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T2-hyperintense lesion in pons... should I get a lumbar puncture?

Hi, I have had many issues over the years with no answers. Back in October I could barely walk, had pins and needles in bottom of foot, down legs, in hands and fingers along with muscle jerks, twitching, insane migraines with sharp stabbing pains in brain. Vibration feeling in body like I am shaking from the inside out. Left eye weak and seems lazy/ blurry. Lack of concentration. Heart palpitations. And more.

MRI revealed T2-hyperintense lesion in pons



I finally found a neuro who wanted to do MRI. They found T2-hyperintense lesion in pons along with other nonspecific white matter lesions. He said the next step would be a lumbar puncture but it is not reliable and he felt the best step would be wait and see with follow up MRI sometime down the road. I wasn’t prepared for the call and due to COVID it was over the phone consult. After we hung up I thought more on it and feel that I should at least do the lumbar puncture to find more answers. I called back and they said they can send me for lumbar puncture once COVID relaxes which they hope to be by middle of June and then they can send me for Lumbar puncture.

Would you get a lumbar puncture?



I guess my question is: is this typical of MS? Would you opt to get more answers and do LP? I don’t even know what to ask. I am near daily struggling with one ailment or another which I think is all related. Ie migraines, shooting stabbing pain in brain, weakness, tremors in hands, tingles down leg etc. I guess any help, insight would be beyond grateful.

Regards, Kim

  1. Hi !
    A spinal puncture is often done, but not always. Here is an article from our editorial team about getting an MS diagnosis: https://multiplesclerosis.net/diagnosis/. I would never wish a diagnosis of MS on anyone, but the sooner you find our for sure whether you have it, the sooner you can begin treatment. So I hope you get answers soon. It's good that you are advocating for yourself with your doctor. If you are unhappy with your neurologist's advice, it would be wise to get a second opinion, hopefully from a doctor who specializes in MS. Sending lots of hugs and warm wishes your way! – Lori, MultipleSclerosis.net, Team Member

    1. Hi Kim, MS diagnostic testing includes the following:

      1) MRIs of the brain and spine,

      2) Evoked potentials testing (EPT) of the eyes and ears that measure the speed at which signals travel to the brain,

      3) Physical exams that test coordination, strength, sensation, balance, and reflexes,

      4) A lumbar puncture.

      I had all tests done after my first attack but no diagnosis. Those tests were repeated five years later after my second attack. The last test was a lumbar puncture, which was positive. That result convinced my neurologist that I had MS and gave me the diagnosis.

      A lumbar puncture might be useful for two reasons:

      1) If the spinal fluid is positive for o-bands, it indicates inflammation in the brain and that is a strong indicator of only a few possibilities, MS being one of them. It is mostly reliable.

      2) At the very least, it is a baseline test that can be compared to future LPs. This is true of all the MS diagnostic tests.

      As Lori said, it is good that you are advocating for yourself. You are pushing for answers, keep it up. Lori also stated it is a good idea to seek out the advice of an MS specialist. I would add that If one isn't available in your area, you could seek out a general neurologist and ask them in your initial appointment how many MS patients they treat. You could gauge their interest in the disease in such a conversation. It might involve a bit of trial and error to settle on a doctor you like.

      I wish you well on your journey and hope you'll update us on what you find out. Best, Kim, moderator

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