Re: LDN and Epstein Barr virus OT

[Guest guest]

Hi Pat,

Wow you have really had the run around. I don't think I would

trust the test results from that first place.

I am certainly no doctor but it sure as heck sounds like ms. Lesions

in a particular location and they come and go. Loss of feeling from

the waist down.

The first neuro. is crazy. There are many more symptoms that

constitute an attack. Yes optic neuritis does increase ones chances

of having ms. 70% go on to have ms I believe it is.

Here is a section I copied talking about symptoms and " O " bands.

Clinical history of MS usually is complaint of numbness, weakness or

visual disturbance of some sort. When the presentation is sensory,

the symptoms can be paresthesias, burning, tightness, diminished

sensation, etc.. Many times the distribution of complaints is not

conforming to anatomic territories which make it seem puzzling. When

the presenting symptoms are weakness, it can be in one or both legs

or can be hemiparesis. Optic neuritis is a common presentation of MS,

complaining of monocular visual acuity loss or central scotoma or

loss of color vision. Less frequently, symptoms can include vertigo,

gait ataxia, diplopia, tremor, or even sexual dysfunction.

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Diagnosis

When the patient presents with a single episode and the signs point

to a solitary anatomic location, one must look and ask about previous

episodes of attacks. Neurologic examination may reveal Babinski's on

one side or the other or both, loss of vibration sense, or possibly

weakness.

By far, the most sensitive test available is magnetic resonance

imaging. It can reveal lesions that are not symptomatic, can also

reveal second lesions in patients that have only mono-symptomatic

presentations.

MS plaques are typically found in the periventricular region, corpus

callosum, centrum semiovale, and deep white matter structures and

basal ganglia. They can also be seen in the posterior fossa, brain

stem, cervical and thoracic spinal cord. The typical shape of these

plaques are oval shaped, with long axis of the plaque directly

perpendicular to the anterior posterior dimension and ependyma of the

lateral ventricle.

The MRI is far more sensitive at detecting these lesions than CT

scan. Furthermore, these plaques are easily seen in the posterior

fossa on MRI and are virtually invisible on CT scan because of the

limitations of the technology of CT.

Delineating differences from acute and chronic lesions: the acute

lesions tend to be larger with somewhat ill defined margins and

eventually become smaller with sharper well defined margins as

resolution occurs. This presumably reflects resolution of edema and

inflammation present at the time of acute plaque formation, leaving

only residual areas of demyelination, gliosis, and enlarged

extracellular space with remission.

These plaques typically are hyperintense on the proton density, T2,

and FLAIR sequences of MRI and appear hypointense on T1 weighted

images without gadolinium.

Gadolinium-DTPA, a paramagnetic contrast agent that crosses disrupted

blood brain barrier, is used to assess plaque activity. Gadolinium

increases signal intensity on T1 weighted images. The accumulation of

gadolinium in plaques is associated with new or newly active plaques

which are thought to have breakdown of blood brain barrier. The

gadolinium thus detects active lesions of MS. Gadolinium enhancement

of acute plaques usually persists for less than one month but may

persist up to 8 weeks. Gadolinium enhancement diminishes or

disappears after treatment with cortico-steroids which is thought to

restore integrity of the blood brain barrier. When plaques are

chronic and old, they typically do not enhance with gadolinium.

CT scans are helpful to exclude other possible cause of symptoms such

as stroke or hemorrhage. However, the sensitivity of CT scans for

plaques it not high. Even with double dose contrast 50 to 60% of

these scans will reveal abnormality on acute relapse of MS compared

to a 90% sensitivity with MRI.

CSF evaluation cannot make or exclude the diagnosis of MS but can be

helpful adjuncts to clinical criteria. In many patients the CSF may

be normal. Total white count in the CSF can be normal in two-thirds

of patients with MS and only exceeding 15 cells per microliter in

less than 5% of patients with MS and only rarely exceeding 50 cells

per microliter. More than 50 cells may raise suspension of other

etiologies such as infection or tumor, etc.. The predominant cell

type is T-lymphocytes. The CSF protein can be normal in the majority

of MS patients.

Specific tests of CSF exist. For example, the CSF IgG level, is

compared to the serum level of IgG and through a formula an IgG index

is determined. An abnormality of this IgG index is found in more than

90% of clinically definite MS patients. Linked to the elevation of

IgG is the finding of oligoclonal bands in the gel electrophoresis

analysis of CSF. A discrete band on the gel electrophoresis

represents excess antibody produced by one or more clones of plasma

cells. The sensitivity for oligoclonal banding of IgG is

approximately 85 to 95% of definite MS patients. Another specific CSF

test that can be helpful is the presence of myelin basic protein.

This is less specific for MS but is seen in other processes that show

CSF myelin destruction and demyelinating activity.

The differential diagnosis in multiple sclerosis is quite extensive.

Other inflammatory diseases might include granulomatous angiitis,

SLE, Sjogren's, Behcet's, polyarteritis nodosa, paraneoplastic

syndromes, ADEM and post infectious encephalomyelitis. Infectious

diseases in the differential might include Lyme, HTLV1, HIV, PML, and

neurosyphilis. Granulomatous processes include sarcoid, Wegener's

granulomatosis, lymphomatoid granulomatosis. Myelin diseases might

include metachromatic leuko dystrophy and adrenomyeloleukodystrophy .

Nutritional deficiencies that might mimic MS would include B12

deficiency and structural causes include Arnold-Chiari malformation.

I don't understand why the " O " bands are so important to these

doctors? I would think lesions and symptoms would be more important.

You are very right in saying you have been searching for a dx for 16

years so your age now is not important.

I wish I could help you more Pat! Good luck! I am so happy you are

on the LDN! In my opinion it will do alot more for you than any of

the existing ms drugs.

Take Care

>

> I had a spinal, high MBP, high IgG CSF serum, no " O " bands, (each

> neuro , 3of them has said they rely on the " O " bands)

>

> Abnormal ABR, abnormal SSEP, abnormal EMG, NORMAL VEP, But all

these

> tests were done by a traveleing tech, in a storage room, with a lap

> top with a broken screen, he pulled out a few antiquated leeds form

> a cardboard box,stuck 4-5 of them on my head, gave me a broken

piece

> of black plastic and told me to hold it over one eye. The ABR was

> done at one sound level only, all four tests took less than a hour.

> and that was including set up time and check out time. I wonder how

> accurate they were? I felt like I was in a back room abortion

> clinic, with the old chairs and equiptment stacked around.

>

> First MRI multiple rounded and oval hyperintensities, in the deep

> white matter and both cerebral hemispheres, and on the 3rd and 4th

> lateral ventricals.

>