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Neurology (Expert Forum)
Possible M.S.-Any input greatly appreciated!
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Possible M.S.-Any input greatly appreciated!
by jadams2809, Mar 12, 2002 12:00AM
THANK YOU!I am a 26 yr old female-always fatigued, tight,weak,occasional mild tremor,twitching, numbness,difficulty grasping,incontinence, bladder, east infections.Tests-EMG normal,EEG,relative slowing peripherally bilateral-median nerve to spinal cord.Central conduction normal except for delay in N13-N20 interpeak latency w rt stim,suggest delayed conduction over pathways in right C-spine cord and left brainstem/hemisphere,but b/c noise and artifact with right-sided stim may be due to tech factors.Clinical correlation required.MRI-basal ganglia show bilateral perivascular spaces at base, normal variant.No enhance.Normal flow in carotid, vertebral, and basilar systems. Hypoplastic right vertebral artery, normal variant.Small area of increased intensity in left parietal subcort deep white matter does not enhance-represents demyelination of any etiology,at this age is prominent, but nonspecific. No enhance.Subtle areas(1mm) of increased intensity only by post contrast FLAIR in rt posterior temporal deep white matter,not seen precontrast.No other abnormal enhancing.2.5 mm MPRAGE images did not enhance.MRI 6 months-Solitary left parietal subcortical deep white matter plaque iunchanged, does not enhance,very subtle.Left frontal lobe plaque not seenm could be present or was artifact.No other demyelinating plaques ID.No masses,mass effects,enhancement.Basal ganglia unchanged.No definite new plaques.Back-central bulging of c3-c4, subtle central soft disc herniation at c4-c5, central spur formation, hard herniation, mild stenosis at c5-c6. Questionable flow phenomenon at t5-t6. ?
Doctor's Answer
by CCF-Neuro-M.D.-JT, Mar 12, 2002 12:00AM
It's impossible to accurately comment on an MRI that I have never personally seen (though I know you tried to be as detailed and close to the report as possible in your posting). The lesions on your MRI that you describe could certainly represent MS plaques, but this would need to be correlated with a formal neurological exam and full medical history. THe other tests seem inconclusive or normal. The next step would be a spinal tap with a special test to look for immune breakdown products such as "Tourtellote's panel," "oligoclonal bands" and "kappa light chains". If the tests come out positive meaning these immune products are indeed present, then it becomes more likely that you could have MS. Talk to your neurologist or get a referral if you don't already have one. Good luck.
All MS patients are diffrent...I sure do wish you the very best..