Thursday, November 05, 2009 Melissa's Mom asks

Q: Can it still be MS if the Spinal tap is normal?

Can you still have MS is Spinal Tap is normal? I went to the neurologist about a year ago beacause I had some tingling on my right side. Shedid a battery of tests. She did a blood test that showed demyliniation (sp?) and a contrast MRI that showed "non-specific" lesions in the white matter. A couple of weeks ago, I got this sudden feeling that someone "pulled the plug" and I felt like i was coming down with the flu or something. The next day, my vision was blurry and i had no appetite. All I wanted to do was sleep. About a week later, the left side of my body felt hot and tingly. I developed a noticable limp, and I had a difficult time writing (I am left-handed.) This lasted for about 3 or 4 days. I still have a little "buzzing" in my left side, but the limp is gone. A couple of years ago, right after my mom died, I had weakness on my right side, and the doctors called it a "conversion disorder."

My question is, even though the CSF was normal, doesn't this sound like MS?

Janet

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Answers (1)

Lisa Emrich, Health Guide

11/ 7/09 11:31pm

Hi Janet,

If you haven't recently, it's time to go back to the neurologist. A diagnosis of MS requires that there be evidence of demyelination, separated by time and location. Oftentimes, two distinct attacks will help to fulfill that criteria. You neurologist will likely want to have you undergo another set of MRIs to compare to the ones last year.

But in answer to your question, yes it can still be MS even if the spinal tap is normal. The "O-bands" which are looked for in the spinal fluid are present when there has been active demyelination going on. Your results might be completely different now as compared to last year.

Time to call the neurologist.

Melissa's Mom

11/13/09 9:04am

Lisa,

Thank you for responding to my question.

I have been afraid to go back to her because she tried to assure me that it didn't fit the profle for MS because of the negative LP. She said that I had a slightly low iron count and attributed the symptoms to vitamin B12 deficiency. I have been taking B12 since last year, but I still have had the symptoms.

I have also been diagnosed with a vitamin D deficiency (2 years ago) and have read that it could lead to ms.

The symptoms of this "episode" are pretty much gone, but I did keep a journal of them. Would it be easier to diagnose (or rule out) MS if I wait until I am experiencing the symptoms?

Do you think that I should seek out another neurologist, or would that be putting me back to square 1?

Thanks,

Janet

Lisa Emrich, Health Guide

11/13/09 8:47pm

Hi Janet,

Here is a post I wrote which describes MS diagnosis - Beginner's Guide to MS: Do I have MS? What does it take to get diagnosed with MS?

It might help to know more about the process. In general, neurologists are not likely to diagnosis MS unless the criteria is completely fulfilled by the book. Even with one episode of a demyelinating event, a person may never fully develop MS. It can be tricky and is certainly no fun being in limbo.

When you are experiencing symptoms is the perfect time to see the doctor. (I get that a lot with my rheumatologist. I might mention a huge flare I had in previous weeks and she responds with 'well, if I had seen you then.....')

There has been more publicity in the suspected link between vitamin D deficiency and MS. It is not a direct cause as the cause(s) of MS are still undetermined. But it could contribute. Getting your vitamin D levels up could help you to feel in better health overall, at least it did me.

Was your neurologist an MS specialist? It's a good idea to see a specialist who is better experienced in noting the subtle changes common in MS patients. You could certainly seek a 2nd opinion if you are uncomfortable in returning to the same doctor. But you would definitely need to get copies of your records to take to any new doctor.

If you've got any other questions, please don't hesitate to ask.

Q: Can it still be MS if the Spinal tap is normal?

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