Possibly MS
About 3 months ago I developed tingling in my right thumb, which would come and go depending on how I was sitting and what I was doing. My PCP ordered an MRI of the cervical spine which showed a suspicious area (possibly MS, myelomalacia, myelitis) so she referred me to a neurologist. He then ordered an MRI of the brain and cervical spine w/ and w/o contrast. The suspicious area on the spine was gone but the MRI of the brain showed multiple small round foci of abnormally increased FLAIR and T2 signal in the white matter of both hemispheres. 8 lesions in right and 4 in left. Ranged from a few mm to 5 mm in right frontal region. No enhancement. Not pathognomonic of MS but on differential. My neurologist then ordered an LP. The elevated levels are as follows: CSF IgG 10.8 (.8 to 7.7 normal), IgG index 0.74 (<.66), C IgG SYN rate +16.5 (9.9-3.3), CS TOT PROTEIN 72 (15-45), CS GAMMA/TP 17 (0-15),
PSERINE IGM 29 (<25), CSF PROTEIN 80 (15-45), and PTT-LA 47 (<=40). Oligoclonal bands were negative as was the myelin basic protein. I am a 35 year old female. All other testing for lupus, RA, and other autoimmune diseases were normal. I have had no additional symptoms. Although now with the power of suggestion everything seems to be tingling. When I went in originally I would have never even thought MS was on the differential because the tingling seemed postional. I'm not sure what I should do with the findings. The neurologist wants to see me back in 3 months and maybe repeat the MRI. If this is not MS what could be causing my elevated IgG index and protein. Is there anything else on the differential? Also if I were symptomatic would these findings be definitive for MS. Thank you for your time. I'm going crazy.
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