Hi! Newbie here! I have a question about the diagnostic criteria which I believe changed in 2017. I was told in 2006 I had MS based on symptoms and history along showing dissemination in time and space. In 2007 both MRI and LP clear, 2 neuro’s at odds - one stated FND, the other convinced still MS but because no proof, I didn’t get a formal diagnosis. Symptoms have been minimal until recently, MRI still clear! Waiting now for outpatient appt to see where we go from here. As I read the 2017 criteria, MRI and LP only confirm clinical dx… but what if they’re clear? Does a clear LP and MRI now definitively rule out MS?
1 Like
Hello Diamond, and welcome.
My first MRI showed dozens of lesions in my brain and a clear spine. My LP was also clear.
Quite some time later, I lost all feeling in my left leg, so a further MRI was taken which showed two or three lesions on the spine.
After an assortment of other tests like EVP, bloods to exclude mimicking conditions, reflexes and a thorough medical history, I was diagnosed, but it had taken about a year.
I think it unlikely anyone would be diagnosed with a clear MRI and LP, but I am not a neuro or medic of any kind so am certainly not qualified to answer that question.
I understand your frustration, you just want to know… but as you’ve already found out… it can take a very long time.
Ben
It makes MS unlikely. However some spinal lesions can be hard to spot, and a small percentage of people with MS diagnosed by MRI may have a negative LP.
But you do need a correct diagnosis to get access to the correct treatment. If it isn’t MS then as DMDs come with not insignificant side effects, then being given DMDs could be harmful.
According to Jon Stone who seems to be one of the most experienced FND specialists in the UK, FND should not be a diagnosis of exclusion but should be based on certain positive signs. So it shouldn’t be diagnosed just because MRI and LP are clear. So the question of the neurologist who has diagnosed you with FND is what were his criteria for his FND diagnosis.
It must be a shock and upsetting though to have your MS diagnosis queried / potentially overturned, and thrown back into uncertainty.
Diamond,
I’m not sure if I made it clear in my above post, but I was diagnosed after a negative LP; however, I don’t think that’s very common.
Ben