About 5 percent of people who are confirmed to have MS do not initially have brain lesions evidenced by MRI. However, the longer a person goes without brain or spinal cord lesions on MRI, the more important it becomes to look for other possible diagnoses.
While it is true that almost all people with MS will have evidence of brain lesions on MRI, not all people with brain lesions have MS.
MS can be present even with a normal MRI and spinal fluid test although it's uncommon to have a completely normal MRI. Sometimes the MRI of the brain may be normal, but the MRI of the spinal cord may be abnormal and consistent with MS, so this also needs to be considered.
These include fibromyalgia and vitamin B12 deficiency, muscular dystrophy (MD), amyotrophic lateral sclerosis (ALS or Lou Gehrig's disease), migraine, hypo-thyroidism, hypertension, Beçhets, Arnold-Chiari deformity, and mitochondrial disorders, although your neurologist can usually rule them out quite easily.
Some conditions that doctors may commonly misdiagnose as MS include migraine, RIS, spondylopathy, and neuropathy. To accurately diagnose MS, doctors must rule out conditions with similar symptoms and look for signs and symptoms specific to MS. As such, the process of diagnosing MS may be lengthy and complex.
Sjogren's syndrome is an autoimmune disease that can mimic some of the symptoms of MS such as fatigue and joint pain.
MRI is considered the best test to help diagnose MS. However, 5% of people with MS do not have abnormalities detected on MRI; thus, a "negative" scan does not completely rule out MS. In addition, some common changes of aging may look like MS on a MRI.
In primary progressive MS, symptoms would be expected to have a gradual and insidious onset over at least 12 months by the time of diagnosis. A common first presentation of RRMS is with unilateral optic neuritis characterised by gradual onset monocular visual loss, pain on moving the eye and altered colour vision.
People should consider the diagnosis of MS if they have one or more of these symptoms: vision loss in one or both eyes. acute paralysis in the legs or along one side of the body. acute numbness and tingling in a limb.
In 5 percent of the people showing clinical MS disease activity, lesions were not visible on the MRI. However, if follow-up MRI studies continue to show no lesions, the MS diagnosis should be reconsidered.
Contents. Multiple sclerosis (MS) is a condition that can affect the brain and spinal cord, causing a wide range of potential symptoms, including problems with vision, arm or leg movement, sensation or balance. It's a lifelong condition that can sometimes cause serious disability, although it can occasionally be mild.
MS activity appears on an MRI scan as either bright or dark spots. Typical MS lesions tend to be oval or frame shaped. MS lesions can appear in both the brain's white and gray matter. Healthcare professionals may use a chemical contrast dye called gadolinium to improve the brightness of MRI scan images.
About 5 percent of people who are confirmed to have MS do not initially have brain lesions evidenced by MRI.
It is also known as neuromyelitis optica (NMO) or Devic's disease. Some of its symptoms are similar to the symptoms of multiple sclerosis, so it may be misdiagnosed as such.
If you've gone some time without relapses, or your MRI scans show no new or growing lesions, then your neurologist might describe your MS as 'not active'. That doesn't mean you have no symptoms – you might still have some left over from earlier attacks on your nerves. And it doesn't mean your MS has gone for good.
Neurological examination
Your neurologist will look for abnormalities, changes or weakness in your vision, eye movements, hand or leg strength, balance and co-ordination, speech and reflexes. These may show whether your nerves are damaged in a way that might suggest MS.
Signs and Symptoms
Characteristic lesions are located in the periventricular and juxtacortical regions, in addition to the brainstem, cerebellum, spinal cord, and optic nerve.
Answer: You can certainly have a normal neurological exam and still have multiple sclerosis.
Some of the most common mimics include migraine and chronic cerebrovascular disease, according to Dr Schiess. Vasculitic autoimmune diseases such as systemic lupus erythematosus (SLE) and Sjögren's syndrome can also result in white matter abnormalities on MRI.
MS can occur at any age, but onset usually occurs around 20 and 40 years of age.
MRI has greater than 90% sensitivity in the diagnosis of MS; however, other white matter diseases can sometimes have a similar appearance on medical imaging.
Now, a study led by Stanford Medicine researchers has proved that the Epstein-Barr virus, a common type of herpes virus, triggers multiple sclerosis by priming the immune system to attack the body's own nervous system.
Nail problems are common, and they are not usually serious. If a person has multiple sclerosis (MS), nail problems can cause pain or discomfort. While nail issues are not directly related to the disease, determining the cause may help prevent a person with MS from experiencing further discomfort.
But despite some similarities, “for the most part, there is no mistaking symptoms of MS with fibromyalgia,” says Philip Cohen, MD, a rheumatologist, professor of medicine and professor of microbiology and immunology at the Lewis Katz School of Medicine at Temple University in Philadelphia.