answers on a postcard... or here will do :-)

Hi all, Can someone answer this for me. I read on here that in order to diagnose PPMS a lumbar puncture is required. Any idea why that is? Thanks in advance… X

No I was disgnosed with an mri scan

I havent got the answer but have a yr old dog exactly the same as ur avatar…spooky xxx

Lol, that’s my old girl Gypsy. She’s nearly 12, virtually blind/deaf and barely any teeth left but she still eats well and is happiest being fussed :slight_smile:

Not sure how one normally progresses from one diagnosis to another, however, speaking from my experiance I was first dx with RR in January '14, but referred by my original neuro to his colleague who I saw in June. He looked at all the original notes etc and the single MRI, but no LP carried out and reclassified my MS as PP.

It made me laugh when we looked at that MRI and he turned to me and said “well that’s a bit of a mess in there”.

Good luck with your dx.


ps I’ve got a pair of Weimeraners, seems there’s a lot of dog owners on here as well.

pps, edit function works


A lumbar Puncture is when they put a needle into your spinal cord and take a sample of your spinal fluid for testing.


Testing for what? I was diagnosed with an MRI only.

Hi Sewingchick,

They check out all the chemicals or make up of your spinal fluid.

Don’t have the knowledge to go further, but that is what onfirmed my DX after all test came back negative.

I had Private medical insurance then !


Yes I had a lumber puncture as well as an MRI last Sept. My LP firstly showed intracranial hypertension, then test confirmed positive ogliclonal bands too. MRI showed lesions. A further MRI in March showed new lesions and I was formally diagnosed with ms in April. I’m also having to take acetazolomide to help prevent fluid build up around my brain. My body is falling to pieces :smiley: Oh well… Keep ploddin on…

The simple answer is that neuros diagnose MS using the McDonald criteria. They say that an LP is required if PPMS is suspected. Just thinking “aloud”, I wonder if that is because other things can cause the demylinating plaques and the other symptoms, but nothing else causes o-bands in the CSF?

Can anyone else offer any better explanation?

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I’ve never had a lumbar puncture but was lead to believe that it was because the MRI showed brain and spinal lesions, but Mitzi’s answer sounds more plausible.

Good luck with it all.

Wendy x

I’m wondering if I’m more ppms than rrms as my symptoms are continuous. Muscle fatigue is a huge factor with me too. Hmmmm… Interesting…

l was diagnosed 32yrs ago - MRI then LP - and yes l have PPMS.

Hmmmmmm - i’ve had an MRI showing approx 16 lesions on brain and 2 on spine, a normal lumbar puncture but positive for O bands and I have not been diagnosed and have been in limbo for a year now. Two seperate neuros say probable MS but MILD. I am having relapses but they are too mild to count apparantly.

I believe that as I am under a MS centre, the lumbar puncture which I had was all part of a research project they are doing on peoples spinal fluid and they book you in as part of the course to get as much data / fluid as possible. EDIT - I was told if I had a LP and it came back positive for O bands then I would get a diagnosis, this didn’t happen…

My MRI showed “lesions indicative of MS” (or some such wording); an LP found I have o-bands in my CSF and an evoked potential test also gave results supporting a dx of MS.

Vinnygirl, my consultant discussed with me whether I have RR or PP and we agreed that I’ve got PPMS based mainly on the fact I’ve lost ground over the last couple of years but without having any obvious relapses.

Don’t be afraid to ask the medics why they do things or what they expect a particular test to show. I have asked about things that were being done to me in the past and I’ve never been refused an answer - the nurses seemed to like it that I took an interest in my treatment.