Doctor insights on:
How Can A Lumbar Puncture Diagnose Multiple Sclerosis
The lumbar part of the spine is the low back. It is made up of five bones (most of the time) stacked one on top of the other. They are connected by disks, facet joints, and ligaments. These soft parts allow for movement controlled by the spinal muscles; the muscles can also keep it stiff when need be. The lumbar spine also contains and protects nerves to ...Read more
Do you need it?: I will do lumbar puncture in pts who are not convincingly diagnosed using MRI images, and who may have alternative diagnoses. If your MRI is diagnostic, you do not need an lp. But you should be starting a disease modifying agent asap. See a neurologist and get a plan in place. Supplement vitamin d-3. ...Read more
Diagnosed by MRI.: Typically MS is diagnosed by mri, but in some patients may require a spinal tap or other specialized studies. These tests may include optical coherence tomography (oct) or visual evoked potentials (ver or veps). Symtoms include numbness and tingling usually on one side of the body starting in the hands and toes and progressing proximally. Weakness in the same distribution. Painful visual loss. ...Read moreSee 2 more doctor answers
What are the most determining symptoms of Multiple Sclerosis? What symptoms have to be present for doctors to diagnose MS?
MS?: Other symptoms exist. Refer to diagram, and please consult your pcp for referral to Neurologist if warranted following exam. ...Read more
ALS can be tricky: There is no specific test available to either rule in or out the diagnosis of als. There can definitely be mimickers of ALS and its diagnosis is not always that straightforward. It may take some time for all the clinical criteria to be met especially if it is early in the disease process. ...Read moreSee 1 more doctor answer
MRI DATA: The diagnosis is certainly based on history and exam, but the MRI is also confirmatory. We discuss "dissemination in time", with lesions emerging and disappearing on serial studies. Also, "dissemination in space", with lesions in different parts of brain and/or spinal cord. Location of lesions are helpful. If there is indication of active inflammation, this prompts aggressive therapy. ...Read more
LBD Clinical only: Neurodegenerative, progressive d/o with milder physical parkinsonism than parkinson's disease typically. (slowed movements, stiff/rigid muscles & posture, possibly resting tremor). But with early dementia, often with associated psychosis (visual hallucinations/delusional thoughts, excessive sleepiness, depression, anxiety, apathy, & rbd=rem behavior d/o, causing acting-out of dreams in rem sleep. ...Read moreSee 2 more doctor answers
How do you diagnose lupus? What is the difference between multiple sclerosis and lupus? Which disease causes tooth loss?
Does a head CT scan help diagnose multiple sclerosis? If a CT scan is normal, is it still likely that multiple sclerosis can be present?
Takes time to show: "Multiple lesions over time and space" is how med students learn about MS. It evolves over time. Sometimes subtle MRI findings can suggest it, but are non-specific ("unidentified bright objects"). But it can take a long time before MS presents itself. If seriously concerned, see a neurologist. ...Read moreSee 2 more doctor answers
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