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Questions posted in the
Neurology and Neurosurgery Forum have been answered by doctors from The Cleveland Clinic Foundation.
Question Title: White area on MRI and L'hermittesForum: Neurology Forum
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| I posted a question regarding L'hermittes sign earlier this year. The response I received prompted me to request referral to a Neurologist. He performed a cervical MRI with and w/o contrast and a test called "Short Latency SSER Lower Limbs". The cervical MRI showed a long, thin white area on the cervical spinal cord which ran the length of about 3 vertebras. He called it an "area of inflamation". The other test involved attaching 3 electrodes to my head and stinulating each foot. The results were recorded by computer and printed out. The results for the right foot were markedly different from the left foot. The neurologist said that MS was not really a consideration at this point. He also mentioned Transverse Myelitis, but I did a web search on that and it seems to be a much worse illness than I have. We agreed to wait and see whether I develop additional symptoms or if the L'hermittes and the inflamation go away. He said I would know when the additional symptoms developed, if they did. The reason I saw him in the first place was because the L'hermittes was becoming more intense and occuring more often (it began in November, 1977). He did not feel that this alone indicated that someting was worsening. My question is just what are the symptoms I need to look for? Is it loss of sensation or movement? Just how common are these "areas of inflamation" and is there a general time period it takes for the inflamation to go away? I like the neurologist, but do I need a second opinion? I am a very active person and I am not looking for a major illness. My reaction to anyting strange happening with my body is to search for information so I can put the concern to rest and move on. The only answers to this seem to be wait to see if it gets better or worse. I am not taking any medications although my primary doctor did put me on anti-inflamatories for a month before refering me to the neurologist. Any help or direction you can give me will be greatly appreciated. Dear Susan: Areas of "inflammation" in the spinal cord could be due to multiple reasons, one them is Mutiple sclerosis. Other possibilities include vasculitis and sometimes tumors. These are rare possibilities, but the presence of Lhermitte sign, abnormal SSEPs of the lower extremities should prompt further work up that may include (beside complete neurological examination) spinal tap and may be repeat MRI. I would agree with you that you should get a second opinion. If you would like to see a specialist at the Cleveland Clinic, please call 1800 CCF CARE to arrange for an appointment. Good luck
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