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Thread: MRI question.

  1. #1
    Senior Member willingtocope's Avatar
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    MRI question.

    After 68 years, I've managed to do several things that could have damaged my spine, if not my spinal cord. Things like jumping off a moving freight train and landing on my neck...getting thrown up against a square post and hitting my spine...slipping on ice and landing on my back on cement stairs...having a severe muscle spasm while lifting weight that the doctor said elongated my spine.

    Is it possible to mistake whatever scars these things left behind for sclolera on MRIs?

    I ask because I've had 8 different neurolists look at the same images over the last 5 years. The inital 4 didn't see MS...the 1 from the Mayo did...and 3 after that said "oh, the Mayo says its MS, I see it".

    And, after 4-1/2 years of getting steadily weaker, I've kind of stabilized and may actually be experiencing a minor improvement.

    Since I've moved around a lot, I have no one doctor with an "eyes on" history, so I don't really have one I can talk this over with.

  2. #2
    sclolera?

  3. #3
    Considering the fact that you've had eight neuros (including one at Mayo), I'm assuming you've had at least one lumbar puncture. Scars/sclerotic changes of the cord can be related to physical trauma, but trauma doesn't cause immunoglobulins (specifically, more than one oligoclonal band and high IgG ratio) to be present in the cerebrospinal fluid. Oligoclonal bands can be seen with several neurological disorders, but they are considered especially suspicious for MS (being present in 80-90% of cases). They are markers for autoimmune myelin destruction and are not associated with externally caused trauma (according to my former neuro - I asked her the same question early in my MS course).

  4. #4
    Senior Member willingtocope's Avatar
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    I've had two lumbar punctures...about six months apart. First was done by a "traveling specialist from Univ of Iowa" at a small hospital in Iowa and sent to the Mayo for evaluation; the second at the Mayo. The first one was clear; the second reported "several" oligoclonal bands.

    But...I was told by neuro #4, who ordered the first puncture, that oligoclonal bands could also be the result of an infection that got past the blood/brain barrier, so, in his words, "its just one part of the puzzle".

    The Mayo (#5) dx'd PPMS. The resident expert in U of I (#6) said he thought it was more SPMS.

    The point is...I'm feeling, and doing, better. I haven't had an attack (low fever in afternoon, chills middle of the night, extreme spasticity until 6am, up and around at 8am) for at least since early July. They used to happen every 6 weeks. I stll can't walk very far, but I've lost a lot of weight that was mostly muscle. No new meds.

    What the hell is going on?

  5. #5
    Yes, oligoclonal bands can be associated with many disease processes. Their presence in the CSF is correlated with findings on clinical exam and test results to make a presumptive diagnosis. According to Timothy Vollmer, MD, an MS researcher at the University of Colorado, progressive MS often levels off after age 60. Maybe you have MS, maybe you don't - if you do, you may be experiencing age-related stabilization.

  6. #6
    Senior Member willingtocope's Avatar
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    I'm 68. I did not have ANY symptoms until 5 yrs ago. At age 63, I began having a slight foot drop. By 65, I was using a wallker and went to the Mayo. At 66, I was in a wheelchair to get around at work. I'm now working from home...in an assisted living facility. I use a walker to get around in the apartment, and a power chair when I go out to get mail.

    Last neuro I saw (#8) was in March here in the big city. He didn't look at the scans himself but started his examination with "oh, I see the Mayo says you have MS". He did order some blood work and when the results came back, he rx'd Vitamin D and B12...and refused to rx Clonezapam which I have been taking for 10 years or more (familial tremor). He suggested Clonezapam was no longer required so I should wean myself off. I have dropped from 3mg twice a day to 1mg at bedtime which may be related. I've also started taking Acetyl-L-Cysteine in July. The ALC only makes sense if you suscribe to what www.cpnhelp.org has to say.

    Otherwise, I'm baffled.

  7. #7
    PPMS (primary progressive MS) is most often diagnosed in middle age or later. While for some, it may "level off" with aging, that is not always the case. My mother was diagnosed at age 52 (in 1980) before MRIs. She had a slow but steady downward functional course for the rest of her life (she died in 2012). Within 2 years of diagnosis she was walking with a quad cane and bilateral AFOs, and within 4 years, with a walker. She started using a manual wheelchair out of the house within 6 years (and stopped driving), and by 10 years was using a power scooter, doing intermittent cath and a bowel program, and needing help with transfers. At 15 years post diagnosis she was in a power wheelchair, and my dad installed a ceiling track lift as the "quad pivot" transfers got too much for him. This is also about the time they bought their first ramp van because car transfers were getting to be too much. Along the way, she also started to develop both some cognitive deficits which continued to progress, and swallowing problems. She had one episode of optic neuritis that lasted about 4 weeks. By 20 years post diagnosis, she was unable to dress herself, do her own caths, or any of her other own care other than feed herself, and needed help with all her personal care. In the last two years of her life she had significant cognitive declines, and lost the ability to feed herself and use the computer. MS is a horrible disease.

    (KLD)

  8. #8
    Senior Member willingtocope's Avatar
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    KLD - So sorry about your mother...sounds like a bad ride all the way around.

    I recognize in the normal course of PPMS there may be some plateaus where symptoms do not worsen for some period, but the trend is always downward. My bewilderment comes from the fact that I seem to be improving. I'm certainly not back to "normal", but I am able to do things that I was not able to do 4 months ago.

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