical conversions are males younger than 35 and have spinal cord lesions.
"....the main causes of overdiagnosis are (1) applying DIS radiological criteria for a patient who has a suspected clinical event suggestive of MS even when atypical based on the history; (2) an abnormal neurological examination; (3) inappropriate application of RIS diagnostic criteria, which have been validated using Barkhof and Tintore MRI criteria10 and not the newest so-called Swanton criteria used for MS; (4) over-reliance on the presence of MRI abnormalities meeting Barkhof and Tintore dissemination in space (DIS) criteria; and (5) mis-determination of lesion count, periventricular or juxtacortical lesion location.
Surveys on treatment practices have been done in the United States and in Europe. Neurologists are inclined to treat RIS patients if their follow-up MRI shows dissemination in time characterized with new gadolinium-enhancing lesions (for US neurologists12) or spinal cord lesions (for European neurologists13).
Neither approach has been demonstrated or prospectively validated with a proper phase III study, even if we know that early disease-modifying treatment (DMT) introduction positively impacts the natural history of CIS patients. With these published surveys, the number of off-labeled treated RIS patients is increasing worldwide and current treatment patterns outside clinical studies are risky......We do not know how many mis-identified cases of RIS are receiving DMT, but no doubt the number will increase in the next few years, with an important undocumented repercussion on our health care systems. Worldwide collaboration is needed to improve characterization of RIS, with development of risk algorithms."
RIS criteria: http://www.ajnr.org/content/ajnr/suppl/2016/02/04/ajnr.A4660.DC1/15-01107.pdf
To be continued.....