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Old 07-25-2008, 03:26 PM #1
tonyaocala tonyaocala is offline
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Question Lady Express.......

I have a quick question for you and others who want to chime in.

I was hospitalized last week for a couple day and received IV steroids. By the way....what a help that was. I felt so much better.

Anyhow, I went to the neuro today and he wants to do a LP. My question is, will the LP be accurate with just having steroids and......... if you have a LP while not in a "flair" can you get a false negative (meaning no o_bands)?
I read that somewhere and wanted to know if it is accurate.

I am really not wanting the LP anyhow! I had (3) MRI and everyone of them gave (2) possibilities for having the lesions that I have in the brain. one was Ischemic and the other was demyl disease. The neuro informed me today that he knew for a fact that it was not ischemic in any way. OK then where does that leave me?

Anyhow, thanks in advance for any and all replies
~Tonya

ps... You may be able to look back on the original thread that I posted to see the MRI results.
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Old 07-25-2008, 08:13 PM #2
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Hi Tonya,

Glad to hear the steroids helped you feel better.

As far as the LP, statistically approximately 90% of us with MS have O-bands . . . but that stat may be somewhat misleading.

We did an informal survey on another forum about 5 yrs ago, and approximately 50% of the people who were dx with MS, either did not have 0-bands, or had never even had a LP. Since a LP is often not necessary for the dx, many (like myself) opt not to have one for confirmation purposes.

Secondly, perhaps if the LP comes back negative, many specialists might refuse to dx definitive MS, at least until test results change. If this is true, it's no wonder that 90% do have O-bands by the time they are dx (they probably have lots of lesions by that point too! )

As far as whether steroids (or any meds) might affect test results, O-bands are found in several other diseases of the central nervous system, such as:

http://www.diseasesdatabase.com/resu...ClassSort=True

In other neurological diseases, it is my understanding that the bands usually disappear from the spinal fluid as a person recovers. However, with MS, the bands are permanent, and do not fully recover with the use of any drugs, or over time. I think MBP (another "marker" for MS) might reduce in MS, once the inflammatory process dies down . . . but MBP isn't a dx criteria anyway (just "helpful" info).

An LP can help them rule in or out other disease though, so that's a consideration.

Personally, I'm fairly certain I could never be convinced to have another LP (the first attempt was botched) . . . but that's just me. Many, many people have had very little problem when undergoing one.

Cherie
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Old 07-25-2008, 09:21 PM #3
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Smile thanks...

I thought I had remembered correctly in that an LP does NOT have to be to have a definite dx. That's from the Mcdonald Criteria revised in 2005. is that accurate?

Thank you so much for getting back with me You are a wealth of information.
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Old 07-26-2008, 02:07 PM #4
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You are welcome.

Yes, a LP is not required according to the McDonald criteria (see attached links):

Quote:
Originally Posted by lady_express_44 View Post
All about MS brain and spinal lesions:

http://www.radiologyassistant.nl/en/4556dea65db62

What they are looking for to dx MS, and large list of differential diagnosis' for MS:

http://www.neurology.wisc.edu/public...bs/Neuro_2.pdf

Cherie
However, if they do not feel they have the right number/shape/size of MS-type lesions, they may want to see O-bands in the LP to firm things up.

Of course O-bands can be found in other diseases too (as I mentioned in my previous post), so it still comes down to making an educated guess once all the results are in.

Cherie
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Old 07-26-2008, 04:14 PM #5
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Cherie, great links -- thanks! Wow, I overlooked the entire thread they came from!
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