Diagnosis not through MRI?
I now have three doctors (including my MS neurologist’s opinion) that I may have MS. My brain and cervical spine MRI appear normal but my symptoms and physical assessments show MS symptoms and all doctors say CNS difficulties. Experienced some mild symptoms for years but in July my right arm went severely numb, tingly and weak. Then my right foot, ankle and toes lost mobility and I experienced trouble walking and nerve pain with bursts of numbness. Then I had some trouble swallowing and blurred vision as well as frequent urination come and go over the course of a few months when symptoms were strong. Some symptoms felt like when I had shingles, but that was the opposite side of my body and I do not have a rash.
I am still undergoing McDonalds criteria. VEP and OCT next week. Then likely a lumbar puncture. Parkinson, lupus and Lyme disease have been ruled out. This diagnosis process is taking very long.
Curious if anyone got a positive MS diagnosis with normal brain and cervical spine MRIs.
Update Summer ‘25
OCT revealed an abnormal optic nerve in my right eye.
My thoracic MRI revealed that I have a rare hydrosyringomyelia syrinx between T3 to T5. Size: about 5 mm front-to-back, 4 mm side-to-side, and 40 mm (4 cm) long.
My portal alerted me to the results and now I have to talk to my neurologist to see if I should still get a lumbar puncture. Apparently this condition mimics the symptoms of MS and some people have both MS and a syrinx.
I'm actually sure, I don't know, but some shit about it is weird.
As you mentioned, McDonalds creteria of disseminated lesions in time and space is the standard. Bands in your spinal fluid can also be used if, say, you had only a few lesions but they couldn’t tell if they were all from the same time period. I personally have never seen a confirmed diagnosis without lesions. Me, for example, I have very few lesions in the brain but bands in my fluid from spinal tap and they still were resistant to give me a confirmed Ms diagnosis. However, if it is ms, getting on a good disease modifying treatment asap is linked to lower risk of disability progression over the long term. I would say get the lumbar puncture and it will help clarify. Best of luck and so sorry you are going through this.