That's an interesting way to look at it, Chez.

I guess I was thinking more along the lines of people NOT getting the proper dx of MS because the MRI didn't show enough accuracy of information.

There was a study done with that focus, and it was determined that very few lesions were visible on an MRI, in certain parts of the brain. They were able to confirm this by reviewing the MRI's (taken prior to death) to the autopsy results.

http://www.ajnr.org/cgi/content/abstract/26/3/572

Cherie

Since I am not a scientist, I don't pretend to understand most of the articles I read.

What I am looking for is how they dx the 5% of MSers who don't show lesions. I kind of wonder if it isn't more than 5%. One never sees articles on MSers who don't show lesions, just atrophy.

Limboland is he^^. Having an MS dx recinded must be much worse though. If the bathtub test was the only criteria then some of us would be out of limboland for sure.

It's long been known that no one thing on it's own really gives a dx of MS... it's a highly subjective assessment by the doctor. Hopefully research will be able to find a definitive test. I often wonder why the inhibition on the part of doctors remains in dxing not only MS but other maladies like fibromyalgia too. TC. JD

cricket,

They can give a clinical diagnosis in someone who has no lesions on MRI. I have been told that I fulfill the clinical criteria for definite MS.

A clinical diagnosis can be established if their is evidence for lesions disseminated in space and time. They tend to rely heavilly on things that aren't fakeable. They worry way too much about people faking symptoms.

My eyes, for example, show clinical evidence of lesions disseminated in space and time. I developed optic disc pallor a number of years after I developed an eye-traction problem (bilateral INO). The optic disc pallor indicates an optic nerve lesion. The eye traction indicates a brainstem lesion. So, there are lesions in two different locations, and they happened at different times.

There is a lot of caution out there against giving a definite diagnosis to someone in whom all of the tests have been negative. It's really up to the doctor what tests they need to show positive for a definite diagnosis if the person has shown clinical evidence of lesions disseminated in space and time.

There seems to be such conflict between giving an early diagnosis and doing the 'watching and waiting' thing to see what develops. It really seems to be random who gets the diagnosis and who has to wait. This might be why people neuro-shop because we hear stories of people waiting a loooong time without any diagnosis whereas others with seemingly identical circumstances get one right away. Just different doctors, that's the only difference.

Here is the full BMJ article that Cherie's article stems from.

http://bmj.bmjjournals.com/cgi/conte...urcetype=HWCIT

What wannabe said. It seems so arbitrary.

Is a poor patient to believe the "Early Diagnosis and Treatment" mantra you hear almost everywhere in MS Officialdom?

Or is the poor patient to believe the conflicting, seemingly arbitrary, blase, AND/OR dismissive attitudes of many doctors toward those without MRI evidence that screams MS?

(Picture the neurologist leaving the room making the Valley Girl "W" sign... "Whatever!")

Nancy

Early DX and TX, I laugh when I hear those words in reference to any disease. That is what is promoted by hospitals and insurance, but they don't practice it, it's just a media thing.

I've had MRI's showing multiple lesions and progression, and many tests that show some sort of abnormalities, but since I don't show "O" bands I'm dismissed and told I am healthy.

When I stumble, have to push myself to walk a block and have to think about every step I take, and my legs twitch and spasm all day long, well all I can do is shake my head.

Something is wrong, hopefully the Cleveland clinic will be willing to figure out what is wrong.
Pat