LP

New diagnosis and before diagnosis
1

Hello eveyone, hope you are all ok and hope you dont mind me asking a wee question or two??

I had what the doctors thought was a stroke 2 and a half years ago, was in stroke ward for 2 wekks with slurred speech, left sided weakness and problems walking.Scans and mri normal lp normal and was told to go home and get on with my life as just a blip!!! anyway, as time has past, i have had what my gp says, many relapses and strange going ons, went to neurologist and a year and a half ago dx me with functional neurological disorder od cns? just been trying to get on as best i can, but had many weird and wonderful symptoms and lately been getting worse with many sensory things. i see my neuro doc december 3rd and my gp says i am well within my right to ask for another mri as its been over 2 years now, but should i ask for another LP? would ms not have shown up the first time anyway? i have a great gp and he has been so supportive and i think he feels it may be ms, but obviously cant say or dx me.

What im trying to ask is, if i were to have MS would it definately show up on scan or LP after a year or two and why does it not always show up at first for some people ?

Thanks again

Mo

2

Hi Mo,

As lumbar punctures aren’t particularly nice, I wouldn’t ask for one unless it’s absolutely clear you have to have one. I am diagnosed without ever having one at all, so it’s not absolutely essential for diagnosis.

The MRI is much less invasive, and in theory, a very good indicator of whether you have MS or not, so I’d stick with that, for the time being. If it does show anything abnormal, you may well be referred for an LP anyway, to try to corroborate the findings. But I wouldn’t put myself forward for one, when it might not prove necessary.

It’s not really known why some people (not many) with MS don’t have evidence on first scans. Most likely, the damage is subtle, in the early stages, and scanners just aren’t powerful enough (yet) always to detect it.

But it might also be that MS causes other kinds of damage, distinct from the lesions that are regarded as the hallmark. If there are other destructive processes going on, which are not yet well understood, it might explain why some people seem to have symptoms independent of the appearance of lesions, or to get worse, even when the lesions haven’t.

Anyway, yes, after two years, it seems reasonable to ask for another scan. The longer you have symptoms, the less likely it wouldn’t show up on a scan - if it was MS - as you wouldn’t expect it to remain invisible forever. I can’t tell you it would “definitely” show up, though. Just that it gets more probable with time. If someone has gone years, but it still doesn’t show up on MRI, the most likely explanation is it isn’t MS.

LP is never “guaranteed” to prove or disprove MS, either. It yields a small percentage of false positives AND false negatives. So LP results are only really useful in conjunction with all the other evidence. It can’t confirm or rule out MS, on its own.

Tina

3

I always thought that an LP was positive from the beginning, but at least one person on here has said that their LP became positive years after the symptoms started. I suppose that could be that they actually developed MS later than they thought, but I don’t know.

Like Tina, I would stick with the MRI though. It is more persuasive than an LP anyway - you can get false positive LPs but it’s pretty difficult to get false white spots on MRI.

Have you seen this website btw?: http://www.neurosymptoms.org/#
It’s a really brilliant site about functional neurological disorders. You might find some stuff on there to argue your case with the neuro?

Good luck.

Karen x

4

Thankyou so much Karen and Tina, you have been a great help. i will have a look at the web site you told me to Karen and see whats what.

Thanks again for your time

mo

5

My MRI scan showed up inflamation with a condition they did not expect as should not have been there. Went on to have a LP which wasn’t too bad really. That ended up positive as well. Se definately have the scan and see if they is anything from that and take it from there.

Best Wishes

Vince