Diagnosis questions

Hi everyone

Please could you answer my question? I’ve had MRI showing lesions, can the neurologist diagnose MS with that or does everyone need an LP too, and does position of lesions control level of symptoms like spinal injury? My whole body seems broken and I seem to be becoming senile too.

Thanks everyone, this forum is a real asset.

Min x

If your history, symptoms, clinical signs and MRI are all consistent with MS, then you do not need an LP. However, some neuros like to do it just in case - you can refuse though and you can challenge them as to what their diagnosis would be if the LP comes back negative (because not all MSers have a positive LP). It’s a pretty straightforward procedure though; most people have no problems at all.

The position of lesions in the spinal cord is like spinal injury, except that the cord and the vertebrae do not match up perfectly so while a spinal injury diagram can be helpful, it doesn’t necessarily tell you exactly where a lesion must be because you have symptom X. (This is because the spinal cord is shorter than the spine.)

The position of lesions in the brain is more complicated. The brain uses multiple areas to do most things. So, e.g., to reach out your arm and pick up a glass, you need to use the visual cortex, various areas along the dorsal visual pathway into the parietal lobe, the premotor cortex, the motor cortex, the ventral visual pathway into the temporal lobe, the cerebellum and all the connections between these areas - and a lesion anywhere in all that could make you miss the glass!

Cognitive problems are due to damage in the brain.


Karen x

Hi Karen

Thanks for replying. I’m not scared of having an lp, it’s just been so long waiting for a diagnosis. I’ve got lots of symptoms, lesions on my mri, my optician, spinal surgeon, gp all think it’s MS but I’m waiting for neuro appointment to confirm it. I’m hoping he’ll be able to confirm or rule it out when I go. Have had this hanging over my head for a year but symptomatic for 2 years where it eased for short times but health continues to deteriorate. I’m at my wits end.



Do ask the “what if it’s negative” question then. If the neuro says that he/she’ll still diagnose you with MS, then you have a very good argument for getting the diagnosis then and there.

I can understand your frustration… 2 years is a long time to be without any answers, but plenty of symptoms :frowning:


Just occurred to me - does the neuro have access to the radiologist’s report and to the images themselves? If not, then it’s crucial that you get them to him/her before your appointment.


And it’s also just occurred to me that it’s probably the neuro who sent you for the MRI! Doh! I should wait till my brain wakes up some times :slight_smile:


Hi Karen

I had spinal surgery last year which was successful but symptoms are still getting worse. Spinal team thought it was MS initially and full mri done then, but found cord compression at C5/6 so operated but 9 months later have repeated mri and referred to neuro, who they will send scans to. Long winded process so I’m sure you can understand frustration. Lesions present in brain on first scan, don’t have results of last one done 2 weeks ago. Do lesions go away?


Min x

Hi Min

I didn’t have a LP just 2 MRIs, 6 months apart and I was diagnosed on Wednesday based on the MRI results and the various symptoms.

Hi I was diagnosed this week through MRI and symptoms … can I ask what is a LP?


Lumbar puncture Becky

Thanks everyone. I’m still waiting for my neuro appointment, hopefully I will then know for definite. I suppose I should just sit and wait but your help has been appreciated.

Min x