Will MRI on brain only be sufficient if I have MS?

New diagnosis and before diagnosis
1

Hi all,

I apologise in advance if I am not posting in the correct place, but I have never used a forum before so I’m new to all of this!

The main purpose of my reaching out on here is to ascertain whether MS is likely to show up on an MRI of the brain only? Or would they need to do the spinal cord too in order to make a formal diagnosis? I understand that the immune system attacks the myelin sheath randomly so lesions could show up on the brain and spinal cord, but would the likelihood be that if it was MS something would show up on a brain scan?

A little background information…

I have hypothyroidism and have recently been told that this is due to Hashimoto’s. My TPO antibodies were apparently “through the roof”. I have suffered for many years with extreme fatigue which I have generally put down to my hypothyroidism or lifestyle factors such as pregnancy, lack of sleep, stress etc. I have done a lot of research on Hashimoto’s so understand that it can cause a whole range of symptoms. However, over the last twelve months in particular, it really feels as though there is something else going on. I have the most awful sensations down the one side of my body, particularly in my arm/hand and leg/foot. The GP suspected Carpal Tunnel or Coeliac Disease but tests have ruled both of these things out. I struggled tremendously with these sensations during the hot weather we had this year. When I look back, I have gradually become more and more uncomfortable in hot weather, to the point that this year I barely went outside during the summer months! In addition to the sensations, the heat just wipes me out and I can barely function.

In addition, I have been suffering with various bladder issues; often with an over active bladder, particularly at night, but also with the feeling that I haven’t emptied my bladder properly, or the feeling that I need to “go” but when I get there hardly anything comes out. I have also struggled to get the loo at times and the urge can come on from nowhere!

I have also found that I am often stumbling and losing my balance and my cognitive functions are appalling. I struggle to recall the most simple things and generally cannot think straight. I have also noticed that I occasionally slur my speech or can’t get my words out.

The fatigue is, at times, crippling and this usually coincides with a flare up of the symptoms mentioned above.

I understand that no one can diagnose on here or offer medical advice, but I am wondering if anyone else had similar issues prior to diagnosis? I feel the neurologist seemed quite dismissive of MS and really referred me for the MRI to rule out anything more sinister. As I am sure you will all understand, I struggle on a daily basis and whilst I don’t want to have a chronic illness, I feel desperate for answers so that I can take steps to help myself. I’m so worried that I should be having an MRI on my spinal cord and something will get missed and I will be left in limbo again.

Apologies for the long post and thanks in advance if you got this far! Any experiences, suggestions or pointers will be gratefully received.

Tia

2

hi tia

don’t worry about it being a brain only mri.

it’s definitely enough for a diagnosis.

i had to google hashimoto’s and it sounds awful.

get an appointment with the bladder and bowel clinic.

they will show you how to self catheterise and, if needed, will supply tena pads.

hope you get satisfaction from your appointment with the neuro.

carole x

3

Hello Tia

Have you had already had an MRI of your brain that’s negative? Or has the neurologist just referred you for one? (Sorry, just a bit unclear!)

An MRI of the brain can be all that’s needed for an MS diagnosis. But if you’ve had a clear brain MRI, but still have symptoms, it’s possible that there are demyelinating lesions on the spine alone.

Although, as you’ve got cognitive/memory and speech problems, I’d expect these would show on a brain MRI (not that I know anything much about MRI and the likelihood of where lesions would be for various symptoms, just a general belief).

What I would say is that the neurologist can often tell from a physical examination whether you have reflexes typical of MS. Although this isn’t infallible.

So if you’ve had a clear MRI and the neurologist doesn’t think you’re presenting as MS, it’s probably not MS. But if you’re currently waiting for your brain MRI, or the results of it, then that would possibly be sufficient to either rule MS in or out.

This is obviously just my opinion. I could be wrong, lots of people have a clear brain MRI but lesions on the spine. What I would do is ask the neurologist what the chances are that you could still have MS with a clear brain MRI, given your particular symptoms and examination.

Meanwhile, as Carole said, you can get help with your bladder issues without a diagnosis of MS. Ask your GP for a referral, or search for the local bowel and bladder service and see if you can self refer.

Sue