Not necessarily so, MX7. I know my neurologist DOES NOT read the current MRI films; he relies on the radiologist's report for the results because the radiologist compares my most recent MRI films to my older MRI films and reports the findings. I'm sure my neurologist would request the films if he saw anything out of the ordinary in the report.

I remember when I first saw my neurologist in 2002 he requested to see the films from the MRI I had done at another facility a few months previously because he did not have the MRI report copy to compare. This MRI was done with no contrast only so my neurologist had to begin a new history of my MRIs.

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greenjeans, sorry, I can't find the thread. But, there is a specific protocol, I believe (besides imaging) related to the contrast. If I come across my prescription for the MRI, I'll look some more with a better key word.

I think it's a matter of where you are in the dx process and if you feel confident with your doctor. Personally, I would not feel comfortable if my MS specialist did not review the films but in the case of my neuro-op and orbital MRIs, I know she was relying on the comparison and I do feel okay about that...

Thanks Beary....I had the "Orbital MRI" that my Optho/Neuro ordered....it's different than a BRAIN MRI? Are you saying they don't show the same results? Is it possible to have a different scan of the brain and find more lesions? Just questioning.... :)

When I had my brain MRI and the MRI of the orbits (done at the same time) they never did see any inflammation in my orbits. My ON that I had was diagnosed by symptoms only....it was never confirmed by the MRI.

I believe that I had the same test as you Erin. My scan started at the top and worked it's way all the way down, and side to side.....

I'm still confused tho....are you saying the orbital is JUST the eyes? Or are you saying it is more focused for the eyes? My first MRI I had done in 2001 showed my tear gland to be bigger than normal, and I actually had a biopsy done. He cut open near my tear gland and removed a peice for study. It came out negitive. But this was the same test he ordered last September...the Brain/Orbital....god, I'm confused :D

LOL!!!!!!!!!

Yes, it is different than a brain MRI. And even with a brain MRI, what it shows can be different; that's why I posted about my 2 different brain MRIs. Although the first one (the pituitary study) did show some lesions, it was not sufficient for my MS specialist in trying to get the whole story. In the span of one month, I had 3 separate MRIs because they were all looking for something else. When I had my recent follow-up, my MS specialist was directed by my neuro-ophthalmologist to order the orbital follow-up -- they were two separate prescriptions.

Completely different study. Different images AND the way that they are produced. A brain MRI may show some images of the orbits but is not necessarily a complete study if an orbital protocol is not ordered. It's very specific.

Sorry for the hijack Julie :D

Okay...So if my Optho/Neuro ordered my Orbital, then my new REGULAR Neurologist reveiwed just that test result (did not look at films, just the radiologists opinion) then it's POSSIBLE that a second MRI was in order by the Neuro? You are saying that if my Optho/Neuro ordered a specific test that he wanted, then my Neuro should have ordered one just for what he would be looking at? I had NO idea.....

So, it is possible that the MRI I had in Sept that showed a lesion, could be done again with a different prescription, and potentially find more lesions?

I've been talking with my Therapist and PCP, and frankley, they aren't finding any reason to think I've done this to myself thru worry. They also indicate that when folks have 'hysterical' stuff happen, it's not a two-six month ordeal...it's a few days or weeks.

This is so damn frustrating....:hug:

The orbital is of the optic nerve, but I dont know if it's more focused or whatever. I would guess that they somehow zoom in on the area of the optic nerve. I dont know that much about MRI's and how they see what they see. (I dont like being in the machines, so I guess I've never researched how they work much)

I know that the two machines that I've been in are Tesla 3's. If I have to get another MRI done, I might have that done at the University Hospital where the MS Clinic is, since they have a Tesla 7 there. (think it's a 7...it's a brand new machine)

But since I dont want to have another brain MRI because I'm seriously claustrophobic, I probably wont. Spinal MRI's arent so bad, but the brain MRI's scare the crap out of me. I cant stand being strapped down into the little helmet cage thingie where I cant move my head. After that brain MRI, my claustrophobia seemed to get triggered to the point where I dont even like to be in a crowd of people while outside in a big open space.

That's fine, I'm leaning a lot here. :D

Thanks Erin,
I do think I'm going to find myself wondering for along time to come....what is really going on! I almost find myself hoping I'll have an attack so it will be looked at again, as a new symptom. I don't know how many times I have to have an attack of some kind for them to take 'time/space' into account. I've had 4 seperate attacks, three of which brought on new symptoms, over a 9 year period. I've never researched MS until the past 6 months, so I had NO idea what I may be experiencing, and since I didn't have one doctor all these years...my records are all over town :o

I'm okay in the tube....I just close my eyes and count the bangs (OCD!) LOL!!!! I feel for those of you who get clostrophobic!!

A study of the orbits is different than the study of the brain. And even then, there are different studies of the brain.

Okay, I found the link -- I had posted about the prescriptions for my follow-ups. The orbital MRI referenced "c-fat". I was informed that this is "fat saturation" and is important for post-gadolinium T1-weighted imaging of the orbits.

I don't think it's appropriate to post to another message board here but if anyone wants the entire link, PM me. (The link also explains T2 and flair.)

*edited to add, it's not just zooming in.

Four separate attacks in nine years and they still havent diagnosed you? Why wont they diagnose you?

I had three attacks in one year and got diagnosed in four months. First obvious symptom was numbness in my right hip/thigh that a PA misdiagnosed as a sprain. Told me to put heat on it. No one would take me seriously about it.

Then came the ON and again I wasnt taken totally seriously by anyone other than my regular doctor and the optho. I didnt do steroids because they were acting as if this was a first attack. (the neuro and neuro-optho both said that the numb hip had nothing to do with the ON)

I felt like crap that winter. I knew something was wrong but couldnt get anyone to listen to me. Finally went back to my regular doctor because my low back was killing me and my feet were freezing cold/burning hot/felt like I had a boot full of thumbtacks on my feet.

The regular doctor (Dr. C) is such a cool guy. He ordered the spinal MRI's and he's the one who got the neuro to listen and they found two lesions in my spine. I LOVE Dr. C! (the fact that he's total eye candy helps too)

I was really surprised to get diagnosed so fast. I thought it would take a few years.

If you have ON and lesions, I don't think there's any faster way to an MS dx!
It's like going to the head of the class with a fast pass! :rolleyes:

I pulled my report it says:

REASON: Clinical Data: MS

TECHNIQUE: MRI performed throught the brain, obtaining sagittal T1, axial fat-saturated T1, axial fat-saturated T2, and postcontrast axial FLAIR, sagittal FLAIR, axial fat-saturated T1 and coronal fat-saturated T1-weighted images. 14 milliliters Magnevist gadolinium contrast adminstered IV.


I think that covered the whole enchilada? :D

Wish I was a doctor!

I have no clue, greenjeans! It would be good to clarify what type of study it was -- or perhaps you could get a radiologist to explain if it did cover everything. ;)

Oh, ok. This is different than an MRI.

LA

Oh, wow! The link didn't work before. Thanks, slskckjebw!

Bearygood

It is an ultra sound.

LA

Yes, I saw. :D And that explains the confusion!

yeah, but I didnt have lesions in the optic nerve. The only ones that they found that they actually called "lesions", were the two they found in my spine. They found spots in my brain, but they just called them "dots" and "spots" and said they werent typical of MS lesions. Apparently those were really small.

That's what I meant, lesions on the brain (along with the ON). That said, you are a special case, Erin, "spots" and all! :) I am under the impression that with ON, the lesion usually does show up in an orbital study. But yes, even with a lesion on the nerve, that would not be sufficient enough for an MS dx. It was my brain lesions that gave me the fast pass!

The only place they even found lesions on me was in my spine. I didnt have anything on my optic nerve according to the MRI, and just the little dots in my brain.

I guess I got diagnosed by the number of flares, and the optic neuritis and the lesions on the spine.

Yup, spine will do it too! They did find one on my t-spine but that was the last thing I had done and it was post-dx.

Are you having any mobility problems?

How did they dx ON without the inflamation on the MRI? How did they know? Under the criteria they looked at you, seems to me that

1. They found you had ON (HOW?)
2. Time and space
3. 1 lesion on the spine


My Optho/Neuro thinks I've had ON, but my RK surgery makes it hard for him to see the back of my eye. It causes problems with the ability to see all the way back!

I have the time and space for flairs, new symptom.

I have 1 lesion spotted my the Radiologist, and two by the Optho/Neuro


WHAT GIVES???? GRIN!!!!

Yep, VEP was normal

Just got my LP results (the real one)

It all looks normal...so I can't complain....

No bands

IgG is within normal range

Myelin is fine

Albumin is fine


The bottom line for me is, I can't show it on my tests, therefore, I can't get a dx. What I do know is that I have a lesion now that I did not have before. I have the eye issues, the vertigo and the numbness.

What else can I say?

Bummer :D

Julie--I would be very happy at being referred to a super-specialist to deal with your eye problem. AND that they are willing to accept your insurance. It sounds like the doctors are really working with you here.

A week may seem like a long time, but in the grand scheme of getting complex problems diagnosed, it's nothing. It's normal to be impatient and want answers as soon as possible, but please give the doctors time to work through their process.

They have the training, knowledge, experience, and perspective to know how best to proceed. They have seen thousands of patients. All we have is the Internet and impatience. :D

I don't mean that to sound harsh--but I do think that a little knowledge can be a dangerous thing. I see people criticizing doctors because they don't read their own MRIs, because they didn't order this or that test, etc. when there may be very good reasons for the doctors' actions. WE ARE NOT THE EXPERTS.

Of course we need to educate ourselves as much as possible about what's going on with us. And it's perfectly legitimate to ask our doctors about anything we don't understand.

Bad doctors, careless doctors, rude doctors, etc. need to be dumped, of course. But we, on the other hand, need to rein in our natural impatience, worry, and attempts to second-guess doctors. We need to give them a chance to do their work--and then be ready to ask them questions.

As I said, I would be thrilled to be referred to a neuro-ophthalmologist--they are the super-specialists and most likely to properly diagnose and treat you. Because they are rather rare specialists, I'm not surprised you have to travel to see one. Don't be put off by this--it will be worth it.

Good luck!!! and very best wishes in getting your problems figured out.

Nancy T.

Thank you, I have an appt. with the new Neuro-op Tuesday. :)

Both of my parents had one of those tests when they needed to get cataracts removed. I got to watch my mom get hers. It was kind of interesting to watch.

Nope, just numbness, occasional wacky vision crap and occasionally some MS hug and spasticity.

Two lesions on the spine.

Symptoms of ON - pain on movement, afferent pupillary defect, giant blind spots that showed up on my visual field test.

Time and space, I had numbness in my hips and legs in April of that year, then I got the ON in august of that year, and then my feet both went numb and were burning, freezing cold and felt like I was wearing boots full of thumbtacks all at the same time. That was when I got the spinal MRI's and they found the two spinal lesions then.

I also think that the day that the neuro diagnosed me, he did a neuro check before he did the diagnosis, and there must have been some neurological weirdness going on in my body that day. Plus, I developed l'hermittes sign that week and it was bugging me that day.

So, do you know if is he still leaning towards a dx of optic neuropathy rather then optic neuritis?:

http://www.merck.com/mmhe/sec20/ch235/ch235d.html

Cherie

Actually I have never heard of an ultra sound of the eye. That would be a little scary! :eek: I would rather go for the MRI of the eye orbits....nothing touching my eye that way...

Hope I am not sounding short in my posts. I just had my first injection of Avonex today and am not feeling 100% myself. :( I feel bad for Julie. I know how difficult it was for me waiting. :(
LA

He said in the office he thought it was optic neuritis or retrobulbar and than his wife (the other Dr in the office that I saw) also said she thought it was optic neuritis.

Have you ever had an opthalmologist test the pressures in your eyes? It's similar to that.

Yes. Everytime I go to the eye doctor, which has been a lot this year. There is glacoma in my family. My mom actually. Oh yes..... and I hate that numb feeling. :eek:

LA