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Dr. Andrew Rynne
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Dr. Andrew Rynne

Family Physician

Exp 50 years

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Had Optic Neuritis But No Brain Lesions. Abnormal Spina Tap. MRI Showed Lesions. Multiple Sclerosis?

Hi, Im in what they call a holding pattern for ms. In 2001 i had an optic neuritis with no lesions on the brain. The doctor then said he couldnt diagnose me with ms because their were no lesions on the brain but to watch for symptoms because I could develope ms. In 2005 my vision kept blurring in and out.. eye doctor said it wasnt from because my script changed. In 2010 i started feeling light headed and the blurry vision returned. I had abdominal pain starting in 2011 , muscles in legs started to become stiff along with the light headed and vision problems. So I went to the gi who said it could be MS but because celiacs ran in my family he tested for that. That came back positive so I went on a strict gluten free diet hoping I would feel better. The doc also did a transient bowel test which showed my nerves in the bowel werent working. Sign of ms? In may of 2012 i came down with vertigo numbness in my hand and leg on the left side. I had an mri of the brain which showed 6 lesions 3 on each side of the brain. They were consistent with the mcdonald theory but not ms specific in the way they were shaped. So I had a spinal tap I only had 1 oband... My ssep came back abnormal which showed slowing in the thoracic spine . Mri was negative in that area... Blood work pretty much ruled out everything else. Dont I have enough to show that it is ms? I had alot of cis episodes... Thanks for reading.... Lisa
Mon, 13 Aug 2012
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Neurologist 's  Response
Hi Lisa,

Thank you for writing to us. Based on the description of your symptoms and clinical course, the most likely diagnosis is multiple sclerosis. I agree in 2001, it was not possible to classify you as MS. Also, if one only has recurrent optic neuritis without involvement of brain and spinal cord, it can not be called as MS (there is an entity called as recurrent optic neuritis). Also, if one has spinal cord involvement and optic neuitis (with normal brain), it could be NMO (neuromyelitis optica).

Best wishes,

Dr Sudhir Kumar MD DM (Neurology)
Senior Consultant Neurologist
Apollo Health City, Hyderabad
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Had Optic Neuritis But No Brain Lesions. Abnormal Spina Tap. MRI Showed Lesions. Multiple Sclerosis?

Hi Lisa, Thank you for writing to us. Based on the description of your symptoms and clinical course, the most likely diagnosis is multiple sclerosis. I agree in 2001, it was not possible to classify you as MS. Also, if one only has recurrent optic neuritis without involvement of brain and spinal cord, it can not be called as MS (there is an entity called as recurrent optic neuritis). Also, if one has spinal cord involvement and optic neuitis (with normal brain), it could be NMO (neuromyelitis optica). Best wishes, Dr Sudhir Kumar MD DM (Neurology) Senior Consultant Neurologist Apollo Health City, Hyderabad