Hi All
My husband attended his long awaited Neuro apointment this afternoon at Walton Neuro Centre. We saw a really lovely Doctor Holt, who really made us feel at ease. My husband went through masses of physical examinations and in total we spent about an hour in consultation with the Doctor.
The Doctor has said that he is ‘90% sure’ that my husband has Progressive MS and we are to be sent an apointment to have a ‘Deep Mri’ done to confirm the diagnosis and to rule out the possibility of some form of tumour on his spine. He is also writing to our GP to arrange for my husband to have some form of physio to help with his mobility issues.
I have read other people’s posts on the forum and have noticed that people say that Neurologists very rarely give any form of diagnosis without being 100% certain. Can the Neuro tell that it is Progressive MS without an MRI? Is it unusual to be told that they are 90% sure of what the problem is? Can they know just from phsical exams?
How helpful will physio be?
Do the Lesions associated with Progressive MS show up any more readily than relapsing or remitting ms?
Handbagx
Hello Handbag!
From what I know your neuro has diagnosed ‘possible or probable PPMS’ on the clinical signs he wuld have picked up during the examination and your hubby’s medical history. He will however need the MRI to take him from 90% sure to 100% sure - and of course as he says he needs to rule out other things x
I would try the physio - it does help for lot’s of people x
xxjenxxx
Very pleased to hear that you had such a productive appointment 
As Jen says, your husband’s history, symptoms and clinical exam results will have been enough for the neuro to be confident, but it’s never straightforward to diagnose a neurological condition and there are some brilliant tools around now so they do like to check their thinking out with at least an MRI.
If anything, people with PPMS (primary progressive MS) tend to have fewer brain lesions than people with RRMS (relapsing remitting MS) and SPMS (secondary progressive MS), which is one of the reasons why there is a slightly different set of criteria to diagnose PPMS. This is because there are two main processes going on in MS: one is more associated with relapses and causes the patches of inflammation and damage that are picked up on MRI as lesions and one is more associated with progression, but happens at a much more micro level and so isn’t easy to see on MRI.
If you didn’t already know, these are the McDonald diagnostic criteria for PPMS:
- One year of disease progression (looking back or extrapolating from what is known to date, normally at least 6 months)
Plus two of the following three:
a. At least one lesion in at least one area of the brain typical of MS
b. At least two lesions in the spinal cord
c. A positive lumbar puncture.
So, if the MRI isn’t conclusive, you can probably expect a lumbar puncture as a next step. This sounds very much worse than it is btw!
I hope the MRI appointment comes through soon.
Karen x
Hi, dunno if you`ve read any of my posts.
I had all the clinical presentation of PPMS for ages.
4 MRIs, 2 LPs, 2 EMG tests showed no evidence of PPMS.
Between 2003 and 2010 I was told I had a 95% dx of PPMS. PPMS is often very hard to detect on tests.
It has recently been decided that I defo do not have MS.
My diagnosis is Spastic Paraparesis, cause unknown. it may turn out to be hereditary.
Does your oh have an family with similar problems to him?
PM me if you`d like more info.
luv Pollx
Hi All thanks for your replies… sounds like we have a long way to go yet… just as I felt we were getting somewhere 
Still always good to have a reality check
Poll there doesnt appear to be anything even remotely similar to my husbands symptoms in the family .
Hi Handbag My MS specialist dx’d me without an MRI. I had positive VEPs and a positive LP but was very claustrophobic so was sent for a CT scan. This proved to be inconclusive but with the clinical exam the neuro was confident that I had PPMS. Teresa xx