When MS symptoms don't show on spinal MRI

[Corriel]

Hi all, about a year ago I experienced a relapse that resulted in a loss of grip strength in both hands (but the dominant hand worse than the other).

Fast forward a year later when only about 40% of the strength has returned so I assume the damage is likely permanent.

At the time of my relapse my neuro ordered a cervical spine MRI and a nerve conduction study of my arms and hands. Nerve conduction study was normal and c-spine scans were clear.

My question is: if this was MS related, and affects both hands, wouldn't the lesion should show up on a c-spine MRI? I know it's a tricky location for scans but it seems odd to me.

I have had arm and hand issues over the years with clear c-spine images but this was a first for bilateral symptoms. I know at the time my neuro stated he didn't think it was MS related but since the nerve conduction study was normal, he did finally call it a relapse.

I would appreciate any thoughts,

Corrie

[suspiciouscombo]

This is an interesting thread and on some level I can relate. My sx are worsening, with vision changes constant, numbness and tingling primarily on left side, with horrible tinnitus that keeps me up at night. Not to mention pain in entire neck and left shoulder and a few other scary sx not mentioned.

Since all other possibilities seem to be checked off, and having a few physicians point back to neurology, I've re visited with my ms neuro recently. After some discussion, and even with a normal examination and clear MRIS in last 6 months, he suggested repeating brain, spine, and thoracic MRIS on a 3T.

As covered here it is perplexing to have so many ms like symptoms for years now yet nothing visible on even a 1.5T.

[Corriel]

Thanks Cheryl. Trying to see if the brain lesions could be responsible too but my MRIs are unchanged from my first scan in 2012 despite new symptoms so who knows?

My previous neuro was convinced I had something in addition to MS but never said much about what he thought there could be.

More of a curiosity than anything else. I like things to be more straightforward I guess. LOL

[cjtmn]

I get that! I'm constantly guessing "is this MS or something else?" I tried to google if brain lesions could cause arm Sx, but really came up empty. My neuro mentioned that the brain stem is particularly difficult to scan; however, that typically affects vision/cranial nerves (I think). It was one of the areas we looked at to try to explain my history.

[cjtmn]

I really don't know, Corrie. I would have thought that for bilateral arm Sx, there would be a lesion across both sides of the spine in the cervical area - like transverse myelitis. However, I have also heard that there isn't always a clear relationship between lesions and Sx we are experiencing.

So, I am completely not helpful...but bumping this up for you so it doesn't get missed by others who might know.