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Old 01-26-2008, 11:44 AM #1
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Default For those of you in limboland with a diagnosis

http://msj.sagepub.com/cgi/reprint/14/1/2

I was googling (because it's cold outside and I was bored in the house! ), and came across a journal called "Multiple Sclerosis". Can't get more specific than that now can you?

This article discussed the challenges in diagnosing MS, and one section actually talked about how some people ARE diagnosed with the disease but actually DON'T have it! (That's not me, unfortunately. I've seen so many MS docs over the years, and I definitely have it. ).

Anyway, I thought that those of you in limbo might find both the article AND the journal itself interesting. Read away!
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Old 01-26-2008, 11:57 AM #2
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Here's another good article:

http://www.neurology.wisc.edu/public...bs/Neuro_7.pdf

Cherie
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Old 01-26-2008, 12:31 PM #3
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I understand 'space and time' to mean that there have been repeated situations, such as vertigo, or numbness, etc.

Am I correct in this?
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Old 01-26-2008, 12:38 PM #4
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Quote:
Originally Posted by greenjeans View Post
I understand 'space and time' to mean that there have been repeated situations, such as vertigo, or numbness, etc.

Am I correct in this?
I'm going to quote someone else who was recently talking about this, as my explanation is rather convoluted.

"Evidence of dissemination in space and time can come from clinical history, MRIs, or the lab (from spinal fluid and visual evoked potentials)."

For a dx of MS, there must be "objective evidence of distinct neurological attacks separated in time, and tied to different areas of the central nervous system (separated in space)."

"An attack must last at least 24 hours to be an attack (and often lasts much longer), but to be a new attack, it must be separated from the old attack by 30 days."

(Sometimes we are left with ongoing symptoms, or symptoms which just flare when we are particularly tired, but an attack is a distinct event, with a start and finish.)

Hope this helps.

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Old 01-26-2008, 12:56 PM #5
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To be clear, can I use me as an example?

1999: A Neurological attack of some kind to my eyes. Not ON that I know of, but I have visual problems to this day

2004: Vertigo that lasted about 2 weeks

2007: Vertigo tht lasted about 2 weeks, followed by numbness of entire left side of body. I also was stumbling, falling, ears popping and my memory and attn span are highly lacking. Trouble getting a job, something that's never been a problem before (get 'lost' in the interview process)


MRI: 2 lesions
Blood tests: All normal
VEP: Normal
LP: Waiting on results (Jan 31)

Is this time and space?
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Last edited by sugarboo; 01-26-2008 at 02:46 PM. Reason: time/space
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Old 01-26-2008, 05:35 PM #6
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Time, yes. Space...a neuro would be best assessing this for you, GJ. Cherie gave an excellent explanation, though!

Last edited by janlici; 01-26-2008 at 07:02 PM. Reason: Used the wrong word....I mean "assessing" not ACCESSing :)
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Old 01-26-2008, 05:44 PM #7
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Quote:
Originally Posted by janlici View Post
Time, yes. Space...a neuro would be best accessing this for you, GJ.
I'd agree with your comments . . . because they know what damage could potentially cause which symptoms.

If the first event was ON, it would seem like you have "space". If not, maybe not.

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Old 01-26-2008, 09:18 PM #8
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Janlici - thanks for the link.

I think before MRI, the dx was mostly based on what they could rule out they did plus your sx history.

You'd have thought the MRI would have cleared a lot up but instead maybe they've found 2 things they did not expect; that not all people with ms present lesions right off, and that a lot of people with or without DO present lesions for whatever other reason (they may never know all the causes of brain scars).

The thing mentioned that really hit home with me was that it (McDonald's criteria) does not mention which diseases/disorders, etc need to be ruled out. That needs to be addressed. We see how hit and miss that is.

Other than that, if MdC was followed, it might keep a lot of people from being mis-dx'd I would think. Maybe the docs need a check off list?



GJ - I have not seen any neuros who dx based on sx - those are not treated as part of the criteria, those are how they decide how they test though. It's the test results that count toward *time and space* in my experience.

Lesions on the brain and an abnormal test like LP would be space. A new lesion a year later would be time.

I could have (and have had) several new sx over the course of more than 5 years in all different parts of my body, and none of that counts for *time and space*. Just my personal experience, as I said. Other neuros may not see it the way mine have.
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