Was it a stroke or do I have multiple sclerosis?

Here is My Question:
I was in Florida for vacation and was sent to the hospital. The hospital thought I was having a stroke. They admitted me and the doctor on call felt I needed to be admitted as he thought I was too young for a stroke. They did an MRI w/wo contrast and several white matter and lesion that was suspicious. Blood work came back as follows: Glucose - high...EOSINOPHILS - high....MCH low....MCV low.....NEUTROPHILS low.....RBC high.....RDW-CV....high Doctor/Neurologist was positive it was MS. Could this be correct? They did not want to do a spinal tap as they felt it was not necessary.

​Answer:
It is very difficult to comment on your case without further details.

I can tell you that anyone who goes to an emergency room with the acute onset of neurological symptoms is considered a “Code Stroke” until they are evaluated. This is done to ensure that all evaluations are completed rapidly in case the person needs acute treatment for a stroke, which can only be administered within 3-6 hours of the onset of symptoms.

I suspect the ER personnel called a “code stroke” and following an MRI scan realized the findings were more consistent with MS. This is very common in people under the age of 50, a rare age for a person to experience strokes if they do not have significant risk factors for strokes.

Whether a lumbar puncture (LP) or spinal tap is required to establish a diagnosis of MS depends greatly on the circumstances. We can certainly diagnose MS without an LP. In order to have a diagnosis of MS, certain clinically criteria have to be applied which you can read about here (http://www.healthcarejourney.com/physician-blog/the-diagnosis-of-multiple-sclerosis-ms). 

The current clinical criteria for MS emphasizes the use of MRI over a spinal tap, so this could explain why the doctors you saw didn't feel compelled to do a spinal tap.  Once again, I cannot render an opinion on this without more information.  I would strongly suggest you follow-up with a MS specialist who knows how to apply the clinical criteria appropriately and who can review your specific situation. 

Revere (Rip) Kinkel MD
Director of the Multiple Sclerosis Program
Director of Hillcrest Neurology
Professor of Clinical Neurosciences
University of California San Diego