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I have read that up to 40% of multiple sclerosis diagnoses…

I have read that...

I have read that up to 40% of multiple sclerosis diagnoses are wrong. Is a 2nd opinion always encouraged and how does one verify a presumptive diagnosis of MS? How do you find an MS expert to verify the diagnosis?

Doctor's Assistant: Have you seen a doctor about this yet? What medications are you taking?

Thanks,

Doctor's Assistant: Anything else in your medical history you think the doctor should know?

No, this is not for me but for a friend. No other medical history. Thanks, Mike

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Answered in 6 minutes by:
3/23/2018
Dr.Saleem
Dr.Saleem, Doctor
Category: Medical
Satisfied Customers: 2,968
Experience: MBBS
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Hello and welcome to JA. Dr Saleem here. Will be answering you shortly

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Well basically the diagnosis is based on clinical history and findings on MRI brain / spinal cord.

Most of the time the symptoms of MS involve different parts / systems of the body and those cannot be explained by any other single condition . For example tingling in face followed by urinary problems with a gap in between. So these two symptoms are not linked to each other but these can be manifestations of same disease i.e MS especially if distributed over a period of time. Similarly there are typical lesions or spots on MRI brain that involve sites which are pathognmonic or typical of MS . These spots also seem to occur at varying intervals with different timelines . So spots or lesions of varyimg ages are found on MRI which is usually suggestive of MS.

Thirdly there are findings on Cerebrospinal fluid analysis as well as Visual evoked potentials ( VEPs) can be used to confirm the diagnosis.

Electromyography and Nerve conduction studies are also useful tesrs to aid the diagnosis.

hope you find it helpful.

Let me know if you have any more queries.

Please reward credit for the consult by clicking 5 stars in rating corner of your page if you are satisfied.

Stay blessed.

Regard

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Customer reply replied 1 month ago
Dr Saleem,
I am well acquainted with the diagnostic criteria for MS. Here are my questions again, please answer if you are able. Mike
I have read that up to 40% of multiple sclerosis diagnoses are wrong. Is a 2nd opinion always encouraged and how does one verify a presumptive diagnosis of MS? How do you find an MS expert to verify the diagnosis?

As i mentioned above the criteria based on clinical , radiological and VEP/ NCS helps an expert confirm a presumptive diagnosis . Its off course useful to get a second opinion as one expert can miss the actual diagnosis while labeling you with something that can have so big an impact on your life . Experts verify the diagnosis based on your history and the findings on these tests ,there is nothing more to it which can aid the diagnosis . Does it help?

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I am available to offer any further help if required. I hope everything works out best for you.

Best regards.

Dr Saleem.

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Dear customer please let me know what remained unanswered as it would help me correct myself in future . I would be grateful for letting me know what made you leave a negative rating to my consult . My job is to provide you information based on my medical knowledge/ expertise with your satisfaction being my goal.

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Would be grateful if you could revisit the rating ,we can continue the conversation . Any additional details would help me understand better. Just to further support what i mentioned in my previous posts i am sharing a useful link for your ,hope it helps ;

https://my.clevelandclinic.org/health/diagnostics/8460-diagnosing-multiple-sclerosis-ms

I appreciate your patience and understanding.

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Customer reply replied 1 month ago
Dr Saleem,
I apologize and must confess that I have not been completely forthcoming with you. While I do have a friend with MS, I am currently involved in a project regarding MS, its relatively frequent misdiagnosis and the need for 2nd opinions and locating the best neurologists for that confirmation of diagnosis. I was sincerely ***** ***** could shed some light on these questions as I have come up empty in my online search thus far. Since you did not answer my questions and my company paid $48 for this, I was very disatisfied with the service and gave you a "poor" rating. I am happy to revisit the ratings and and give you 5 stars if you can just answer my questions. Given that there is a very high misdiagnosis rate with MS despite the use of the Modified MacDonald Criteria, what additionally or differently does the 2nd opinion neurologist do to verify a presumptive diagnosis of MS (can OCT be used to verify the diagnosis)? Secondly, how does one locate the best MS neurologists in the country to obtain a 2nd opinion? Is there a resource or website you could recommend? Thank you for your time. Mike, MD

Hello ,

Thanks for giving me a chance to explain it again.

Well although NMR/MRI (nuclear magnetic resonance )

techniques have improved specificity for the detection of lesions and provided more quantitative information about MS. Optical techniques including OCT and CARS microscopy are opening up new ways for diagnosis and mechanistic study of myelin diseases. But conventional MRI still remains the most critical tool in the diagnosis of MS with most experts relying on this . These are the latest modalities which can be used for verification although still not commonly used.

You can look for MS experts on this link ;

https://www.hopkinsmedicine.org/neurology_neurosurgery/centers_clinics/multiple_sclerosis/index.html

You may like to read the research article below ;

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2662586/

Other useful links are as follows;

https://www.nationalmssociety.org/Treating-MS

https://my.clevelandclinic.org/departments/neurological/depts/multiple-sclerosis

Hope you find it helpful this time

Dr.Saleem
Dr.Saleem, Doctor
Category: Medical
Satisfied Customers: 2,968
Experience: MBBS
Verified
Dr.Saleem and 87 other Medical Specialists are ready to help you
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Customer reply replied 1 month ago
Heartfelt thanks Dr Saleem. I and my colleagues are most grateful for the information. Rest assured I am rating you 5 stars. Mike

Grateful for that.

Wish you all the best.

Kind regards.

Dr Saleem

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