Old 02-14-2011, 10:48 AM #1 (permalink)
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Lightbulb Mri's aren't the be all!

Hi-
I got my MRI at 4:30 in the morning. Revealed no neurological problems but nearly all my vert are damaged with arthritis and osteoarthritis and several compressed disks. Says my brain stem is alright and no pressure from scare tissue build up from the arthritis that would cause my bulbar symptoms.

While I now have a reason for the pain in my back, neck and head, it doesn't explain my bulbar and progressive weakness in my limbs.

I have several areas of swelling on my head which is believed to be a respones to bone and tissue damage from the arthritis- makes sense, I'll accept that. But when I asked why did those areas not show up on the MRI but did on ultrasound, my doctor said MRI's are not as senitive as we are believed they are.

I was shocked to hear that from my doctor. I'd suspected that but to be told means no findings on an MRI does not mean there are no problems. So MRI's aren't the be all and end all.

So MG and ALS are still on the back burner and my doctor has agreed to another EMG next summer to chart only changes. If there's no decline then who knows.

Take care everyone- Blessings and happy happy valentine's- Karin
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Old 02-14-2011, 11:12 AM #2 (permalink)
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Default Re: Mri's aren't the be all!

Karin,

A mri of just the brain stem itself is considered necessary by many neurologists. I would ask for a "coned down" mri of brain stem, with and without contrast. Sorry about the continued progression and ambiguity for you!
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Old 02-14-2011, 04:08 PM #3 (permalink)
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Default Re: Mri's aren't the be all!

There are different MRI"s as well. The 2 tesla and 3 tesla, maybe even more, but the new MRI here is the 3 tesla, which is much, much more sensitive. You also have to remember it takes slice , so a very small defect can miss the slice. The key is a very good operator that sets the MRI up correctly and most importantly of all, a neuroradiologist to read the MRI. Some are really bad at it, some are amazing.
My husband has had his spinal MRI read by 3 people, When the really great gun got back from holiday last week he found a profound congenital abnormality that no one else had noticed.
This makes MRI's rather subjective in some cases and therefore not perfect.
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Old 02-15-2011, 06:16 PM #4 (permalink)
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Default Re: Mri's aren't the be all!

Aly, I heard the same from a radiologist friend. The stories he tells about the wide variability in ability to interpret those images are discouraging. It is very hard for me to accept someone's interpretation as trustworthy with those stories always in the back of my mind. The radiologist that read my MRI included a serious typo in his subsequent report: something to the effect of there being no cerebral flow at some part of the brain (can't remember details now). It was an absurd statement. I know it is 'just' a typo but my imagination runs wild; he is careless, inattentive to detail, unprofessional.

Karen, I am sorry you seem no closer to answers with respect to your bulbar symptoms!

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Old 02-15-2011, 09:17 PM #5 (permalink)
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Default Re: Mri's aren't the be all!

I agree Lydia. I don't think people realize that there are neuroradiologists as opposed to general ones. I know at our local hospital all the neurology MRIs with any abnormality are looked at by a whole team of neurologists and radiologists. It's compulsory for all to attend. This helps decrease the chance of misinterpretation. I have been lucky and know that the best guy always read mine.
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