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Neurology (Expert Forum)
worried about MRI results
This forum is for questions and support regarding neurology issues such as: Alzheimer's Disease, ALS, Autism, Brain Cancer, Cerebral Palsy, Chronic Pain, Epilepsy, Fibromyalgia, Headaches, MS, Neuralgia, Neuropathy, Parkinson's Disease, RSD, Sleep Disorders, Stroke, Traumatic Brain Injury
worried about MRI results
by DET, Oct 02, 2005 12:00AM
42 male Brain MRI w/w/o contrast Sept 2005. Brain Parenchyma: 2-3mm T1 hypointense focus in the right periatrial white matter failed to reveal signal abnormality on the T2 weighted sequences. Finding likely variant. No abnormality of enhancement corresponding to this lesion noted. Brain parenchma otherwise demonstrates normal signal. No signal abnormalities on the difussion weighted sequences or the post contrast enhanced images noted in the cerebrum or cerebellum. There is no evidence for mass effect. All other areas unremarkable. Cervical MRI without contrast May 2005 revealed degenerative disc changes with normal spinal cord signals. I frequently have buzzing/tingling/twitching feet arches,calves,right eyelid can be any extremity. Pain/sorness left butt/hip and back of thigh. Neurological exams normal reflex strength vision etc. I have seen two different neurologist twice each in the past six months. I saw a spine surgeon that recommended physical thearpy to alliviate symptons-after two sessions said he did not think the cervical changes were enough to cause my symptons. My Gp has completed all the blood work and exams he feels are necessary including PSA b-12(400 something),Tyroid,lyme(elysa)HIV, monoclonal antibodies sed rate all normal. I am a dentist. My GP and first neurologist prior to Brain MRI recommended psychiritist for anxiety over these symptons. Do you feel this is all anxiety,that would be great? What could cause the hypointense T1 lesion? What does likely represent varient mean? Could other MS lesions be hiding in the rest of the spine? What next?
Doctor's Answer
by CCF-Neuro-M.D.-PW, Oct 06, 2005 12:00AM
My advice is limited by not seeing the MRI scans, so I cannot give you any formal opinions or clinical diagnosis over the internet
A variant is a medical term for a variation or slight difference in peoples brain anatomy that is still considered normal as opposed to abnormal - it is just a feature of our individuality in the general population.
Its not clear what the T1 hypointense focus is - it could just a 'perivascular space' also called a Virchow-Robin space - just some space around a normal blood vessel. Also potentially it could be an old stroke or MS lesion - but the lack of signal abnormality would go against this and would support that it is a normal variant. Hypointense MS lesions usually occur in advanced disease, so there would be other MRI and clinical signs of MS. It would not hurt to have your stroke risk factors assessed anyway. A repeat MRI in 6 months might be reasonable to make sure it has not increased in size. No change over time would also support a normal variant.
The leg symptoms are not classic for a lumbar myelopathy or radiculopathy (pinched spinal cord or nerves), a more sensotive test would be an EMG and nerve conduction study of the most symptomatic leg.
I would be encouraged that your tests have shown no significant pathology to date!
A variant is a medical term for a variation or slight difference in peoples brain anatomy that is still considered normal as opposed to abnormal - it is just a feature of our individuality in the general population.
Its not clear what the T1 hypointense focus is - it could just a 'perivascular space' also called a Virchow-Robin space - just some space around a normal blood vessel. Also potentially it could be an old stroke or MS lesion - but the lack of signal abnormality would go against this and would support that it is a normal variant. Hypointense MS lesions usually occur in advanced disease, so there would be other MRI and clinical signs of MS. It would not hurt to have your stroke risk factors assessed anyway. A repeat MRI in 6 months might be reasonable to make sure it has not increased in size. No change over time would also support a normal variant.
The leg symptoms are not classic for a lumbar myelopathy or radiculopathy (pinched spinal cord or nerves), a more sensotive test would be an EMG and nerve conduction study of the most symptomatic leg.
I would be encouraged that your tests have shown no significant pathology to date!
Thanks,
Mistyd41559
Have you checked into the possibility of mercury poisoning as the cause of your symptoms? While I know there is some misperception out there about the prevalence of this condition (many people think they have it when they don't), it has been proven to be an issue among dentists and people who works in dental offices. The symptoms you describe are consistent with mercury exposure. A simple blood test can reveal your levels. You may want to read more about this online just as a possibility, if you aren't finding answers elsewhere. I know how it feels to be having these symptoms without clear reasons--I'm in the same boat, and I wish you the best.
It's amazing how similar your story sounds to mine.
You can read the details of my problems at:
http://www.medhelp.org/perl6/neuro/messages/33611.html
It's now been eight months, and I still don't know what's going on. I still endure the burning and pins-and-needles sensations in my feet, radiating up into my shins. Some days, I feel almost completely normal and pain free. But much of the time, I feel some sort of abnormality, whether it be pain in the arms and legs, sensation loss, loud tinnitus and muscle twitching.
Like you, many of the "specialists" I've seen have implied it's all due to anxiety. It's frustrating, because prior to January I was perfectly fine. The symptoms happened suddenly.
My GP has speculated that it may have been a virus. Of course, he's also one of the doctors that has suggested it's "all in my head."
Some of these doctors should really learn to show patients a little respect. Just because they haven't found it on test, doesn't mean you're not feeling it. I certainly sympathize with your issue and wish you the best of luck.