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Neurology (Expert Forum)
Abnormal MRI and MS
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Abnormal MRI and MS
by mlsteven, Nov 01, 2005 12:00AM
I am a 27 year old female. I have no major medical history other than a psychotic episode six years ago. I am not taking any medication (over the counter, prescribed, or recreational.) I drink rarely.
Last year, I had some sensory symptoms. One of my fingers, a left toe, and part of my right heel became numb. These symptoms did get better, but occassionally are present.
I had an MRI in April, which two small lesions in the left parietal region and one small in the right frontal lobe. They were present in an MRI I had six years ago.
Recently, I have noticed slight balance difficulties. Sometimes, I lose my balance when I start to walk. It feels like my shoulders are being pulled down. At a recent follow-up visit, I was able to walk toe-to-toe fine. Also, my right leg feels heavy sometimes, as high up as mid-thigh. It is more noticeable at the end of the day.
Despite being able to walk toe-to-toe fine and an MRI that has not changed in six years, the neurologist said something like MS is possible. The doctor does not recommend any additional testing. In your experience, would an MRI that hasn't changed in six years really indicate a possible problem?
Thank you for your time. I do appreciate it.
Last year, I had some sensory symptoms. One of my fingers, a left toe, and part of my right heel became numb. These symptoms did get better, but occassionally are present.
I had an MRI in April, which two small lesions in the left parietal region and one small in the right frontal lobe. They were present in an MRI I had six years ago.
Recently, I have noticed slight balance difficulties. Sometimes, I lose my balance when I start to walk. It feels like my shoulders are being pulled down. At a recent follow-up visit, I was able to walk toe-to-toe fine. Also, my right leg feels heavy sometimes, as high up as mid-thigh. It is more noticeable at the end of the day.
Despite being able to walk toe-to-toe fine and an MRI that has not changed in six years, the neurologist said something like MS is possible. The doctor does not recommend any additional testing. In your experience, would an MRI that hasn't changed in six years really indicate a possible problem?
Thank you for your time. I do appreciate it.
Doctor's Answer
by CCF-Neuro-M.D.-PW, Nov 08, 2005 12:00AM
Its hard for me to comment accurately on your MRIs without seeing them. Comparison of MRIs can be somewhat subjective, but if it has not changed over 6 years, it is less likely that you have MS. MS has a broad range of severity though and can appear in very mild forms. Also, sometimes the bullk of lesions are in the cervical spinal cord, and could also cause those symptoms. If this has not been done it probably should be. It doe snot seem like you meet any diagnostic criteria for MS at this time, but whether you have or not will surely reveal itself in time also. Ancillary tests like spinal fluid analysis and visual evoked potentials can support a diagnosis and could be considered.
Good luck
Good luck
In my opinion, it is unnecessary to do extra tests at the time when your symptoms are minor. Even if this is a minor form of MS, your symptoms may not need to be treated and a work-up may not be needed at this time. The best way to follow this up would be to do another MRI in 6-12 months (with gadolinium) OR at the time when you have new or debilitating (hopefully, not!) symptoms. Your doctor should also have you undergo a spinal tap to look for certain markers of MS. There are also other things that could cause these types of symptoms -- some more benign than others: one can look for these during the spinal tap as well.
Bottom line is: don't fix something that ain't broke. Unless your symptoms are severe (in your opinion), don't go chasing a diagnosis. You're bound to find something (like you did on your MRI) and you wouldn't know what to do with those findings. It's better to wait for a while, you're not risking much by doing so.
Good luck.
ON