To Contrast or Not to Contrast?
Hi all...I wanted to get some thoughts on my upcoming MRI. I suspect MS and my neuro (though her suspicion is low) wants to do an MRI on my cervical spine with and without contrast.
Totally normal MRI one year ago
Long story but I had an MRI about exactly one year on just my brain with contrast and it was totally normal. At that time, I was experiencing severe brain fog, a strange headache behind my left eye, and facial numbness. I've had an issue with my left eye off and on for about 5 years where I would wake up and it would feel slow and my brain groggy and then it would wear off. It would always deeply unsettle me but I ignored it.
Electric shocks and vision problems
Two years ago I had my first child and started to experience a variety of symptoms. After that MRI last year came back clean, I had an episode this past Oct where I was waking up every night with electricity shooting through my hands. It was very painful and persisted for about 2 months. The episode started out again with that same weird headache and then, later, experienced temporary blurred vision in that eye. Then I started having non-stop muscle twitches any time my body was at rest, occasional numbness and tingling on my skin. The neuro I just saw is supposed to be an MS specialist but seemed really dismissive of my symptoms based off of my last MRI. I'm hesitant to get contrast again after all of the research I've done on GBACs and their retention in your body. I've had 2 MRIs with contrast already in the past 2 years.
Should I refuse the contrast?
Apologies for the long post... the question is whether or not I should just refuse the contrast and do the cervical MRI without. She doesn't want to re-image my brain. If I do have lesions on my spine, will they likely appear without contrast? When I raised this concern to her, she said 'oh yes, GBACs have heavy metals, good question' but then she irritably told me to follow up with the technicians to share my concern about GBACs.
Thanks for your thoughts. I feel like this is going to be a long haul and I don't want to rack up a bunch of GBACs unnecessarily... Thanks again.
Hi,
! Don't apologize for you post (it's not that long). In cases like this, more information is helpful! I am glad you shared details.
I do hope you get some helpful feedback from other community members that may have some more personal insight on the topic of MRIs. I am sorry your physician seems dismissive of your symptoms. MS and other neurological conditions can be so darned tricky to properly diagnose and treat. Is your physician thinking that you may have another condition? There are a number of conditions that can mimic MS symptoms -- https://multiplesclerosis.net/diagnosis/ruling-out-other-health-conditions/.
Also, the bar for diagnosing is pretty specific when it comes to MRIs (you can read more about it here) -- https://multiplesclerosis.net/diagnosis/mcdonald-criteria/.
I don't blame you for wanting to avoid unnecessary MRIs, so I think it's okay for you to discuss this more with your physician, if possible.
I am sorry I can't just give you a straight "yes" or "no" answer, but each individual is unique and so is their disease course.
Again, I hope you get some helpful feedback from other community members!
Best, Erin, MultipleSclerosis.net Team Member.
Hey there! In addition to Erin's excellent response, I would say that your neuro's irritable suggestion to talk to the technicians about your gbacs concerns might mean that she doesn't know enough about it to discuss it with you and won't admit it, and isn't interested in taking the time to read up on it.
None of my neuros (I've had three) have done contrast with my spine MRIs. Their opinion is that it just isn't necessary. But your case is different from mine and everyone else's who have neurological symptoms. I'm not going to second-guess your doc and I'm not qualified to give you medical advice.
It's good that she wants to scan your cervical spine as part of diagnostic testing. My very first set of MRIs showed a clean brain but two cervical lesions. Brain lesions showed up eventually. Point being that for a number of us, lesions first appear in the spine. That's why it is mystifying that lots of neurologists scan only the brain when MS symptoms first present.
My suggestion is to follow up with the techs about your concerns. While they can't give you medical advice, they might give you some insight about why dye is preferred for cervical scans by some doctors. If they don't you can ask them where to check next. So much of getting diagnosed and managing a chronic disease is self-advocacy. We have to assert ourselves to get answers, sometimes exhaustively so!
I hope you can get some answers very soon! Best, Kim, moderatorYes, thank you! My only concern was that she ONLY did a c-spine MRI. My brain MRI was a year ago and despite what I thought was some sort of flare up and things could have changed, she did not want to re-image my brain. So I'm hoping that everything is still clean but I still can't shake that something is not right. She said, if I wanted, I could purse a nerve test. Would that be worth it in your opinion, for peace of mind, if nothing else?
Thank you for your response, Erin! I finally relented (albeit with a condition to use a specific contrast) and the spine MRI came back normal. I am relieved but am still worried about the persistent muscle twitches. It seems odd to have both ocular migraines and benign fascilation syndrome, two uncommon conditions. Trying to be patient and not seem like a crazy person. Thanks again for the response!
