Son with "lesions indicative to Multiple Sclerosis"?

Question

Approximately a month ago my son had two seziures with in 48 hours, the first one had visable signs of seizure activity & memory loss of the event. The 2nd one he had no visible seizure activity, but did have the after effects. We went to the ER on both times, have have blood tests done to rule out Lyme disease andHypoglycemia. He had a normal CT scan. Normal Sleep deprived and regular EEG. He had a MRI done that shows several lesions on his brain, which lead us to having a spinal tap done.

None of the specialists are giving us straight answers, one says it seems he has MS, another says he "probably has epilepsy". Our Family Dr definitely has reservations about the epilepsy, as she saw the 2nd episode for herself. What would you do? Where do we go from here? Need more information to give me some ideas, please feel free to email me.

OH I almost forgot, I have looked at all the symptoms that my son has on various websites, and they are all pointing to MS or MS-mimic diseases. If you go to the MS Society home page, my son has 10 out of 18 symptoms... and only ONE for epilepsy..

Ok, the specialists we have seen are neurologists, so far we have driven anywhere from 30 mins to 5 hours to see them.

Answer 1

First of all, is it possible that your son may have gotten Lyme disease more than a year ago? If so, the standard ELISA test done for Lyme will not show anything. If this is the case, you will need a Western Blot test performed. There's really only one good lab in the country that does this (IGeneX in Palo Alto) and they don't take any insurance, so you have to pay for the test out-of-pocket.

Second, some of the potential reasons that professionals are being thrown off the MS trail:

- Age. How old is your son? MS usually strikes between 20 and 40
- Uncommon symptom: Seizures in MS patients are very rare, and nearly match the rate of seizures in the general population, so with standard error thrown in, you can almost say that there is no increase in seizure rate for MS patients than in the general population. Seizures strikes about 2-5% of MS patients, where the incidence of seizures in the general population is estimated to be about 3%.
- inconclusivity: in order for a conclusive diagnosis of MS, clinically recognized symptoms include two indications disseminated by time and space with no other explanation. The two attacks need to be separated by at least one month. MRIs alone would need to show disease progression over time (so you'd need more than one, at least a month apart), and they would need to show Gd-enhanced T1 lesions, showing active lesion activity. You would also want to see two separate symptoms involved, representing different physical CNS systems. What you have is a MRI indicating a probability towards MS, and one (very rare) symptom. This would not be enough evidence to positively diagnose MS.

If the epileptic symptoms persist, they can be controlled very well with anticonvulsive medication like carbamazepine (Tegretol®) or diphenylhydantoin (Dilantin®). But I think it's too early in the process to positively diagnose any one disease.

Did you get results of the spinal tap? Were they positive? That would be another piece of evidence.

For now, I would say hang in there. As more symptoms present themselves, you'll get a better idea of what's going on.

Good Luck

Answer 2

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Answer 3

Have you seen a Neurologist? That would be your next step. He is the doctor who can give you a diagnosis. To find a good Neurologist in your area or in you state, go to the National Multiple Sclerosis Society on their website and they can refer you to a doctor. Remember, you want the best doctor that you can get, so if you have to drive a little to get there, do it. We drove 300 miles one way to see my sons Neurologist for over 3 years. Finally, a great doctor moved into our area and we only have to drive about 20 minutes, But, this close doctor knows that she is only the secondary doctor and that his first doctor will always make the major decisions. Best of luck to you!

Answer 4

Perhaps you can find a neurologist who has a great deal of experience with MS. It can be hard to diagnose. Contact your state MS society