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Neurology (Expert Forum)
MSA...'hot cross bun' sign
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MSA...'hot cross bun' sign
by AMO, Dec 17, 2004 12:00AM
Dear Doctor~
First thank you for your time, it is apprciated.
I will not go into alot of my history, very long and complex and I undersatnd you can not make a direct personal dx to me without seen me. Ove rhte last four+ years have gone round and round with very many specialists and even saw dr. Calabrese and Dr. Cohen there at you clinics.
My case has evolved through the years and this last visit i see my movement disorder specialist here at the Colorado University. There i see the neurology dept for my care. Since i not had a deffenite diagnosis these years, althought ms was one high of ideas, i saw my doctors this week and on this latest mri scan has progressed and she has now detected a 'hot cross bun' sign. I also have cortical and cerebellar atophy. After a extreme testing work up trough the years and so far todate the SCA profiles have been negative, although she has said since the latest they have identified a couple more we may test for.
My question to you will be..........
what other disease posibilites are there for this HCB finding beside MSA?
In my limited searches this is the only one that comes in relation. Is it possible for MS to have this finding?
and have you ever seen it in ms?
I have seen noted that it is not exactly dagnosic just of MSA, but i can not find anywhere other diseases it relates to.If you could tell me what other diseases it is possible to have this sign, i would appeciate it.
Thank you very much,
Amo
First thank you for your time, it is apprciated.
I will not go into alot of my history, very long and complex and I undersatnd you can not make a direct personal dx to me without seen me. Ove rhte last four+ years have gone round and round with very many specialists and even saw dr. Calabrese and Dr. Cohen there at you clinics.
My case has evolved through the years and this last visit i see my movement disorder specialist here at the Colorado University. There i see the neurology dept for my care. Since i not had a deffenite diagnosis these years, althought ms was one high of ideas, i saw my doctors this week and on this latest mri scan has progressed and she has now detected a 'hot cross bun' sign. I also have cortical and cerebellar atophy. After a extreme testing work up trough the years and so far todate the SCA profiles have been negative, although she has said since the latest they have identified a couple more we may test for.
My question to you will be..........
what other disease posibilites are there for this HCB finding beside MSA?
In my limited searches this is the only one that comes in relation. Is it possible for MS to have this finding?
and have you ever seen it in ms?
I have seen noted that it is not exactly dagnosic just of MSA, but i can not find anywhere other diseases it relates to.If you could tell me what other diseases it is possible to have this sign, i would appeciate it.
Thank you very much,
Amo
Doctor's Answer
by CCF-Neuro-M.D.-CS, Dec 17, 2004 12:00AM
There is limited literature on the topic. It was first described in patients with MSA, and simply describes the appearance of the pons (brainstem structure) on a T2 MRI. I have seen a few over the years, in patients with unknown conditions. There is one report in the literature about a case of vasculitis involving the pons. In this case after the swelling had stopped, a "hot cross bun sign" was noted. Therefore, although it is commonly reported in MSA, it can probably also be noted in other conditions. ALthough, there is no good study to document this. Good luck.
