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10-14-2008, 12:50 PM | #11 | |||
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In Remembrance
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I was told I had MS in 1988 - without an MRI. I spent 16 months on a waiting list for an MRI. The 1989 MRI showed 3 lesions.
My 1994 MRI had only 1 lesion. My 1993 MRI showed 4 lesions. My 2003 MRI showed dozens of lesions. I got a stack of MRI films... Lesions come, go, swim around, grow, shrink, fade away, disappear, etc. I got tired of trying to predict the course of my MS based on lesions. It is not possible. There is a school of thought that the body may go through a re-myelination process on its own accord. I believe it. Tom |
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10-14-2008, 08:35 PM | #12 | ||
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Junior Member
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Quote:
thanks again. |
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10-14-2008, 09:32 PM | #13 | |||
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Grand Magnate
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According to the revised 2005 McDonald criteria , all a MS diagnosis really requires is "objective evidence of lesions disseminated in time and space”. The very simplest evidence of that would be a doctor witnessing two attacks, with a 30 - 90 day break (dissemination in time), affecting two different areas of the CNS, ie. spinal cord one time, ON the next (dissemination in space). Using myself as an example, a MRI and/or spinal tap was not necessary for the dx as I had “clinical evidence” of two attacks, and of having two lesions. The way they assessed that (without doing a MRI) was by my doctors witnessing two attacks over separate years (proof of dissemination in time) combined with clear evidence that I was affected in two different ways; once from the chest down, the other time from the ears down (proof of dissemination in space). HOWEVER, accumulation of that “clinical evidence” can take many years, so if I/they had wanted to pursue a dx earlier, they would have had to add in the use of a MRI (and/or spinal tap) to try to prove “visual” evidence of lesions (or positive CSF/O-bands). In the table below, “Clinical lesions” (WITHOUT the use of a MRI) are defined as evidence/witness of multiple lesion involvement (two areas of the CNS affected). Where there are less then two clear attacks, and/or less then two areas of the CNS involved, they then move onto the additional “requirements for diagnosis of MS”. It’s when they have to move onto “additional requirements” that things get complicated. For example, if a person has two attacks, but is affected the same way in each one (no dissemination in space), they will usually do a MRI. At least 3 out of 4 of the Barkhof criteria need to be present to fullfill the MRI criteria for MS, as per the the table below: If that doesn’t give them what they need, sometimes they will do a spinal tap to see if we have a “positive” CFS (usually defined as two or more O-bands). When a patients presents with only one symptom that could be a first presentation of MS (possible MS), sometimes a follow up MR is needed to prove that there is also dissemination in time in order to fullfill the McDonald criteria. The table on the below summarizes the MR criteria for dissemination in time. Another way to prove dissemination in time is to await a second clinical attack. http://www.radiologyassistant.nl/en/4556dea65db62 Relying mostly on a MRI isn't such a good idea anyway: http://www.medpagetoday.com/Neurolog...erosis/dh/2929 Cherie
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I am not a Neurologist, Physician, Nurse, or Hairdresser ... but I have learned that it is not such a great idea to give oneself a haircut after three margaritas
. Last edited by lady_express_44; 10-14-2008 at 09:50 PM. Reason: added -90 |
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