# Positive lumbar puncture **URL:** \ **Category:** New diagnosis and before diagnosis\ **Created:** [29 September 2018 12:28 UTC](https://forum.mssociety.org.uk/t/positive-lumbar-puncture/13349 "2018-09-29T12:28:31Z")\ **Posts on this page:** 6\ **Page:** 1
**Author:** ![Kate167](https://avatars.discourse-cdn.com/v4/letter/k/d6d6ee/32.png) [@Kate167](https://forum.mssociety.org.uk/u/Kate167)\ **Post date:** [29 September 2018 12:28 UTC](https://forum.mssociety.org.uk/t/positive-lumbar-puncture/13349/1 "2018-09-29T12:28:31Z")
Hello lovely people, Can anyone help with the diagnostic criteria? I have the following: Positive lumbar puncture for oligoclonal bands, positive VEP, three clinical relapses and bladder damage. However, clear MRI. I’ve looked at the McDonald criteria and I’m getting the impression that a diagnosis can be made without mri still. Is this right? They literally have all the evidence of dissemination in time, relapses and lab results. Everything else and I mean everything else has been ruled out. Are they able to diagnose now? Thanks in advance. ---
**Author:** ![Ssssue](https://dub1.discourse-cdn.com/mssociety/user_avatar/forum.mssociety.org.uk/ssssue/32/4182_2.png) [@Ssssue](https://forum.mssociety.org.uk/u/Ssssue)\ **Post date:** [29 September 2018 13:45 UTC](https://forum.mssociety.org.uk/t/positive-lumbar-puncture/13349/2 "2018-09-29T13:45:39Z")
Hello Kate I don’t think you can be diagnosed with a completely clear MRI. There’s no evidence of dissemination in space without MRI. But, have you had your brain and entire spine MRI’d? If you’ve just had a brain MRI, then there could be lesions on your spine. But if you’ve had the works, I don’t know what the answer is. What does your neurologist say? How does s/he explain the LP, VEP and clear MRI, given your relapses? This is what the MS Trust say about the McDonald Criteria: [McDonald criteria | MS Trust](https://www.mstrust.org.uk/a-z/mcdonald-criteria) Sue ---
**Author:** ![Kate167](https://avatars.discourse-cdn.com/v4/letter/k/d6d6ee/32.png) [@Kate167](https://forum.mssociety.org.uk/u/Kate167)\ **Post date:** [29 September 2018 14:23 UTC](https://forum.mssociety.org.uk/t/positive-lumbar-puncture/13349/3 "2018-09-29T14:23:21Z")
Hi sue, Thanks so much for your reply. That’s what I mean, the MacDonald criteria states that dissemination in time can be either mri or lumbar puncture. So that’s why I’m confused. She’s a normal Neuro and didn’t believe it was ms until she ran all the tests, as she’d done a brain MRI the year before and that was clear. But she did run full brain and spine this time. Clear. But then it’s only a 1.5T. So who knows. I haven’t actually been back to see her after the lumbar results, she wrote me a letter (i didn’t book an appointment for the results as I thought it would be clear) and wants to refer me to an MS specialist. So he might be able to take a fresh look at my MRI’s. I’ve just got to wait to see what the MS Neuro says haven’t I… ---
**Author:** ![catwomanCarole58](https://avatars.discourse-cdn.com/v4/letter/c/e95f7d/32.png) [@catwomanCarole58](https://forum.mssociety.org.uk/u/catwomanCarole58)\ **Post date:** [29 September 2018 18:02 UTC](https://forum.mssociety.org.uk/t/positive-lumbar-puncture/13349/4 "2018-09-29T18:02:54Z")
the ms specialist is the person who can really help. good luck and i hope you don’t have to wait too long. ---
**Author:** ![Harebell](https://avatars.discourse-cdn.com/v4/letter/h/90db22/32.png) [@Harebell](https://forum.mssociety.org.uk/u/Harebell)\ **Post date:** [29 September 2018 21:01 UTC](https://forum.mssociety.org.uk/t/positive-lumbar-puncture/13349/5 "2018-09-29T21:01:44Z")
"Because MRI is particularly useful in detecting central nervous system demyelination, it is a powerful tool in helping to establish the diagnosis of MS. However, approximately 5 percent of people with clinically-definite MS do not initially show lesions on MRI at the time of diagnosis. If repeat MRIs continue to show no lesions, the diagnosis of MS should be questioned." from [https://www.nationalmssociety.org/Symptoms-Diagnosis/Diagnosing-Tools/MRI](https://www.nationalmssociety.org/Symptoms-Diagnosis/Diagnosing-Tools/MRI) This would indicate that a small number of people are diagnosed without definitive MRI lesions - on the basis of other indicative test results as you describe. I understand that areas of MS inflammation in the brain can sometimes resolve, ie they don’t always leave a permanently detectable lesion or scar visible on MRI. It will be interesting to hear the specialist’s interpretation of your results and whether they feel there is enough evidence to start a DMD or not. Sorry this means more waiting for you, though, it’s not easy. best wishes ---
**Author:** ![Kate167](https://avatars.discourse-cdn.com/v4/letter/k/d6d6ee/32.png) [@Kate167](https://forum.mssociety.org.uk/u/Kate167)\ **Post date:** [29 September 2018 22:38 UTC](https://forum.mssociety.org.uk/t/positive-lumbar-puncture/13349/6 "2018-09-29T22:38:09Z")
Thank you Harebell. Yes, it’ll be an interesting conversation with him. I shall post an update when see him. Of course, I had to be the small percentage of atypical patients, my life! 😉 Thanks for taking the time to reply to me. X