Confused about this!!- please help!!!

[KelseyAnn]

My symptoms include: numbness in left leg, face and upper right back, headaches, stiff neck and severe fatigue.  because of this I have been through all of the usual testing for MS. I have not had good results from any of my tests.  However, my MRI showed lesions in occipital lobe, but a month or so later I had a contrast MRI that shows nothing.  Does this mean that I do not have MS?  I do have low b12, but even so the doctor still suspected MS.  I don't go in for a week- all i know is that the contrast MRI results were normal... what is the next step? has anyone had this happen?

[jensequitur]

That's the tough thing about an LP.  If you're currently in a state of remission, there may not be any antibodies in your spinal fluid, because there's no disease activity.  Does this make any sense?  I don't know how long it takes before the evidence disappears - maybe somebody else will weigh in on that.

Something I found interesting - there tends to be one band for each type of antibody.  So you may see one band for mononucleosis, one band for chicken pox, etc.

[KelseyAnn]

the doctor said that the will look for antibodies and protein in the fluid from my spine? will my fluid indicate antibody and protein present, no matter the normal mri, if i do have ms?

[Heather3418]

This is actually good news for you, but does point to MS.  You must be early on in the disease, for your lesions to resolve on the second MRI.  Your Neuro is right...if these lesions were caused by some type of injury or even Lyme disease, they would not have disappeared with no treatment.

One MRI showing lesions and the second showing none would be of extra importance if you had them done on the same machine at the same facility.  This is what Neuro's try to do to get an accurate picture of what is really going on.

Since there are currently no lesions in the brain, the results of the lumbar puncture may come back normal.  They are looking for inflammatory cells ( or banding ) in the cerebral spinal fluid.  But once the oligoclonal banding shows up, its there for good.  It doesn't disappear.  So at least with that, you don't have to worry about your "evidence" disappearing.

If this is MS, you are at a stage where your body is able to repair the myelin that is being attacked.  If you Neuro strongly suspects MS, then this is the time to be put on one of the disease modifying drugs, to help prevent further attacks.  These medications are most helpful in the beginning of the disease process - which is what you seem to be in.  Please talk to your Neuro about this.

I would suspect that your doctor is treating you for the low B-12 readings.  This is important.  Hopefully I have mentioned a couple of things to you that you can talk to your Neuro about, when you return to his office in a few days.

Please let us know what he says.  And tell him that a person with MS for over 10 years, told you about the disease modifying drugs and their benefit, early in the disease process.  See what he says.  Maybe he will agree with me.  Then again, maybe he won't.

We will be waiting for news of your appointment.  In the meantime, hang in there.  We are here for you.

Heather

[KelseyAnn]

I'm back! Ok I went it to see me neuro.  NO Lyme's Disease! My Contrast MRI was normal....which makes him suspect MS, because the lesions can disappear in a matter of weeks, which would explain their disappearance on this second MRI.  He said that if it were an injury or trauma that they would have reappeared on the contrast MRI, and also that b12 doesn't ordinarily cause lesions.  He is sending both MRIs to the radiologist to be compared, with a note to keep in mind that i do have a b12 defficiency.  He said that depending on their advice he can't make a clear diagnosis and I will have to come in for a spinal tap in two weeks.  If i have MS can the LP confirm this at any period and time even if im in a state of remission and have no spots on my brain?
Thanks for your help in trying to figure this out!

[doni54]

Hi Kelsey Ann and welcome to the forum.  

I agree with Shelly and Ess, hope that you can give us a little more information which helps us answer your questions better.

Look forward to getting to know you better.

doni

[sllowe]

Hi there,

You still with us? You able to list the responses to Ess's questions? We'd like to help you out, just need a little more from you.....

Welcome! And, see you around,
Shell

[essdipity]

Hi, KelseyAnn, and welcome to the forum. I'm not sure I understand the outcomes of your tests, including MRIs. Do you mean that all the blood work was normal? Have you had evoked potentials testing? What about LP? How was your neurological (physical) exam?

As to MRIs, do you mean that lesions that showed up initially were completely gone a month later? If so, what explanation does your neuro offer for this? Or maybe you mean that when the contrast dye was added, none of your lesions "enhanced". If this last is the case, that would not affect your status one way or another, because only relatively new lesions will enhance when contrast is used. "New" for lesions usually means formed less than about 6 or 8 weeks before the date of the MRI.

Perhaps you could tell us more about yourself and your history of symptoms. Have you had clear attacks and remissions? Also, please look over our Health Pages (see above right). There's a great deal of info that should interest you. Don't be discouraged if you get fairly slow responses to your questions here. It's just that most of us are very busy with holiday activities. Hang in there and things will pick up again soon.

ess