MS lesions. Now migraine lesions

[Criddybuggin]

How can MS lesions and migraine lesions differ (I believe two leisons were 6mm but all others are smaller?  I've had headaches but only one that was surely a migraine in 2013. No family history of migraines either except my aunt who had a brain tumor. I definitely do not have a tumor but a 15mm polyp in my right maxillary sinus cavity at the bottom that looks like bone in the middle of it.  ENT doc asked if I had an dental implant in which I do not.  He aslo said polyp needed any attention due to size and possibilities that it would come back.  I had 3 OBands in my CSF and none in serum.  Still have symptoms till this day but only when I overheat. I sometimes can tell when I'm hot one both sides of face and hands and feet but overall body temperature I cannot.  2 neurologist suspected MS and both referred me to movement disorder specialist which said I have silent migraines. The other neurologist want me to come back for checkups.  I've heard there is a Mcdonald Criteria list to be diagnosed with MS.  Has anyone been though any of this and is it true about the criteria list? Also the migraine meds have not changed to much after 3 weeks of use.  Thanks for any questions or answers you may have for me, Criddybuggin

[Criddybuggin]

Thank you both for your replies.  Yes my test had Mayo Clinic on the bottom of test results which also stated 4-8 Obands as a positive marker for MS. I had only 3.  Fungus, bateria, and viruses were ruled out as well.  They want another MRI of my brain in June. As you mentioned I do as well have abnormal reflex respones, but they won't explain them to me.I recently been to the hospital for dizziness and nausea and had a seizure while I was there. They gave me Ativan that worked.  They watched me for a while and about 2 hours later I had another. The Ativan worked again eith a second dose.  I was told to stop taking nortriptyline for I had a severe reation to it.  This was another trip with no siezures, only dizziness and nauesa.  They gave me something for vertigo.  Had a checkup the next day with primary doctor that told me to get my neuro to prescribe me a AED. I have an appointment next month and I only have a weeks worth of Klonopin the hospital gave me.  My psychiatrist said I do not have any signs of non-epileptic seizures and asked me to get my neuro to prescribe me something for siezures. So I'm sorta stuck until next month.  I still have tremors and facial spams without siezures that come and go, but I always have siezures when I overheat or before my cycle starts.  Im still staying postive though.  It could always be worse  Bless you all for your help.  

[supermum_ms]

Hi and welcome to our little MS community,

Yes the Mcdonald diagnostic criteria for MS exists, it aids the neuro to clinically define MS based on the patients MRI findings, it has been revised and revised, this is the latest one i have....

http://onlinelibrary.wiley.com/doi/10.1002/ana.22366/full

MS is still suppose to be a clinical diagnosis, the MRI, LP, VEP etc are just singular pieces of evidence pointing towards the most likely. Lesions are like real estate, location location location, size, shape, enhancing etc do play there part in distinguishing type but the lesion location(s) are even more telling eg non specific lesions were located in subcortical or periventicular which 'could be' associated with migraines but if say a non specific lesion of similar size was also located in the cerebellum, then the most likely diagnosis for 'all' the non specific lesions wouldn't be migraine, because migraines do not cause lesions in the cerebellum.

Keep in mind that for a neurological causation like MS to be even on the list of possible conditions, the patient will typically have abnormal 'clinical signs' of lesion damage despite their MRI evidence eg clonus, hyper-reflexia, action tremor, positive Babinski reflex, Optic Neuritis, Nystagmus etc etc etc. If there isn't any neurologically abnormal clinical signs, the symptoms are less likely to be from a neurological condition and more likely being caused by something else.....

Cheers..........JJ

ps curiosity - was this all coming from Mayo by any chance?    

  

[HVAC]

I would follow up with the neurologist. Yes the MC Donald Criteria is what they go by. How long have you been seeing the neurologist. With the McDonald they like to follow you over time which could be years. You have a mixed bag it could be MS or migraines. Not being a doctor I can't tell. I have both migraines and MS. When my headache goes away so do migraine symptoms. When I get a migraine it can be like a stroke. My left side goes numb sometimes I lose vision in my left eye. All of this for me is not MS unless the MS causes the migraine.

Alex