I'm 31. I was in a car accident 2½ years ago and was paralyzed for 7 months. Then I was able to walk for a few days. Today I still have lower back pain, with a roller coaster of walking and then being wheelchair bound. I also have numbness, and pain in my legs, which are cold to the touch. My doctors can't seem to find anything. They suggest that I may have MS.

Question

I'm 31. I was in a car accident 2½ years ago and was paralyzed for 7 months. Then I was able to walk for a few days. Today I still have lower back pain, with a roller coaster of walking and then being wheelchair bound. I also have numbness, and pain in my legs, which are cold to the touch. My doctors can't seem to find anything. They suggest that I may have MS.

Answer

There are no specific tests that can determine if a person has MS (multiple sclerosis) or is likely to have it in the future. Definite diagnosis of MS involves both clinical (history and neurological exam) and paraclinical (MRI, spinal tap, Evoked Potentials) evidence. If these have not yet been done following your accident then it cannot be positive that you have or are getting MS.

The diagnosis evolves from a discussion between the patient and the physician. A careful medical history is taken; symptoms and signs are assessed. Other ailments are ruled out. The diagnosis is highly dependent on the accuracy of the patient's medical history and the physician's skill in eliciting and evaluating this information. The diagnosis is sometimes obvious and sometimes very difficult. Even in the hands of experts, the diagnosis is correct only 90% - 95% of the time.

The physician must be able to find neurological evidence of lesions or plaques in at least two distinct areas of the central nervous system (CNS) white matter, evidence that the plaques have occurred at different points in time, and most importantly, that these plaques have no other reasonable explanation, thus ruling out other illnesses that mimic MS.

I understand the frustration that you must be having right now. In the beginning phases of multiple sclerosis, diagnostic tests, such as MRI's, may be negative but the patient may experience subjective sensations such as you are having with the cold, numbness and pain in the legs.

Other symptoms can include tingling, or fatigue, and will not be seen on diagnostic tests. This leads doctors to believe there is no illness or that anxiety is present.

You should also know that a clinical diagnosis of MS may take years. Often a physician observes a person over a period of time before reaching a diagnosis of MS.

Not all symptoms affect all MS patients. No two persons have the same complaints; no one develops all of the symptoms. That's what makes it so difficult for your physician to diagnose this condition in the early stages.

Your current symptoms could be from your previous accident, but tests, x-rays and neurological diagnostic tools should have ruled this out, especially if your doctor's have said that nothing is wrong.