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Does MS Always Have Lesions On MRI And Is It
Question: Does MS always have lesions on MRI and is it frequently associated with optic neuritis?
Brief Answer:
Almost always there are lesions on MRI, frequently associated.
Detailed Answer:
I read your question carefully and I understand your concern waiting for your MRI results.
MRI has a very high sensitivity for multiple sclerosis, meaning it almost always detects some lesion, with a sensitivity of about 94%. So a normal MRI almost excludes the diagnosis of multiple sclerosis, only in some very rare cases in the initial stages.
As for association MS with optic neuritis, yes, it is a common association. It often is the initial manifestation of MS, in about 20% of cases. In those where it has manifested with other symptoms first there is still about 50% chance of having optic neuritis at some time over the course of the disease. It similarly goes that patients who have an isolated optic neuritis have an about 50% chance of developing MS during their lifetime.
I remain at your disposal for other questions.
Almost always there are lesions on MRI, frequently associated.
Detailed Answer:
I read your question carefully and I understand your concern waiting for your MRI results.
MRI has a very high sensitivity for multiple sclerosis, meaning it almost always detects some lesion, with a sensitivity of about 94%. So a normal MRI almost excludes the diagnosis of multiple sclerosis, only in some very rare cases in the initial stages.
As for association MS with optic neuritis, yes, it is a common association. It often is the initial manifestation of MS, in about 20% of cases. In those where it has manifested with other symptoms first there is still about 50% chance of having optic neuritis at some time over the course of the disease. It similarly goes that patients who have an isolated optic neuritis have an about 50% chance of developing MS during their lifetime.
I remain at your disposal for other questions.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Thank you. I know they say no news is good news but it can be nerving waiting on MRI results. I’ve am undergoing treatment for optic neuritis and they are suspicious of a mild flame up last year that was diagnosed as something else.
Brief Answer:
Read below
Detailed Answer:
Thank you for the additional information.
It's understandable to be nervous. Hopefully nothing will turn out. One thing against MS would be your age, while it can manifest at any age, it is not typical after the age of 40. Anyway the MRI should clear it out, if there was a MS relapse already last year, MRI should show something by now, if negative you can be confident in its result. Even if it turns out to be MS keep present that there are many therapeutic alternatives and you should go on to live many healthy years with therapy.
Let me know if I can further assist you.
Read below
Detailed Answer:
Thank you for the additional information.
It's understandable to be nervous. Hopefully nothing will turn out. One thing against MS would be your age, while it can manifest at any age, it is not typical after the age of 40. Anyway the MRI should clear it out, if there was a MS relapse already last year, MRI should show something by now, if negative you can be confident in its result. Even if it turns out to be MS keep present that there are many therapeutic alternatives and you should go on to live many healthy years with therapy.
Let me know if I can further assist you.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
What are your thoughts for a B12 of over 2000?
Brief Answer:
Usually not significant, some tests may be done.
Detailed Answer:
Hello again! Sorry for answering a little late.
That value as I guess you know is much higher than the norm. If you are wondering whether it can cause any damage, the answer is no, high levels are not associated with any detrimental effect.
On the other hand a reflection on the cause is necessary. If you have been taking supplements whether as vitamin B12 alone or in the form of multivitamins it can be an explanation.
Some liver and kidney conditions may also alter vitamin B12 levels but I suspect you have had blood tests for liver and kidney function. Some blood malignancies may be a cause but they cause marked changes in blood count tests and I would assume you've had such routine tests as well.
Another cause would be genetic traits influencing absorption or transportation and usage of Vit B12.
What I would advise would be to repeat the test in a couple of weeks. If you've been taking supplements would interrupt them during this time. If second test normal no need to do anything.
If still very high then would advise two tests which check how much B12 is available and used by body cells as even with high levels there may be a deficiency of vitamin B12 available to the cells when there are genetic metabolic defects in the transporting proteins which introduce it in the cells. The two tests would be methylmalonic acid in urine and HoloTC blood test which evaluate the products of its metabolism in the urine and the B12 attached to transporter respectively.
Usually not significant, some tests may be done.
Detailed Answer:
Hello again! Sorry for answering a little late.
That value as I guess you know is much higher than the norm. If you are wondering whether it can cause any damage, the answer is no, high levels are not associated with any detrimental effect.
On the other hand a reflection on the cause is necessary. If you have been taking supplements whether as vitamin B12 alone or in the form of multivitamins it can be an explanation.
Some liver and kidney conditions may also alter vitamin B12 levels but I suspect you have had blood tests for liver and kidney function. Some blood malignancies may be a cause but they cause marked changes in blood count tests and I would assume you've had such routine tests as well.
Another cause would be genetic traits influencing absorption or transportation and usage of Vit B12.
What I would advise would be to repeat the test in a couple of weeks. If you've been taking supplements would interrupt them during this time. If second test normal no need to do anything.
If still very high then would advise two tests which check how much B12 is available and used by body cells as even with high levels there may be a deficiency of vitamin B12 available to the cells when there are genetic metabolic defects in the transporting proteins which introduce it in the cells. The two tests would be methylmalonic acid in urine and HoloTC blood test which evaluate the products of its metabolism in the urine and the B12 attached to transporter respectively.
Above answer was peer-reviewed by :
Dr. Raju A.T
Thank you
Brief Answer:
You're welcome!
Detailed Answer:
You're welcome!
You're welcome!
Detailed Answer:
You're welcome!
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
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