It is possible, but it takes a lot longer, and of course, it's more difficult. I doubt you would stay lesion free (clean MRI) forever.

I would suggest, if this is what's going on with you, that you find a MS specialist. Someone who deals ONLY with MS patients.

That would be the best way to start ruling out other conditions.

-Jen

A diagnosis of MS, requires proof of time and space. Time that it progresses over time & space that mre than 1 area of the CNS system is involved.

AND EVERYTHING ELSE POSSIBLE HAS BEEN ELIMINATED, because MS is ALWAYS a last resort diagnosis. Anything else it could be, it is.

That means means more than 1 attack and the attacks affecting different areas of the CNS.
Note too, in the McDonald criteria it says "clinical evidence of lesion" that means the clinical observation indicates that a lesion must be there. Not that the lesion shows on MRI.

There are various ways to prove time & space.

The mri with with lesions is just a probablity that another attack will happen within 10 years. So an MRI taken because a 1st attack caused it to be done proves time with lesions, because it is proof that a second attack is likely to occur within 10 years. An MRI can show both old & new lesions which also proves time. An MRI with lesions located in different areas of brain, show space.

A VEP test results will shows space.

The Spinal tap proves demylenation is happening. I'm not altoghether sure I understand how it proves time or space. But that's just me, I don't understand it. (I think it says it proves time)

In 2005 the McDonald Diagnostic Criteria was updated....below I pasted it in. 2 episodes are needed in diffent CNS area's and a doc that has eliminated every other possible things it could be.

So yes it can be dx by history and symptomology. Not done often, though. One person wrote he was diagnosed that way & 6 years after his diagnosis lesions showed on MRI.


********2005 McConald Criteria
Table 4. The 2005 Revisions to the McDonald Diagnostic Criteria for Multiple Sclerosis
Clinical Presentation Additional Data Needed for MS Diagnosis

Two or more attacksa; objective clinical evidence of two or more lesions

NEEDED: None

Two or more attacksa; objective clinical evidence of one lesion

NEEDED: Dissemination in space, demonstrated by:
? MRIc or
? Two or more MRI-detected lesions consistent with MS
plus positive CSFd or
? Await further clinical attacka implicating a different site

One attacka; objective clinical evidence of two or more lesions

NEEDED: Dissemination in time, demonstrated by:
? MRIe or
? Second clinical attacka

One attacka; objective clinical evidence of one lesion
(monosymptomatic presentation; clinically
isolated syndrome)
NEEDED: Dissemination in space, demonstrated by:
? MRIc or
? Two or more MRI-detected lesions consistent with MS
plus positive CSFd and
Dissemination in time, demonstrated by:
? MRIe or
? Second clinical attacka

Insidious neurological progression suggestive of MS(Primary Progressive)
NEEDED: One year of disease progression (retrospectively or prospectively
determined) and
Two of the following:
a. Positive brain MRI (nine T2 lesions or four or more
T2 lesions with positive VEP)f
b. Positive spinal cord MRI (two focal T2 lesions)
c. Positive CSFd

If criteria indicated are fulfilled and there is no better explanation for the clinical presentation, the diagnosis is MS; if suspicious, but the criteria
are not completely met, the diagnosis is possible MS; if another diagnosis arises during the evaluation that better explains the entire clinical
presentation, then the diagnosis is not MS.

1a. An attack is defined as an episode of neurological disturbance for which causative lesions are likely to be inflammatory and demyelinating in
nature. There should be subjective report (backed up by objective findings) or objective observation that the event lasts for at least 24 hours.

1b.No additional tests are required; however, if tests (MRI, CSF) are undertaken and are negative, extreme caution needs to be taken before
making a diagnosis of MS. Alternative diagnoses must be considered. There must be no better explanation for the clinical picture and some
objective evidence to support a diagnosis of MS.
1c. MRI demonstration of space dissemination must fulfill the criteria derived from Barkhof and colleagues20 and Tintore and coworkers21 as
presented in Table 2.
1d.Positive CSF determined by oligoclonal bands detected by established methods (isoelectric focusing) different from any such bands in serum,
or by an increased IgG index.3638
eMRI demonstration of time dissemination must fulfill the criteria in Table 1.
1f.Abnormal VEP of the type seen in MS.

39,40 MS multiple sclerosis; MRI magnetic resonance imaging; CSF cerebrospinal fluid; VEP visual-evoked potential.
****End 2005 McDonald Criteria

Current models aside. It's always good to remember they really still don't know what causes MS. People have been shown to have lesions on MRIs and not have any MS symptoms their entire lives.

(I think they call this "benign" MS)

I'm not a skeptic or anything. Just a point to keep under consideration.

Lets hope 50 or 100 years from now they don't look back and laugh and the widely accepted practices for MS today.

I had my 1st. episode 3 yrs. ago, at age 76. Had all sorts of tests done, all neg. At my age, way above the onset for MS,so my Neuro told me. In the next 3 Mos. i had several symptoms going on. Neuro suggested i see MS Dr. However , because of my age, i was in denial.
Within 6 Mos. MRI with contrast did show MS lesions. I saw a MS.Sp. for 2nd opinion. Took with me all MRI films and reports. When i walked in his office he said " You don't have MS. you are not in the age Gp " Then, after looking at the film, he said " You do have MS" I felt like the lone ranger.
I think my body is trying to play catch up, after all the yrs. symptom free. LOL
I suggest you see a MS Dr.
Also, visit DS. every day, the support is great. Only those with MS symptoms can really understand.

THANKS ALL! My sis was dxd with Paroxymal Dyskinesia. Yeah, say that 3x fast. ROFLOL We have the exact SAME symptoms but my worse and encompass entire body. It's just the neuropathy (burning down leg) has begun AGAIN and sometimes my speech slurs or I say one word but I'm thinking of another or better yet, I can't remember the stinking word I want at all. Dr. asked if I'd had a stroke and I replied "NO and I don't want one." LOL

I do fit ALL CRITERIA FOR PAROXYSMAL DYSKENSIA which is "cousin" to epliepsy but not epliepsy. UH.....Yeah.

I am thinking of going to HER Neurologist as if that is what this is, it is genetic, her symptoms just began and there is an age gap of 12 yrs so I could be her future or she may just be my answer.

Thanks again.....Should I go to her neuro or just ask mine to conference with him? Her's is at 3 hr drive and I jerk so badly I take 3 meds 3x daily to control jerking and an extra type at bedtime. Still, I feel like a bean bag with all that med rolling around as I walk, stagger or bump into things. Also a symptom of Paroxymal Dyskinesia