I'm wondering, is it possible for multiple sclerosis to be triggered or outright caused by an actual physical injury to the neck? I have experienced vague foggyheadedness, some disequilibrium and weakness/numbness in my left leg ever since I received a neck manipulation in December. (I had been seeing a chiropractor since a rear-end car accident the month before.) I went to a neurologist who ordered a brain and neck MRI. The neck was clear, but the brain MRI showed two small white matter lesions, perfectly round and parallel to each other. My neuro has ordered blood work to check for MS, as well as lupus or Lyme disease. I have been doubtful about this, since my symptoms began specifically after the adjustment and I've never ever had them before then, but I've just been reading about a possible correlation between neck trauma and the onset of MS symptoms. Anyone know if there's anything to this?
Just a little update here: I received the full report on my MRI and it seems my neuro kind of downplayed the findings. It said there was numerous patches in the spinal cord at the cervical and thoracic region, as well as several subcentimeter lesions in the white matter of the brain and in the brainstem, all suggestive of a "demyelinating source such as multiple sclerosis."
Should I be very worried? I can't ignore the fact that none of my symptoms (mentioned above) had ever, ever in my entire life happened until literally within an hour of that neck manipulation...
Unfortunately, the diagnosis of multiple sclerosis (MS) cannot be make soley off of the MRI. The white plaques can be seen in other conditions, which is why the radiologist stated that it is "suggestive" of MS.
The diagnosis of MS is largely based on the patient's history and physical examination. Lumbar punctures are not always needed any more, if the H&P is consistent with the diagnosis, along with the MRI. But, in cases where there is doubt, it is still often used. Other testing, such as electrical studies of the nerves can also be done.
As to the association of trauma or manipulation with the onset or exerbation of MS, it has been found to have no assoication in several research studies. The articles that state that there is an association come almost exclusively out of the chiropractic field, and the research methodology is very questionable.
As one article states, that this practioner's patients with MS could all remember some neck trauma within the 10 years preceeding the onset of the MS. So, therefore, this association could not be overlooked. Well ... that is like saying that these patients could remember taking a vacation in the 10 years before the onset of MS, so taking a vacation is the cause of MS. It is poor methodology.
The following are four studies that were done using prospective methods to look at the association of MS and trauma:
A Prospective Study of Physical Trauma and Multiple Sclerosis.
Author: WA Sibley, et al
J Neurol Neurosurg Psychiatry. July 1991; 54(7): 584-589.
Department of Neurology, University of Arizona, College of Medicine, Tucson.
----> "There was no linkage between the frequency of trauma and progression of disability. MS patients had two to three times more trauma than controls."
Trauma and Multiple Sclerosis: A populationbased cohort study from Olmsted County, Minnesota
Author: A Siva, et al
Neurology. October 1, 1993; 43(10): 1878
Mayo Clinic and Mayo Foundation, Rochester, MN.
----> "Thus, we found no association of head injury and spinal disk surgery with onset of MS."
Trauma and Multiple Sclerosis.
Author: LT Kurland
Annals of Neurology. 1994; 36: S33-S37.
Department of Health Sciences Research, Mayo Clinic, Rochester, MN
---- "Thus, on the basis of credible epidemiological studies, and particularly the studies of cohorts with MS and with trauma, there is no indication that either onset or exacerbation of MS is the result of physical trauma."
Trauma and Multiple Sclerosis
Author: CM Poser
Journal of Neurology. 1987; 234(3): 155-159
Harvard Medical School and Beth Israel Hospital
---- "There is no evidence to support the idea that trauma ever causes multiple sclerosis."
If this is MS, it is doubtful that the neck manipulation brought it on.
The MRI is concerning. If you do not feel that your current neurologist did a thorough enough examination, find another neurologist. Again, the main way that MS is diagnosed is by history and physical examination, with studies being ancillary or confirmatory.
Hope you find the information you are seeking. Good luck.
Then I feel that MS just seems way too farfetched. Granted, I may be grasping at straws and wishful thinking, but it's very odd for MS to be triggered out of nowhere. I will remain hopeful that this is directly the result of that manipulation -- which, as I recently remembered, also included a thrust force to my upper back as well as a rotational neck adjustment. Perhaps posterior cord syndrome or a spinal cord concussion? I can't ignore the fact that my symptoms specifically started RIGHT AFTER this event.
Oh, and I got the full MRI report, and the radiologist actually noted several lesions in my brain and on the posterior aspect of the spinal cord. However, the MRI report also gives no mention of the fact that I was in a car accident or that my symptoms started immediately after a chiropractic adjustment. When I went to the scan center, the nurse or whatever was actually surprised when I mentioned being in a car accident, because apparently that had been left off of my referral order. Maybe the radiologist based his impression on the assumption that my symptoms started out of nowhere for no reason, and he was unaware that I had a physical trauma immediately preceding it.
I recently had another brain MRI in which multiple white spots were found one being identified as M.S. with years of M.S. symptoms--optic neuritis, balance problems, serious falls, pain, grip problems, various problematic muscle spasms, falls caused by legs just stopping. When can this be called M.S. and treated as such?