Dr Brandon, thank you for another excellent video. I am almost 55 and was diagnosed a little over four years ago but I never had a spinal tap. They didn't think it was necessary for the diagnosis. I'm going to revisit this subject with them again for my own peace of mind. Thank you again and have a great day.
spinal taps are performed less and less over the years which I think is actually appropriate given advances in MRI. If someone has lesions typical of multiple sclerosis in the brain and spine and a history and exam consistent with MS, I don't think it is necessary. Basically, I would recommend a spinal tap in a situation where a spinal tap without oligoclonal bands unique to the cerebrospinal fluid would convince me that the person likely does not have MS.
Honestly I thought this before I even went back to the neurologist to go over my MRIs. The spots on mine are very tiny small circles and they look like a migraine MRI. I had to bring to his attention migraines and how my symptoms are coming from migraines. Also you don't always have head pain with migraines. Mine make me lightheaded and sensitivities to light. I have bad anxiety which is no good for anything and also going thru alot of stress! I was told at age 16 I would have MS diagnosed at 19 and haven't been on any MS medicines. I'm 32 now and just recently got back into the neurologist to make my primary doctor happy! I've never had any issues! Just recently been having some light sensitivity and lightheadedness. I just don't believe it and I refuse to.
I agree with her! If you can see a ms specialist- do it! My first neurologist told me I didn't need a spine mri that ms isn't in the spine. Which didn't make sense how I had in my brain and neck and why do they do spinal taps If not in spine? Just seemed off. So I switched and the first thing he questioned me on was where was my mri for thoracic spine. I believe she's a good Dr. She's obviously incredibly intelligent but I don't think neurologists all really know ms . I'm wondering what are those specific qualifications to be labeled ms. I know a lady was told they are pretty sure she has ms from all her symptoms but can't give diagnosis off of 3 brain lesions. I was diagnosed with 4. These poor people suffering because they can't get a diagnosis Thanks again Dr B!
I have interesting symptoms, very similar to MS. I have been diagnosed with MG. I do have migraines (since 18 yrs old). I have white spots on the brain, but it's not at the actual areas where it would be MS and I have one "O" band in my spinal fluid and was told I need 2 or more "O" bands. It's frustrating. All my family members were jumping for joy and I'm stressing more than ever, because I don't know what is happening to my body. I went to an MS specialist at Stanford (Dr. Kipp) and I totally trust him and the fact that I do not have it.
She is being nice and I could not agree with her anymore. I actually just left a message for her for the study. I would love to help any way I can. She is one of the Drs who is not only highly educated she was blessed with commonsense to connect the dots whether you have MS or Not.
Finding live parasites in the central nervous system of MS patients at time of death is a very significant finding that is not getting enough attention. Please share this research with MS groups and practitioners so together, we can bring much needed change to the way MS is treated.
I’ve met many people with MS (and other diseases) who have become “invested” in their disease. For some people it’s quite a frightening thought to imagine getting well suddenly and having to re-enter their old lives. It can have huge implications…such as receiving less support from family, friends, insurance, government payments etc. Caroline Myss broaches this phenomenon in her books.
This is disguised disablism. Please bring forth all these people with MS or other diseases that would not give anything for their renewed freedom in exchange for governmental or social support? Do you live with one of these diseases?
when I was diagnosed I had had an episode of numbness on the left hand side of my body. This numbness and then tightness in arm and leg along with feeling a little light headed, lasted a few days with varying intensity. On the first day of the symptoms though, I had severe muscle weakness or lack of balance (unsure) on that left side for just about 1 hour or 2 (left side felt like a rag doll but could push or hold onto things just not stand or even kneel because I would get thrown to that left side as if it weighted a ton (I didn’t feel it heavy at the time). I went to ER and initially they suspected stroke but after mri I was diagnosed with MS. It bothers me a bit but this part of just momentaneous lack of balance remains unexplained (and nobody seems to mind too much). Eventually they said that, maybe, because I had quite a bit of inflamation on the brain, that could have cause some other symptoms at the time apart from those of the ms lesions. What do you think? I seem to check lots of boxes for the ms diagnoses so not doubting it but I worry that we miss anything else.
I cannot believe there are people wanting to be diagnosed with MS. Every time I go to the Dr ask him if It could be something else. I had to force him to do a Lyme disease test. Thanks Dr B!!
People want an explanation for their symptoms, even if the diagnosis is unfavorable. Imagine having daily disabling symptoms only to have doctors say, "There's nothing wrong with you."
I had three neurologists look at my MRIs before I started my DMT. I had blood tests and a spinal tap too. I figured that was enough to be sure...but now I'm wondering...
I think it's just wishful thinking though. All my tests had indicators. But since my first flare ups early this year I feel completely normal. It's strange feeling normal but knowing I could flare up again.
MS checked so many boxes for me. My mri, was very cryptic to me, spots but no lesions, masses or swelling. Not MS a second opinion would say, but offer no opinion beyond that, for a cash customer. A fabulous neuro-immunologist would eventually see me, SFN, nutrient deficiencies and Gastroparesis were pretty simple diagnosis for her, The components she missed before my insurance lapsed, excessive vomiting also allowed my already thinning and degenerated disks to aggravate my paresthesia and my new endocrinologist would do a CIMT finding 87% carotid stenosis in both bulbs causing my confusion, muscle weakness, fatigue and eye problems among other symptoms? I think
Glad it was helpful. Hopefully we are not scaring too many people with MS into thinking they are misdiagnosed. The 18% figure is probably higher than reality in most areas.
I never had a spinal tap..... Symptoms were double vision. They did blood work and said it could be myasthenia Gravis which huh (rare eye disease) then an mri which showed white spots. Now.....I want to get a second opinion. It happened all to fast
Hello! Came across the vid late..hope ur doing well..do u mind me asking did drs. Every tell u that white lesions can look the same but have different diagnosis? Im wondering how they can differentiate is it the location or shape or? I personally have MS but and b12 deficiency..i do get migraines too but i dont know if they show on mri
@@lararose9106 hello there, so MS also can cause headaches that are like migraines, but that’s my concern too, so it’s been 10 years that I think of it as just a migraine. Because migraine can cause symptoms like MS. Tingling, weakness, pain, vision problems. So I’m not sure. But we are strong enough to handle anything ♥️♥️
@@samarsafavi7403 hello! God bless u true we cant tell sometimes if its from ms or migraines i feel drowsy and nauseous all the time extreme fatigue like im going to pass out..i hope ur well🙏 yes we r fighters no matter what💃😊
@@samarsafavi7403 do u mind me asking r u on a dmt? And how has it been for u? I was diagnosed last year and not on a dmt..not doing so well now going through some infections and a major relapse..i wish u health and send u my prayers❤️🙂
That’s disgraceful. I normally read that happens with older doctors who are basically set in their way and Apparently know everything. I am newly diagnosed this year and my doctor who is basically the same age as me went through each Scan and asked me to point things out and went over each spot. With my follow up MRI she told me that her and the radiologist go back and forth and tend to not really agree. I hope you can find a better Neuro if possible.
@@monicamar8616 I no longer see a neurologist. I was unimpressed and sought an alternative. I accessed a different treatment through a vascular specialist which worked, so I’ve not had symptoms in years.
I haven’t had a relapse in years, never took the MS drugs, (only LDN) so I don’t even bother to see a neurologist anymore. I figured what’s the point? I will either stay stable or get worse but I don’t want the MS drugs.
They funded this on my mri A few small foci of T2 and FLAIR hyperintensity are seen in the deep and subcortical white matter, which are nonspecific in appearance and may reflect complicated migraines, early microvascular ischemic disease, sequela from prior traumatic or inflammatory insults No abnormal intracranial vascular flow void is noted. The visualized paranasal sinuses demonstrate mild scattered mucosal thickening But till now I don’t have no diagnostic of anything a having lips drooping right side little bit of wicked headache I don’t know what else to do 😢
Interesting. Not that anyone (at least I would hope not) would want a diagnosis of MS, for those that know something is truly wrong, it can be a relief. I personally am one of those people. My story is unique and one that I won’t share in full detail here, but I feel it is important. It took me five years and five neurologists prior to getting an official diagnosis. I didn’t fit the McDonald criteria 19 years ago and was diagnosed based on the Poser criteria. Positive evoked potentials, space and time between relapses, and neuro exam. Sometimes not everyone is going to be a textbook case and it needs to be approached as thinking outside of the box. I appreciate new research and more ways to definitively diagnose, however one should always absolutely make sure prior to taking away a diagnosis as well. Just thoughts from a unicorn 🦄.
deep video ..... i hear so meny pele bring up migraines being only a few hours causing symptoms and thts enough to dismiss ms symptoms ... but what happens if someone has ms and migraines lol i mean woudlent that mean there ms symptoms would be pesudo exsaterbated also along sonde the migriane symptoms ..... same with people with panic disorder ms and migraines ... coudlent they all cause the other symptoms to flair .....my MRI is not typical typical of ms manly cuz some of my lsins are considered linear to some docs mainly as i don't have spinal cord lisons or otic nerve lisons i do have lisons on the outside of my corpus callosum and vetricals touching called dawson fingers an dis the main reason they gave me my ms diagnosis along side having ms symptoms show up for days then subsiding ... but also have a lot of pesudo symptoms that last only a few hours during a migraine attack but its the ms symptoms that mimic and show up ...... no to mention i have intermedeate uveitus and 4 others in my immediate fam with ms .... so this video really made me think as really i get confused on the trying to dismiss symptoms caused by migranies or panic disorder as dismissing ms ..... as i have all of these illnesses and i can tell they all flair around the same time with the same symptoms but the panic disorder and migraines only last less then 24 hours ... and i know i have ms as last july i had a relpase that made me start to use a cain for like 6 mouth till physical therapy helped me get streghth back lol now everytime i over heat have panic attack or migraine ill need my cain but that only started after i ad the ms attack that landing me in the hospital agen ..... but even then my inflammation was small and only a coulp of my lisons grew during the attack .... ms is such a complicated illness and runs deep in my fam even out side my intermedeate fam of me my mom and older sisters my mom had an uncle with ms and a cusion ....runs deep lol
This is a timely subject! After being diagnosed with MS 10 years ago my latest MRI looked so much worse that I was sent to a MS specialtist (2 hours away). They don't think I have MS after all! I'm being re-tested for all the things that make up neurological alphabet soup. Enough bloodwork to satisfy all the vampires in Transylvania, VEP (again) and now genetic testing! Cadasil this time. It's been a whirlwind of hurry up & wait...
Hello! I came across ths video late! I was diagnosed with MS last year. Im not on Dmts because im not willing to take risks of serious malignancies and infections. I already have a weak immune system and not functioning well. Im using a cane already. Im going through a serious relapse now and because ive had 4 infections ths month im very dizzy and weak and in a wheelchair. Do u mind me asking would i benefit from a vascular specialist and how they helped u improve? I do have migraines but drs. And vit b deficiency but drs. Only focus on the ms part. Bless u and hope ur doing great😊
What other diseases should one look into if they have MS like symptoms? I have had multiple CT scans and had a full set of MRIs. The nureologist didn't have any answers for me. Blood work and urine came back clean. He wasn't an MS specialist but I think he would have noticed lesions. But I get migraines on a weekly bases so those would have shown up as well? Gave up on being diagnosed for while but symptoms are getting worse. Looking to start up on a diagnosis again. It's just so exhausting.
It would be impossible to give you advice without knowing more details, but if you take a look at her article and scroll down to table 2, you can find some of the most common alternative diagnoses: www.clinicalkey.com/#!/content/playContent/1-s2.0-S2211034819300483?returnurl=https:%2F%2Flinkinghub.elsevier.com%2Fretrieve%2Fpii%2FS2211034819300483%3Fshowall%3Dtrue&referrer=https:%2F%2Fpubmed.ncbi.nlm.nih.gov%2F
@@DrBrandonBeaber thanks for answering questions, its very helpful! One followup, on an MRI can lesions show up without contrast? Also can lesions repair enough over time to where they're hard to see on a non-contrast mri (i.e. 3 years after an episode or relapse)? Just wondering because I only had my mri done about 3 years after I had my second episode.
Can you have only spinal lesions ? And can your mri only say diffuse dymelation. On cervical and thoracic area . But no lesions ? Mri brain very small lesions not enough for ms on brain ?
I have a video on NMO, and if you go to 14:00, I talk about difference between MS and NMO. Some of the key diagnostic tests are antibodies (anti APQ4/ anti MOG) and the MRI of the brain.
Some people with lupus can have cerebritis or vasculitis. Usually, the lesions on MRI are not typical of MS. Here is an example of lupus cerebritis from radiopaedia: radiopaedia.org/cases/lupus-cerebritis-2?lang=us A positive ANA is fairly common in the general population, but it can be a helpful test. Many people with neurological manifestations of lupus have sigs of systemic lupus (skin/kidney/joint disease). Some people with lupus can have personality changes or even psychosis (neuropsychiatric lupus) but may have a normal MRI brain.
@@allisonphillips-zabelin1710 A positive ANA is not associated with MS. As far as I know, people with MS have an equal probability of a positive ANA as the general population.
An MRI or an scan are tests that really prove whether the patient has MS or not, right? Just a question, can a patient be rightly DX with MS, but in a wrong way? I mean, maybe the DX is worse, but the symptoms are actually due to something else?
Part of it is cost of the software. The other problem is that right now neuroquant doesn't help with the diagnosis of MS, but perhaps in the future, the software could include the ability to look for the central vein sign.
Yes. Approximately 90% of people with MS have 2 or more oligoclonal bands in the cerebrospinal fluid which are not in the blood. However, a very large number of people in the general population have subcortical white matter lesions on MRI which are not typical of MS. You may appreciate this video: th-cam.com/video/GNnba5HVvdY/w-d-xo.html
Hmm.. interesting. I'm going to have another spinal tab to confirm my diagnosis. After my 3rd grade AV Block and the possibility of mini strokes. I asked for a re-evaluation. Are ogliconal bands a good marker or I could have ogliconal bands with cerebrovascular events? Also, will Neurofilament blood test be helpful with this? Or it could be high with migraines and the other diagnosis as well?
Generally speaking, microvascular disease would not be associated with OCBs in the spinal fluid. For certain diseases such as primary CNS angiitis (which can cause strokes), OCBs could be present. I am publishing a video on serum neurofilament next week, but it is not helpful for diagnosis because it is elevated in many diseases (not migraine but any disease with CNS injury).
If misdiagnosed with MS and you are treated with steroids will your symptoms remain if you dont have MS? If diagnosed with MS and steroids and our symptoms subside can you lean on a MS diagnosis is correct?
It would depend on the alternative diagnosis. Many diseases respond to steroid treatment or improve spontaneously. Improvement with steroids does not strongly support an MS diagnosis in my opinion.
@@DrBrandonBeaber Oh okay. Thanks so much for your reply! Im being screened for MS after incidentally fulfilling the McDonalds criteria on MRI after a headache, radiologically both dissemination of WML in space and time, had one gadolinium enchancing lesion along with periventricular, juxtacortical and the rest of the suspects. Just did a lumbar puncture and will do a VEP too since the opthalmologist found signs of optic nerve atrophy on my right side. Do you see many MS patients without any focal neurological deficits? My symptoms have just been headache and fatigue. And what are your thoughts on radiologically isolated syndrome? Seems so strange as 30-40% of them develop MS within 5 years. Is that enough to justify prophylactic treatment in RIS?
I had Lyme disease and Bartonella. I’m so surprised how many doctors ignore chronic tick diseases.
Dr Brandon, thank you for another excellent video. I am almost 55 and was diagnosed a little over four years ago but I never had a spinal tap. They didn't think it was necessary for the diagnosis. I'm going to revisit this subject with them again for my own peace of mind. Thank you again and have a great day.
spinal taps are performed less and less over the years which I think is actually appropriate given advances in MRI. If someone has lesions typical of multiple sclerosis in the brain and spine and a history and exam consistent with MS, I don't think it is necessary. Basically, I would recommend a spinal tap in a situation where a spinal tap without oligoclonal bands unique to the cerebrospinal fluid would convince me that the person likely does not have MS.
My gosh how lucky I’d feel if someone told me “you don’t have MS, it is migraines.”
This happens all the time.
Honestly I thought this before I even went back to the neurologist to go over my MRIs. The spots on mine are very tiny small circles and they look like a migraine MRI. I had to bring to his attention migraines and how my symptoms are coming from migraines. Also you don't always have head pain with migraines. Mine make me lightheaded and sensitivities to light. I have bad anxiety which is no good for anything and also going thru alot of stress! I was told at age 16 I would have MS diagnosed at 19 and haven't been on any MS medicines. I'm 32 now and just recently got back into the neurologist to make my primary doctor happy! I've never had any issues! Just recently been having some light sensitivity and lightheadedness. I just don't believe it and I refuse to.
I agree with her! If you can see a ms specialist- do it! My first neurologist told me I didn't need a spine mri that ms isn't in the spine. Which didn't make sense how I had in my brain and neck and why do they do spinal taps If not in spine? Just seemed off. So I switched and the first thing he questioned me on was where was my mri for thoracic spine.
I believe she's a good Dr. She's obviously incredibly intelligent but I don't think neurologists all really know ms .
I'm wondering what are those specific qualifications to be labeled ms. I know a lady was told they are pretty sure she has ms from all her symptoms but can't give diagnosis off of 3 brain lesions. I was diagnosed with 4.
These poor people suffering because they can't get a diagnosis
Thanks again Dr B!
I have interesting symptoms, very similar to MS. I have been diagnosed with MG. I do have migraines (since 18 yrs old). I have white spots on the brain, but it's not at the actual areas where it would be MS and I have one "O" band in my spinal fluid and was told I need 2 or more "O" bands. It's frustrating. All my family members were jumping for joy and I'm stressing more than ever, because I don't know what is happening to my body. I went to an MS specialist at Stanford (Dr. Kipp) and I totally trust him and the fact that I do not have it.
She is being nice and I could not agree with her anymore. I actually just left a message for her for the study. I would love to help any way I can. She is one of the Drs who is not only highly educated she was blessed with commonsense to connect the dots whether you have MS or Not.
Finding live parasites in the central nervous system of MS patients at time of death is a very significant finding that is not getting enough attention. Please share this research with MS groups and practitioners so together, we can bring much needed change to the way MS is treated.
I’ve met many people with MS (and other diseases) who have become “invested” in their disease. For some people it’s quite a frightening thought to imagine getting well suddenly and having to re-enter their old lives. It can have huge implications…such as receiving less support from family, friends, insurance, government payments etc. Caroline Myss broaches this phenomenon in her books.
This is disguised disablism. Please bring forth all these people with MS or other diseases that would not give anything for their renewed freedom in exchange for governmental or social support? Do you live with one of these diseases?
when I was diagnosed I had had an episode of numbness on the left hand side of my body. This numbness and then tightness in arm and leg along with feeling a little light headed, lasted a few days with varying intensity. On the first day of the symptoms though, I had severe muscle weakness or lack of balance (unsure) on that left side for just about 1 hour or 2 (left side felt like a rag doll but could push or hold onto things just not stand or even kneel because I would get thrown to that left side as if it weighted a ton (I didn’t feel it heavy at the time). I went to ER and initially they suspected stroke but after mri I was diagnosed with MS. It bothers me a bit but this part of just momentaneous lack of balance remains unexplained (and nobody seems to mind too much). Eventually they said that, maybe, because I had quite a bit of inflamation on the brain, that could have cause some other symptoms at the time apart from those of the ms lesions. What do you think? I seem to check lots of boxes for the ms diagnoses so not doubting it but I worry that we miss anything else.
I cannot believe there are people wanting to be diagnosed with MS. Every time I go to the Dr ask him if It could be something else. I had to force him to do a Lyme disease test. Thanks Dr B!!
People want an explanation for their symptoms, even if the diagnosis is unfavorable. Imagine having daily disabling symptoms only to have doctors say, "There's nothing wrong with you."
@@DrBrandonBeaber what is the main difference between lyme disease and ms?
It’s because some ms mimics are much worse than ms like nmo and als and msa or brain tumor. Ms has a much better outcome than those.
I had three neurologists look at my MRIs before I started my DMT. I had blood tests and a spinal tap too. I figured that was enough to be sure...but now I'm wondering...
I think it's just wishful thinking though. All my tests had indicators. But since my first flare ups early this year I feel completely normal. It's strange feeling normal but knowing I could flare up again.
MS checked so many boxes for me. My mri, was very cryptic to me, spots but no lesions, masses or swelling. Not MS a second opinion would say, but offer no opinion beyond that, for a cash customer. A fabulous neuro-immunologist would eventually see me, SFN, nutrient deficiencies and Gastroparesis were pretty simple diagnosis for her, The components she missed before my insurance lapsed, excessive vomiting also allowed my already thinning and degenerated disks to aggravate my paresthesia and my new endocrinologist would do a CIMT finding 87% carotid stenosis in both bulbs causing my confusion, muscle weakness, fatigue and eye problems among other symptoms? I think
Wow! Thanks so much for this. I learned something new today. I will definitely ask my neurologist about this at my next appointment.
Glad it was helpful. Hopefully we are not scaring too many people with MS into thinking they are misdiagnosed. The 18% figure is probably higher than reality in most areas.
@@DrBrandonBeaber I should’ve been more clear. I will ask her about ‘central vein sign’ - I find that fascinating!
I never had a spinal tap..... Symptoms were double vision. They did blood work and said it could be myasthenia Gravis which huh (rare eye disease) then an mri which showed white spots. Now.....I want to get a second opinion. It happened all to fast
Agreed same here
Can you please address the "Chronic Lyme Disease" advocates? Am so sick of them telling me that MS is a tick born infection.
I have a video on exactly this topic: th-cam.com/video/Ak04PIcxbTg/w-d-xo.html
Totally an immune condition. I had no idea it was so misdiagnosed..! Wow.
Thanks a lot Drs
i was diagnosed with Migraine at the age of 4 and when i was 15 i was diagnosed with MS
Hello! Came across the vid late..hope ur doing well..do u mind me asking did drs. Every tell u that white lesions can look the same but have different diagnosis? Im wondering how they can differentiate is it the location or shape or? I personally have MS but and b12 deficiency..i do get migraines too but i dont know if they show on mri
@@lararose9106 hello there, so MS also can cause headaches that are like migraines, but that’s my concern too, so it’s been 10 years that I think of it as just a migraine. Because migraine can cause symptoms like MS. Tingling, weakness, pain, vision problems. So I’m not sure. But we are strong enough to handle anything ♥️♥️
@@samarsafavi7403 hello! God bless u true we cant tell sometimes if its from ms or migraines i feel drowsy and nauseous all the time extreme fatigue like im going to pass out..i hope ur well🙏 yes we r fighters no matter what💃😊
@@samarsafavi7403 do u mind me asking r u on a dmt? And how has it been for u? I was diagnosed last year and not on a dmt..not doing so well now going through some infections and a major relapse..i wish u health and send u my prayers❤️🙂
@@lararose9106 yess I hear you ♥️
I asked my neurologist to go over my MRI scans with me, he said “I am not a radiologist “. So he only reads the reports. 🤦♀️🤦♀️🤦♀️
:(
a common experience!
That’s disgraceful. I normally read that happens with older doctors who are basically set in their way and Apparently know everything. I am newly diagnosed this year and my doctor who is basically the same age as me went through each Scan and asked me to point things out and went over each spot. With my follow up MRI she told me that her and the radiologist go back and forth and tend to not really agree. I hope you can find a better Neuro if possible.
@@monicamar8616 I agree!
@@monicamar8616 I no longer see a neurologist. I was unimpressed and sought an alternative. I accessed a different treatment through a vascular specialist which worked, so I’ve not had symptoms in years.
I haven’t had a relapse in years, never took the MS drugs, (only LDN) so I don’t even bother to see a neurologist anymore. I figured what’s the point? I will either stay stable or get worse but I don’t want the MS drugs.
They funded this on my mri A few small foci of T2 and FLAIR hyperintensity are seen in the deep and subcortical white matter, which are nonspecific in appearance and may reflect complicated migraines, early microvascular ischemic disease, sequela from prior traumatic or inflammatory insults
No abnormal intracranial vascular flow void is noted. The visualized paranasal sinuses demonstrate mild scattered mucosal thickening
But till now I don’t have no diagnostic of anything a having lips drooping right side little bit of wicked headache I don’t know what else to do 😢
You may find this video to be enlightening: th-cam.com/video/GNnba5HVvdY/w-d-xo.html
Interesting. Not that anyone (at least I would hope not) would want a diagnosis of MS, for those that know something is truly wrong, it can be a relief.
I personally am one of those people. My story is unique and one that I won’t share in full detail here, but I feel it is important.
It took me five years and five neurologists prior to getting an official diagnosis. I didn’t fit the McDonald criteria 19 years ago and was diagnosed based on the Poser criteria. Positive evoked potentials, space and time between relapses, and neuro exam.
Sometimes not everyone is going to be a textbook case and it needs to be approached as thinking outside of the box.
I appreciate new research and more ways to definitively diagnose, however one should always absolutely make sure prior to taking away a diagnosis as well. Just thoughts from a unicorn 🦄.
deep video ..... i hear so meny pele bring up migraines being only a few hours causing symptoms and thts enough to dismiss ms symptoms ... but what happens if someone has ms and migraines lol i mean woudlent that mean there ms symptoms would be pesudo exsaterbated also along sonde the migriane symptoms ..... same with people with panic disorder ms and migraines ... coudlent they all cause the other symptoms to flair .....my MRI is not typical typical of ms manly cuz some of my lsins are considered linear to some docs mainly as i don't have spinal cord lisons or otic nerve lisons i do have lisons on the outside of my corpus callosum and vetricals touching called dawson fingers an dis the main reason they gave me my ms diagnosis along side having ms symptoms show up for days then subsiding ... but also have a lot of pesudo symptoms that last only a few hours during a migraine attack but its the ms symptoms that mimic and show up ...... no to mention i have intermedeate uveitus and 4 others in my immediate fam with ms .... so this video really made me think as really i get confused on the trying to dismiss symptoms caused by migranies or panic disorder as dismissing ms ..... as i have all of these illnesses and i can tell they all flair around the same time with the same symptoms but the panic disorder and migraines only last less then 24 hours ... and i know i have ms as last july i had a relpase that made me start to use a cain for like 6 mouth till physical therapy helped me get streghth back lol now everytime i over heat have panic attack or migraine ill need my cain but that only started after i ad the ms attack that landing me in the hospital agen ..... but even then my inflammation was small and only a coulp of my lisons grew during the attack .... ms is such a complicated illness and runs deep in my fam even out side my intermedeate fam of me my mom and older sisters my mom had an uncle with ms and a cusion ....runs deep lol
This is a timely subject! After being diagnosed with MS 10 years ago my latest MRI looked so much worse that I was sent to a MS specialtist (2 hours away). They don't think I have MS after all! I'm being re-tested for all the things that make up neurological alphabet soup. Enough bloodwork to satisfy all the vampires in Transylvania, VEP (again) and now genetic testing! Cadasil this time. It's been a whirlwind of hurry up & wait...
Best of luck to you Tina. Let me know if you get any definitive answer.
@@DrBrandonBeaber
Thanks so much.
What are your thoughts on the rare subtype of Tumefactive MS and would love to see a video on just Tumefactive MS.
MS is primarily a vascular disease. I was treated by a vascular specialist, stopped degenerating, and actually regained functionality.
You should rewrite the demyelinating diseases of CNS chapters in neurology books
Hello! I came across ths video late! I was diagnosed with MS last year. Im not on Dmts because im not willing to take risks of serious malignancies and infections. I already have a weak immune system and not functioning well. Im using a cane already. Im going through a serious relapse now and because ive had 4 infections ths month im very dizzy and weak and in a wheelchair. Do u mind me asking would i benefit from a vascular specialist and how they helped u improve? I do have migraines but drs. And vit b deficiency but drs. Only focus on the ms part. Bless u and hope ur doing great😊
What other diseases should one look into if they have MS like symptoms? I have had multiple CT scans and had a full set of MRIs. The nureologist didn't have any answers for me. Blood work and urine came back clean. He wasn't an MS specialist but I think he would have noticed lesions. But I get migraines on a weekly bases so those would have shown up as well? Gave up on being diagnosed for while but symptoms are getting worse. Looking to start up on a diagnosis again. It's just so exhausting.
It would be impossible to give you advice without knowing more details, but if you take a look at her article and scroll down to table 2, you can find some of the most common alternative diagnoses: www.clinicalkey.com/#!/content/playContent/1-s2.0-S2211034819300483?returnurl=https:%2F%2Flinkinghub.elsevier.com%2Fretrieve%2Fpii%2FS2211034819300483%3Fshowall%3Dtrue&referrer=https:%2F%2Fpubmed.ncbi.nlm.nih.gov%2F
@@DrBrandonBeaber thanks for answering questions, its very helpful! One followup, on an MRI can lesions show up without contrast? Also can lesions repair enough over time to where they're hard to see on a non-contrast mri (i.e. 3 years after an episode or relapse)? Just wondering because I only had my mri done about 3 years after I had my second episode.
Is having 3 oligoclonal bands in the CSF a sure diagnosis for MS?
It is about constalation not about 1 parameter.
I'm sure I meet the McDonald criteria many times over 99.9% sure I have MS. However, I understand it is very complex.
Can you have only spinal lesions ? And can your mri only say diffuse dymelation. On cervical and thoracic area . But no lesions ? Mri brain very small lesions not enough for ms on brain ?
The link to the other doctor was only seen on the screen for a while. Using iPad 7th gen.
What might be the best test to differentiate MS from NMO?
Was originally diagnosed with NMO, went to Cleveland Clinic and they changed it to MS.
Were you tested for
NMO-IgG or anti-AQP4 antibody?
I have a video on NMO, and if you go to 14:00, I talk about difference between MS and NMO. Some of the key diagnostic tests are antibodies (anti APQ4/ anti MOG) and the MRI of the brain.
@@DrBrandonBeaber thank u!!
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How would you differentiate between MS and lupus? Can you do a video on this? Is ANA results a key indicator?
Some people with lupus can have cerebritis or vasculitis. Usually, the lesions on MRI are not typical of MS. Here is an example of lupus cerebritis from radiopaedia: radiopaedia.org/cases/lupus-cerebritis-2?lang=us A positive ANA is fairly common in the general population, but it can be a helpful test. Many people with neurological manifestations of lupus have sigs of systemic lupus (skin/kidney/joint disease). Some people with lupus can have personality changes or even psychosis (neuropsychiatric lupus) but may have a normal MRI brain.
Could MS cause a positive high ANA?
@@allisonphillips-zabelin1710 A positive ANA is not associated with MS. As far as I know, people with MS have an equal probability of a positive ANA as the general population.
An MRI or an scan are tests that really prove whether the patient has MS or not, right?
Just a question, can a patient be rightly DX with MS, but in a wrong way? I mean, maybe the DX is worse, but the symptoms are actually due to something else?
With so little time to evaluate the MRI results in clinic , why aren't NeuroQuant type technologies more widely adopted?
Part of it is cost of the software. The other problem is that right now neuroquant doesn't help with the diagnosis of MS, but perhaps in the future, the software could include the ability to look for the central vein sign.
Have you have or had patients with Hashimotos with MS?
Yes, though they are not specifically associated.
If you have mri lesions, but normal csf study can you still have ms?
Yes. Approximately 90% of people with MS have 2 or more oligoclonal bands in the cerebrospinal fluid which are not in the blood. However, a very large number of people in the general population have subcortical white matter lesions on MRI which are not typical of MS. You may appreciate this video: th-cam.com/video/GNnba5HVvdY/w-d-xo.html
Hmm.. interesting.
I'm going to have another spinal tab to confirm my diagnosis.
After my 3rd grade AV Block and the possibility of mini strokes. I asked for a re-evaluation.
Are ogliconal bands a good marker or I could have ogliconal bands with cerebrovascular events?
Also, will Neurofilament blood test be helpful with this? Or it could be high with migraines and the other diagnosis as well?
Generally speaking, microvascular disease would not be associated with OCBs in the spinal fluid. For certain diseases such as primary CNS angiitis (which can cause strokes), OCBs could be present. I am publishing a video on serum neurofilament next week, but it is not helpful for diagnosis because it is elevated in many diseases (not migraine but any disease with CNS injury).
@@DrBrandonBeaber thanks a lot for your answer..
I guess a second spinal tab is the way to go to be certain.. We really need a good test 🙏😔
Oh my goodness
If misdiagnosed with MS and you are treated with steroids will your symptoms remain if you dont have MS? If diagnosed with MS and steroids and our symptoms subside can you lean on a MS diagnosis is correct?
It would depend on the alternative diagnosis. Many diseases respond to steroid treatment or improve spontaneously. Improvement with steroids does not strongly support an MS diagnosis in my opinion.
If the treatment is the same, will it matter?
The treatment of MS and these other conditions is often not the same.
@@DrBrandonBeaber Oh okay. Thanks so much for your reply!
Im being screened for MS after incidentally fulfilling the McDonalds criteria on MRI after a headache, radiologically both dissemination of WML in space and time, had one gadolinium enchancing lesion along with periventricular, juxtacortical and the rest of the suspects. Just did a lumbar puncture and will do a VEP too since the opthalmologist found signs of optic nerve atrophy on my right side.
Do you see many MS patients without any focal neurological deficits? My symptoms have just been headache and fatigue. And what are your thoughts on radiologically isolated syndrome? Seems so strange as 30-40% of them develop MS within 5 years. Is that enough to justify prophylactic treatment in RIS?
Nice hair
Who?