Do MS patients always have lesions on an MRI?
Do MS patients always have lesions on an MRI?
This is a tricky question to answer. Know that I am not a doctor....I am just another MS patient.
But I will tell you my history as briefly as I can.
Over ten years ago...when I was in my early thirties...I experienced a bout of optic neuritis. My vision narrowed, colors became dim, and I had a blind spot. I went to see the doctor who was worried that I had a stroke or a brain tumor or MS. So...I had an MRI at that time. It came back normal...no lesions.
Fast forward to more then ten years later. In October of 2007 I was diagnosed with MS and then I had multiple lesions.
So...did I have MS way back when I had no lesions? I don't know if I can answer that. But now I do.
This is why they do other tests sometimes like the spinal tap or evoked potentials.
But honestly...the MRI is one of the best tests to help diagnose Multiple Sclerosis.
Thank you for your question.
MRI is one of the best tools used to gather evidence to make a diagnosis of Multiple Sclerosis. Just like Merely Me's story, I had optic neuritis years before my MS diagnosis. At that time, definite inflammation was seen but no demyelination (which is what causes our lesions.) See Beginner's Guide to MS: What is a Lesion?
Making a diagnosis of MS can be tricky and it truly depends upon the evidence (or lack of evidence) and the clinical signs of MS. The current criteria used to diagnose MS incorporate the use of MRIs to make an earlier diagnosis possible. See By What Criteria Were You Diagnosed with Multiple Sclerosis? and be sure to read Julie's comment.
As for me, my lesions have all been in my cervical spine. At diagnosis, I still did not have brain lesions. I hope that your neurologist had ordered an MRI with and without contrast for both your brain and neck at least.
Imagine just 30 years ago, there was no MRI testing and a diagnosis of MS came from observing clinical symptoms and eliminating other possibilities. It was truly a wait-and-see game.
Here is what the National MS Society says about diagnosing MS without the presence of lesions....
"Because MRI is particularly useful in detecting central nervous system demyelination, it is a powerful tool in helping to establish the diagnosis of MS. It should be remembered, however, that approximately 5% of patients with clinically definite MS do not show lesions on MRI at the time of diagnosis. Also, since many lesions seen on MRI may be in so-called "silent" areas of the brain, it is not always possible to make a specific correlation between what is seen on the MRI scan and the patient's clinical signs and symptoms. In addition, with advancing age (probably over age 50), there are often small areas seen on MRI in healthy people that resemble MS but are actually related to the aging process."
When searching for a diagnosis, it can be frustrating to not get answers or even to not have a name for something which we know is going on inside our bodies. Keep working with your physician and always be willing to get a second opinion.
Be well and let us know how you're doing. Lots of good folks here.
I was diagnosed with MS even after 2 negative MRI's of brain and C-spine. My symptoms started with Optic Neuritis then within a year I had 2 episodes of right sided weakness, drop foot, parasthesia's etc. that required steroid therapy. After the steroids my symptoms dramatically improved over the month. Because of 3 total attacks my Dr diagnosed me with MS and put me on meds. So, yes I believe that you can have MS with a negative MRI. I just wonder if I will ever show lesions?
No they dont, but probably will eventually show up. I have a neg MRI, neg LP and have a partially positive Lyme WB. Imagine that? Think it's confusing just trying to diagnose this parasthesia, fatigue and speech issue? I am in search of a well trained non biased provider who can look with a wide angle lens and provide solid answers.
41, mom of two from NJ
I have been struggling with MS symptoms for about 9 years after a massive attack that put me out for three weeks, couldn’t walk unattended for over two months, had split double vision, numbness, tingling, extreme vertigo, total balance failure, reverse sensation, altered perception, spasms, ect
It left me with many symptom that I fight with every day, spasm, involuntary movement of limbs, brain fog, blurred vision, tingling, numbness, trouble with balance and coordination, memory problems. I have had three MRI scans that showed no lesions’ but I have failed two EP tests, I have asked for an MRI scan with contrast more than once’ but the consultants are reluctant to do this!!
Yet tests done in the states prove that up to 60% of lesions are not found without contrast!! I sometimes get the impression that they don’t want to find the truth behind the symptoms, it would be interesting to hear of other that have been treated in this manner. I have now been diagnose with Functional Neurological Disorder (FND), What’s this when it’s at home? If you read all the info about this condition it becomes simple’ it’s all in my head! What rubbish.
I think this is a massive cop out because they don’t know, or maybe there just waiting for me to have another massive relapse like the first one!!
i am a 29 year old female and at age 22 had nystagmus in one eye for 3 weeks ive had a couple bouts of right sided facial numbness in which was given oral steroids and went away over night but have pain in head neck and right arm almost constant i had an mri of brain only showing white matter lesions in which i was referred to two nuerologist who ran no other tests besides a eye test ? i was never diagnosef with anything judt left with no answers or explanation they said i did not have any nuerological symptoms for dx of ms. i had ana panel on blood came back normal i cant help but think i have ms because i have btain lesions and im scared does something bad have to happen before they help u ? i feel like they think im crazy .
I started having multiple MS symptoms in Jan.2013. I went to the hospital and was told by the E.R. doctor that I may be having mini strokes or I had MS. The following day the smurky Neuro doctor told me I was "too old" to have MS (I'm 49). He ordered an MRI of my brain - it was neg. He did NOTHING for me... NOTHING!
My family doctor referred me to a local Neuro doctor, where it took me 3 months to get in. Although he too has suggested my symptoms are due to anxiety, he was kind enough to order an MRI of my C-spine - it was neg as well. He also ordered all necessary labs to rule out other possibilities, such as lymes disease, lupus, etc. (Some labs are still pending). There are a couple of symptoms that have lasted while others have recently disappeared, such as head bobbing and memory problems. He gave me a med to help with the head bobbing, which it has helped, but maybe the dosage needs to be increased to make it completely go away.
I'd like to list my symptoms to see if anyone else has experienced the same. Even if you've gotten a diagnosis other than MS I'd like to hear from you.
*Confusion *Memory Problems *Tingling & Numbness leg, arm, hand *gated walk *blurred vision eye *trunk of body and/or head sways back & forth *stumbling *hoarseness that comes and goes
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