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Neurology (Expert Forum)
Does 'Normal' MRI rule out all CNS abnormalities?
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Does 'Normal' MRI rule out all CNS abnormalities?
by LollieBoo, Sep 26, 2005 12:00AM
Diagnosed with Urticarial Vasculitis, with joint involvement, and Fibromyalgia. Sudden-onset, severe headache begin when I was 9wks PG. Remained consistent for 6wks, has beeen relatively constant (2 years), with occasional recessions and flares. My vision is affected; one eye or the other suddenly losing vision- often only peripheral or central vision in both eyes will be affected. Episodes of extreme weakness, confusion and incoordination. During one recent severe episode, where I was unable to walk, my husband mentioned that it wasn't the first time; I have no recollection of previous incidences. It seems to worsen with each flare. During one severe occurance, where I had difficulty talking as well, I was told that I was having "stroke symptoms". Following MRI, husb and I were told that there was "swelling around the veins in the area of the brain that controls the affected functions". I was put on steroids. I now look at the report and see that it says "Normal"??
Occasional numbness and odd sensations- what I would call "over my kidneys", and down my shoulders, the back of my arms, affecting 21/2 of my fingers. Lasts sometimes days.
Traveling deep, tingling numbness affects one side, stopping midline (lips affected, then tongue as separate- still only 1/2, caused retching) then subsides.
MRI/ MRA both normal, blood and urine tests all appear normal. Lymes, ANA neg. One dr has suggested that a small-vessel vasculitis would not be visible on MRI, but capillaries could cause symptoms similar. Other has said MS possible with receding or spinal lesions only. I'm lost.
Occasional numbness and odd sensations- what I would call "over my kidneys", and down my shoulders, the back of my arms, affecting 21/2 of my fingers. Lasts sometimes days.
Traveling deep, tingling numbness affects one side, stopping midline (lips affected, then tongue as separate- still only 1/2, caused retching) then subsides.
MRI/ MRA both normal, blood and urine tests all appear normal. Lymes, ANA neg. One dr has suggested that a small-vessel vasculitis would not be visible on MRI, but capillaries could cause symptoms similar. Other has said MS possible with receding or spinal lesions only. I'm lost.
Doctor's Answer
by CCF-Neuro-M.D.-PW, Sep 30, 2005 12:00AM
I cannot give you a specific diagnosis over the internet, but I wil try to answer some of your questions
A normal MRI makes it highly unlikely that there is MS, or strokes. An MRI of the cervical spine should also be done if there is a question of MS, as this is also a common place for MS lesions. THe MRI can be normal in vasculitis but makes it less likely to be the cause - further testing to disprive vasculatis includes an angiogram.
I'm not sure how to interpret your MRI findings based on your description. An MR venogram may also be useful to exclude a venous blood clot which could cause similar symptoms. Likewise a spinal tap looking at teh pressure in teh spinal fluid may give evidnce of benign intracranial hypertension, which could cause similar symptoms, including intermittent visual loss and headaches. IF this is suspected you should also have a full ophthalmoloigcal exam as well.
Good luck
A normal MRI makes it highly unlikely that there is MS, or strokes. An MRI of the cervical spine should also be done if there is a question of MS, as this is also a common place for MS lesions. THe MRI can be normal in vasculitis but makes it less likely to be the cause - further testing to disprive vasculatis includes an angiogram.
I'm not sure how to interpret your MRI findings based on your description. An MR venogram may also be useful to exclude a venous blood clot which could cause similar symptoms. Likewise a spinal tap looking at teh pressure in teh spinal fluid may give evidnce of benign intracranial hypertension, which could cause similar symptoms, including intermittent visual loss and headaches. IF this is suspected you should also have a full ophthalmoloigcal exam as well.
Good luck
