Neurosurgeon saids I have MS, but the neurogists isn't sure and is pushing for a spinal tap. There are about five lessions and the protective coating on the nerve in the cervical spine is dissolving (can not remember how to spell the other word, was an excellent speller at one time). Why can't he start me on a lower dosed medicine and see if it can help?
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Q: Why is it so important to have a spinal tap when then MRI of brain and cervical spine show MS.
Answers (4)
8/ 8/08 12:58pm
Sometimes it is frustrating in getting an official diagnosis. It actually took several years from my first attack before I received a 'definite MS' label. I, too, had to undergo a Spinal Tap in the diagnosis stage. They certainly aren't a pass-time pleasure, but sometimes they provide a necessary piece of the puzzle.
The following comes from the Diagnosis Section here on Health Central.
No reliable single laboratory procedure or test can establish the diagnosis of multiple sclerosis. Several are necessary before a diagnosis can be made. Analysis of Cerebrospinal Fluid (CFS). Obtaining a sample of spinal fluid requires a lumbar puncture, or spinal tap. Testing spinal fluid is becoming increasingly important for detecting abnormal proteins, tiny fragments of myelin, or specific white blood cells that can help in making a diagnosis. For example, high levels of the immunoglobulin IgG is useful for making a diagnosis and may be a marker for disease progression. (Immunoglobulins are protein chains that are part of the immune system.) In general, I believe that doctors prefer to have as much information as possible before beginning any new treatment regimen. Again, I was anxious to begin using an MS disease-modifying treatment, but I had to wait until changes were detected by MRI in location and number of lesions. Good luck and know that for many other MS patients diagnosis took a longer-than-wished-upon time to become definite MS. Please come back and let us know how you're doing.
9/15/08 8:02am
Hey Alaine
I am just going to add onto what Lisa has already said by telling you about my personal experience. My neurologist wanted to do a spinal tap as well. I had my MRI which showed multiple lesions, I had the evoked potentials test for vision and hearing (this did not reveal anything), and my symptoms. I basically refused to do the spinal tap and they ended up not needing it. I did have to get more MRI's which did show a slight change and this is what they needed to make the official diagnosis. So I think it just depends on the doctor.
I think that some docs are just more conservative in their making the diagnosis. The drugs are costly and do have side effects so they want to make sure that you do have MS. And the insurance companies do not want to pay for things unless they have that official for sure diagnosis. I have been reading, however, that some folks get MS drugs for one clinically isolated syndrome such as optic neuritis in order to prevent MS from developing.
At any rate, it was my personal experience that I did not need a spinal tap to make my diagnosis and I waited six months from the first MRI to the second to receive my diagnosis. It is totally up to you as to how you wish to proceed.
Thanks for your question. I hope you get the answers you are looking for.
9/16/08 5:12pm
I had two MRIs and there was a change. They were 8 months apart and went from two leisons to five and one of the existing lesions had increased in size. That is why I don't understand why they still want to do the spinal tap. I am having more trouble withmy muscles and don't have any insurance now to go back to the doctor. I need some prayers right now. Thank you both for your answers.
9/23/08 2:53pm
Hi Alaine
I am so glad you came back to tell us what has been happening with you lately. So they still did not give you a diagnosis? I would think that would be enough to go on but sometimes they just want to do all the tests they can. I am so sorry you are without insurance at a time like this.
I know that Lisa had some good information about insurance...here is what advice she gave to a fellow who was having that problem.
Also I am wondering if you might contact The National MS society. They definitely have advocates there who might be able to assist you. Also here is some information on their site about insurance and money matters pertaining to MS.
I am just so sorry you are going through all of this. I hope you get the answers that you need and the care that you need as well.
Please stop back and tell us how things are going with all of this.
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By Alaine— Last Modified: 12/25/10, First Published: 07/13/08
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