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-   -   Lesions and diagnosies (https://www.neurotalk.org/multiple-sclerosis/39912-lesions-diagnosies.html)

molpep 02-26-2008 04:47 PM

According to the report the O-bands are the ones typical to MS...I am going to find an MS specialist to get a second opinion i think to get some clarification...my current neuro does not seem keen to clarify too much...he knew i was confused when I left the appointment because I told him I didn't understand anything that he had said and he said "see you in 4 months".

Bearygood 02-26-2008 06:31 PM

molpep, I think that a second opinion would be a good idea and since MS is suspected, I would go to an MS specialist.

My MS specialist concurs with Cherie -- he told me that 90% of all demyelinating diseases turn out to be MS.

braingonebad 02-26-2008 08:40 PM

Quote:

Originally Posted by lady_express_44 (Post 224693)
Transverse Myelitis has the same spinal lesions, and it presents exactly as molpep has described her Nov attack. It can be idiopathic, but ends up as MS dx a good % of the time too:

http://www.ninds.nih.gov/disorders/t...s.htm#41903234

O-bands can be found in other diseases, as can various shapes/sizes of brain lesions. He would want to be sure they are the "MS" variety . . .

I think you are right, Snoopy, he may be waiting for the second attack or change in MRI (McDonald criteria).

Cherie

You're good, you know that?

:cool:

I'm just thinking, what are the odds anybody would have C spine lesions from Tranverse Myelitis, plus brain lesions (a dozen of them) from something unknown AND O bands from yet another cause?

If I were a neuro, MS would be the horse and not the zebra here.

Either that or Molpep should win a prize for collecting the most rare disorders in one day.

:winner_first_h4h:

All that said, it is okay for him to watch and be sure before dx-ing. I wish he would not have given the dx and tsaken it back. Once you say it, just stick with it unless you were wrong about it. Or don't say it at all.

lady_express_44 02-26-2008 09:22 PM

Quote:

Originally Posted by braingonebad (Post 225033)
You're good, you know that?

:cool:

I'm just thinking, what are the odds anybody would have C spine lesions from Tranverse Myelitis, plus brain lesions (a dozen of them) from something unknown AND O bands from yet another cause?


I am "good" . . . what's your point?

I fully believe she has MS, just like we all believed I had MS when I had my first TM attack. As I said, a good % of the time TM does lead to a MS dx. However, my neuros followed the criteria (as I think hers are), and I waited 12 yrs before I had another attack. That happened to be ok by me, but I did not mean to imply that it should be to her. :cool:

If you have followed my posts, I ALWAYS recommend a second opinion, whether we are dx at first or not. Others had already said that though, so I didn't think it was necessary . . . :rolleyes:

Cherie

molpep 02-27-2008 02:32 AM

Thanks everyone. My torso has started to go numb again today so I have called a friend of mine who has managed to get me in for an appointment with an MS specialist. Really appreciate all the support and help trying to clarify! :hug:

lady_express_44 02-27-2008 02:46 AM

Molpep,

I initially tried to answer your specific questions, which were:

Quote:

Originally Posted by molpep (Post 224273)
I am confused as if these lesions are not from ms, what would they be considering all the other test results and the radiologists report? Can anyone think of any reasons for the change of heart? My neurologist is not great at explaining things and makes me feel stupid when i ask questions


The only other condition that I knew of which has the same kind of spinal lesions is Transverse Myelitis. There may be many other conditions, but I have not researched that.

Transverse Myelitis, which can be the first indication of MS, may be CAUSED by several conditions. NOTE: The following list includes only those conditions (that I am aware of) that ALSO may have onocological bands present:

Systemic lupus erythematosis (SLE)
Sarcoidosis
ADEM
Bacteria
Bacterial infections
Multiple sclerosis

http://www.myelitis.org/tm.htm

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

The definition for “lesions” is very broad, and simply means “damage”. Lesions can be found anywhere on the body, but in this case the lesions are in your brain. If they suspected the lesions were the “demyelinating type”, the following is a list of some conditions where they might be observed:

http://spinwarp.ucsd.edu/NeuroWeb/Text/br-840.htm

It seems his initial conclusion was that this is MS, but he is now questioning whether your brain lesions are the right size/shape and/or location for MS. This dilemma is actually quite common . . . but the other testing evidence seems to make the case for MS fairly convincing.

Some neurologists will treat “Clinically Isolated Syndrome" (only one attack) with MS disease modifying drugs (if that is what you are wanting immediately). However, it MAY still come down to needing a second attack before you get the final confirmed dx.

Good luck with the specialist.

Cherie

molpep 02-27-2008 03:59 AM

Thanks Cherie, all those other possibilities like lupus, bacterial infection, etc have all been ruled out. We'll see what happens, but I really do appreciate you trying to help me make sense of it all. It has been terribly confusing and upsetting. I have been having numbness come onto my legs when I have been trying to walk since i finished on the IV steroids, and last night my left arm went numb which was followed by my trunk going numb today. It usually settles down after a couple of hours though. Just makes it hard to get fit and healthy. If they could give me something to manage that i would be grateful!

Snoopy 02-27-2008 06:51 AM

Quote:

Originally Posted by lady_express_44 (Post 224693)
Transverse Myelitis has the same spinal lesions, and it presents exactly as molpep has described her Nov attack. It can be idiopathic, but ends up as MS dx a good % of the time too:

http://www.ninds.nih.gov/disorders/t...s.htm#41903234

O-bands can be found in other diseases, as can various shapes/sizes of brain lesions. He would want to be sure they are the "MS" variety . . .

I think you are right, Snoopy, he may be waiting for the second attack or change in MRI (McDonald criteria).

Cherie

Oops! Your right, Cherie - Thanks!

TheSleeper 02-27-2008 08:38 AM

Confusion? I went to the doctor because the symptoms I was suffering indicated Mononucleosis. Nope dx`ed with Bronchitis.

Still continued to get sicker, mono spot test had been negative. Sent to the hospital for more extensive blood work, maybe lyme, west nile, anything? and a chest x-ray to check for pneumonia.

LOL dang? Mono! Then Chronic fatigue syndrome, then when my walking became to bad to ignore a neuro and mris.

First brain mri, abnormal, small strokes, not severe enough to cause walking problems.

C-spine mri, lesions clearly seen at c-2 and c-4, old injury, myelitis, myelopathy, a botched LP, then a new neuro.

I had told the first and then the new dude I thought PPMS, ignored, a negative lp. Refusal by both to order a t-spine mri second refused to order repeats of the brain and c-spine also. His comment? T/M no further testing is needed or necessary.

We disagreed on that and I went to a specialist, more testing, repeats of B-C and a T-spine MRI and a dx of PPMS. Evidence was there, they have to be willing to look!

lady_express_44 02-27-2008 11:13 AM

Quote:

Originally Posted by molpep (Post 225378)
I have been having numbness come onto my legs when I have been trying to walk since i finished on the IV steroids, and last night my left arm went numb which was followed by my trunk going numb today. It usually settles down after a couple of hours though. Just makes it hard to get fit and healthy. If they could give me something to manage that i would be grateful!


The disease modifying drugs we use are not intended to manage ongoing symptoms, and often make us feel worse initially (until our bodies adjust). The idea though, is that they may help to manage the disease process by hopefully reducing the number of relapses (attacks) we have . . . which in turn could ultimately result in a reduction of symptoms from attacks.

Each of the options we have MAY work for one person and not at all for another; it's trial and error to hopefully find the right one that works for YOUR body.

Are they not giving you symptom management drugs right now though, i.e. for pain, tingling, etc.? I don't happen to take any of these drugs, just because I am too sensitive to medications, but normally they will offer relief with or without a confirmed dx.

BTW, an attack is defined as "new symptoms . . . or worsening of old symptoms . . . lasting longer then 24 hrs". There must be 30 days between accelerated symptoms before it would be counted as a second attack (. . . those aren't the exact words, but the easiest way that I can personally explain it).

For as long as it takes to get in to see the specialists, it is probably a good idea to research your drug options to determine the best potential fit for you. The NMSS has some good information in this regard:

http://www.nationalmssociety.org/sit...ures_comparing

I found the following website helpful also, for another perspective:

http://www.themcfox.com/multiple-sclerosis/ms-drugs/

Cherie


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