can a diagnosis of ms be made.....?

Question

if the neurological exam shows 'signs' and the neurologist suspects demyelination, 2 attacks in the past year (both characteristic of MS), female sex 18 years old, no lesions on mri and negative spinal tap? (and the symptoms cant be explained by any other condition)

I'm just a bit confused by all the diagnostic criteria out there

Answer 1

From what I know, no lesions and negative spinal tap, no MS. Let's hope I'm right. And yes, it is very confusing!

I've had lots of weird symptoms and was convinced I had MS; I have five brain lesions but they are not in the right place for MS. I do, however, have chronic fatigue syndrome.

From Wikipedia:
Multiple sclerosis is difficult to diagnose in its early stages. In fact, definite diagnosis of MS cannot be made until there is evidence of at least two anatomically separate demyelinating events occurring at least thirty days apart.

Historically different criteria were used. The Schumacher criteria and Poser criteria were both popular. Currently, McDonald criteria represents international efforts to standardize the diagnosis of MS using clinical data, laboratory data, and radiologic data.[6]

Clinical data alone may be sufficient for a diagnosis of MS. If an individual has suffered two separate episodes of neurologic symptoms characteristic of MS, and the individual also has consistent abnormalities on physical examination, a diagnosis of MS can be made with no further testing. Since some people with MS seek medical attention after only one attack, other testing may hasten the diagnosis and allow earlier initiation of therapy.

Magnetic resonance imaging (MRI) of the brain and spine is often used to evaluate individuals with suspected MS. MRI shows areas of demyelination as bright lesions on T2-weighted images or FLAIR (fluid attenuated inversion recovery) sequences. Gadolinium contrast is used to demonstrate active plaques on T1-weighted images. Because MRI can reveal lesions which occurred previously but produced no clinical symptoms, it can provide the evidence of chronicity needed for a definite diagnosis of MS.

Testing of cerebrospinal fluid (CSF) can provide evidence of chronic inflammation of the central nervous system. The CSF is tested for oligoclonal bands, which are immunoglobulins found in 85% to 95% of people with definite MS (but also found in people with other diseases).[7] Combined with MRI and clinical data, the presence of oligoclonal bands can help make a definite diagnosis of MS. Lumbar puncture is the procedure used to collect a sample of CSF.

The brain of a person with MS often responds less actively to stimulation of the optic nerve and sensory nerves. These brain responses can be examined using visual evoked potentials (VEPs) and somatosensory evoked potentials (SEPs). Decreased activity on either test can reveal demyelination which may be otherwise asymptomatic. Along with other data, these exams can help find the widespread nerve involvement required for a definite diagnosis of MS.[8]

Another test which may become important in the future is measurement of antibodies against myelin proteins such as myelin oligodendrocyte glycoprotein (MOG) and myelin basic protein (MBP). As of 2007, however, there is no established role for these tests in diagnosing MS.

The signs and symptoms of MS can be similar to other medical problems, such as neuromyelitis optica, stroke, brain inflammation, infections such as Lyme disease (which can produce identical MRI lesions and CSF abnormalities[9][10][11][12]), tumors, and other autoimmune problems, such as lupus. Additional testing may be needed to help distinguish MS from these other problems.

Answer 2

I'm not real familiar with MS but, my niece was just diagnose with it after three years. She just now showed on the MRI's the white lesions in the brain.

We were judging her with everything from a druggie to something she ate.
She would come home and sleep for hours, she would pass out for no reason. She couldn't walk, or see at times.
We were wondering about her taking drugs. They couldn't find anything wrong for almost three years. Now, it's all showing up.
I can only tell you what I know here.