MRI scan more accurately
diagnoses multiple sclerosis
- October 18, 2006
DEAR DR. DONOHUE: Do medical doctors sometimes misdiagnose a patient? Here's the reason I ask: After seeing the same doctor three times, he examined a sample of my spinal fluid and concluded that I probably had multiple sclerosis. That has been on my medical records for 35 years. Now when any doctor sees that, I am treated as though I have it. I have never had an exacerbation in all that time. I have not gone downhill. I am 87. Do I have MS? My arms and legs work well. I speak clearly. I am still driving a car with no accidents.
-- R.H.

Do rocket scientists ever miscalculate? Do juries ever render a wrong verdict? Did Einstein ever make a mistake? Sure, doctors misdiagnose. They're human.

The criteria that establish a diagnosis of multiple sclerosis are clear. A single episode of a neurological disturbance is not proof of MS. A "neurological disturbance" is something like a temporary loss of vision in one eye, double vision, peculiar sensations running down the back when the neck is bent, weakness of an arm or leg, or difficulty walking. Typically, the original symptom or symptoms go away, only to be replaced by new symptoms. That's relapsing-remitting MS, the most common variety. As time passes, symptoms generally become permanent.

You had a spinal fluid test, which is only one test for MS, and it can't make the diagnosis alone. A person must have symptoms, as I described above. Today, MRI scans are invaluable in establishing the diagnosis. They show the multiple scars (sclerosis) scattered throughout the brain and spinal cord — the fingerprints of MS.
I don't believe you have MS. You have no symptoms. You had only one test that might have been a bit suspicious for but is not diagnostic of MS. If you want to be sure that the diagnosis was an error, check with a neurologist,
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