Clear MRI but GP still thinks MS

Hi everyone

I have been having symptoms for approx 2 years- Poor balance, cognitive difficulties, twitches, tingling, bowel urgency, wobbly eyes (they shake from side to side really fast) fatigue and abnormal skin sensations. My GP refferred me to a neurologist (Specialises in strokes) the examination threw up a few things that concerned the neuro- positive babinski sign in both feet, brisk reflexes on my right side and unseady heel to toe. He ordered an MRI of my brain and cervical spine which has come back clear so he has discharged me.

I went back to the doctors and my original GP was unavailable so I saw another in the practice. I told him all my symptoms and about the MRI results. At first he said he was 'stumped', then he read the letters from the neurologist and said that MS is still a possibility. Why would he back track like that after reading the letters?

So now he wants to do a full blood work up again and if that doesn't show anything then a refferal back to the neurologist.

Has anyone else ever experienced anything similar? Is it possible to have a clear MRI but still have MS? Should I get my GP to refer me to an MS specialist if it comes to that again?

Sorry for the long post I am just so confused about everything at the moment.

Claudette x

Hi Claudette, no wonder you're confused.

Yes it is possible to have MS with a clear MRI, although it makes dx very difficult and could take a long time. It could be that lesions didn't show up on the MRI. Some of the scanners, esp the older ones, don't always show up lesions. They might want to use 'contrast' which can enhance the lesions on the MRI.  A few people do end up with an MS dx (or a 'possible MS' or 'probable MS' dx) even though no lesions are evident.

I think the reason why he back-tracked after reading the letters is because your symptoms are very MS-like and he realises that even with a clear MRI your symptoms do seem to indicate MS. So he's doing absolutely the right thing... more blood work to rule out anything else that might give similar symptoms, and then back to neuro. At this stage I think you should just follow the course that the GP has set in motion... blood work and neuro. They will probably do another MRI to see if anything is now showing. They might also suggest a lumbar puncture which would be a good idea given your symptoms.

As you know, there's no test that shows absolutely that you have MS. They gather as much evidence as they can including your symptoms, rule out anything else, put it all together, and make dx with that evidence. MRI results are one piece of that evidence. 

For now you will have try and accept that you still possibly have MS and go through the long (and I know frustrating) period of 'not knowing', but be reassured that the GP has taken your symptoms seriously.

I hope you get some answers very soon,

Take care,

Pat x