Member Comments are provided by individuals and reflect their personal opinions only. Under NO circumstances should you act on any advice or opinion posted in this forum. ALWAYS check with your personal physician before taking any action regarding your health! MedHelp International and our partners, sponsors and affiliates have no obligation to monitor any comments posted on this site, or the content and/or accuracy of such exchanges. MedHelp International does not endorse the views of any user.
Neurology (Expert Forum)
5mm droopy brain tonsils, or MS?
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
5mm droopy brain tonsils, or MS?
by alucheni, Sep 03, 2006 12:00AM
As of the last couple months, I've had many symptoms typical of MS. I think MS is quite likely, though I noticed on an MRI taken a year ago that the radiologist had dictated this:
"IMPRESSION: The cerebellar tonsils extend approximately 5mm below the level of foramen magnum compatible with cerrebellar tonsillar ectopia/borderline Chiari malformation."
My research so far suggests that this would be asymptomatic for most people but that a small percent of the population could in fact have problems. Check out this site about borderline Chiari: http://www3.sympatico.ca/ejfs/chiari0.html
One year ago my only symptoms were light headedness and pain in the chest+backofhead that could be made worse by exertion. Three months ago is when my seemingly MS symtoms have come onto the scene. A month ago, an MRI of the head and C-spine have shown no demylenation. Current symptoms span the gambit of things I read about MS, some of which specifically exclude similar neurological problems. For example, I get "intention" tremors as opposed to the "resting" tremors seen in Parkinson's. Also, I have vision problems that are more severe in one eye. I'm 27 years old, male, caucasian, and live in Ohio. Many symptoms shuffle throughout the day and appear/disappear.
What may be a bit unlike MS is that I'm having some mild breathing problems already and sometimes experience harsh radiating pain when sneezing. I know that this can happen in MS but I'm hardly disabled yet. It seems odd. What are the chances of having 5mm freaky brain tonsils and MS at the same time? Thank you so much.
"IMPRESSION: The cerebellar tonsils extend approximately 5mm below the level of foramen magnum compatible with cerrebellar tonsillar ectopia/borderline Chiari malformation."
My research so far suggests that this would be asymptomatic for most people but that a small percent of the population could in fact have problems. Check out this site about borderline Chiari: http://www3.sympatico.ca/ejfs/chiari0.html
One year ago my only symptoms were light headedness and pain in the chest+backofhead that could be made worse by exertion. Three months ago is when my seemingly MS symtoms have come onto the scene. A month ago, an MRI of the head and C-spine have shown no demylenation. Current symptoms span the gambit of things I read about MS, some of which specifically exclude similar neurological problems. For example, I get "intention" tremors as opposed to the "resting" tremors seen in Parkinson's. Also, I have vision problems that are more severe in one eye. I'm 27 years old, male, caucasian, and live in Ohio. Many symptoms shuffle throughout the day and appear/disappear.
What may be a bit unlike MS is that I'm having some mild breathing problems already and sometimes experience harsh radiating pain when sneezing. I know that this can happen in MS but I'm hardly disabled yet. It seems odd. What are the chances of having 5mm freaky brain tonsils and MS at the same time? Thank you so much.
Doctor's Answer
by CCF-Neuro-M.D.-SH, Sep 04, 2006 12:00AM
First of all, keep in mind that I am unable to diagnose you because I am unable to examine you, this forum is for educational purposes.
The signs and symptoms you describe are more likely to be due to chiari, rather than MS (multiple sclerosis). An MRI of the brain and C-spine that does not show any demyelination is reassuring. Also symptoms that come and go during the day is not the clinical picutre of MS. MS exacerbations cause focal symptoms that last for 3-4 weeks (untreated) on average (much longer than you describe). Chiari symptoms can change rapidly. They will respond to increases in intracranial pressure, such as valslava maneuver (bearing down), sneezing, bending over, etc. You also describe an intention tremor, which is seen in cerebellar dysfunction and common in symptomatic chiari malformations (and very uncommon in MS).
I would recomend an MRI brain with CINE flow study to evaluate for CSF obstruction around your Chiari. I would also recommend some evoked potential studies to evaluate your c-spine (often kinked in chiari malformations) and a visual evoked potential to evaluate for past optic neuritis (seen in MS).
I hope this has been helpful.
The signs and symptoms you describe are more likely to be due to chiari, rather than MS (multiple sclerosis). An MRI of the brain and C-spine that does not show any demyelination is reassuring. Also symptoms that come and go during the day is not the clinical picutre of MS. MS exacerbations cause focal symptoms that last for 3-4 weeks (untreated) on average (much longer than you describe). Chiari symptoms can change rapidly. They will respond to increases in intracranial pressure, such as valslava maneuver (bearing down), sneezing, bending over, etc. You also describe an intention tremor, which is seen in cerebellar dysfunction and common in symptomatic chiari malformations (and very uncommon in MS).
I would recomend an MRI brain with CINE flow study to evaluate for CSF obstruction around your Chiari. I would also recommend some evoked potential studies to evaluate your c-spine (often kinked in chiari malformations) and a visual evoked potential to evaluate for past optic neuritis (seen in MS).
I hope this has been helpful.
But what is really importat is the shape of the tonsils (? triangled or pointed) and also the symptomes
1- Chiari could give MS like symptomes (any way MS symptomes are not what you are describing)
2- Chiari 1 spells are symptomes when you sneez or push up u get dizzy, back head pain..ext which means the pressure is building up in your head for few seconds
3- But what may worry me is the episodes of breathing difficulties which should not be of a long duration ..generally speaking, u should keep an eye on thes episod and see a neurologist to re evaluate your recent MRI for any signs of brainstem (the base of the brain)compresiion.
4- it could not be easy for you defferentiat (as many GPs)between an actual intention tremor from a physiologic tremer.
In brief try to get your MRI re evaluated
Bob
In many of the self reported testimonials I've read; Chiari sufferers have mentioned steady symptoms in addition to ones that were agitated by movement. Many were falsly diagnosed with MS. Also, it seems that the size of the the abnormality is now less important than how the abnormality affects the passage of CSF or applies pressure to the brain: http://www.chiarione.org/chiari.html
As far as my symptoms not being MS-like, I just plain have to disagree. I've spent many many hours and days reading about this affliction and it's quite common to have asymetrical vision problems and intention tremors (this is in addition to a host of buzzing/numbness/gait issues that I didn't have room to mention). It's pretty simple to differentiate between intention tremors and resting tremors I think. One activates when you move, one activates on it's own. The third variety would be an "essential" tremor which I don't think is relevant here seeing as I'm having a zillion other problems too.
Anyway, I do agree that I should get my MRI re-evaluated! That's what I intend to do. What I'd also like to do is possibly speak with someone who has experience with both afflictions...
I'm soon to undergo a lumbar puncture. Perhaps that will illuminate things some. Anyway, I'm trying to prepare mentally for the worst while hoping for the best.
Was wondering if you could read my comment on the next post that talks about numbness and exercise...your thoughts would be greatly appreciated.
Thanks,
Lesley
Everything was relatively dandy until about 3 months ago when my vision became noticably worse (now including the left eye to a lesser extent). I also noticed that I had trouble reading
An opthamologist hasn't been able to find a neuritis, MRI showed nothing, and apparently I passed the vision test. But... I know that my vision isn't right. Also, I tend to have contrast issues. I also get some sparkly effects in my eyes (think kalideskope, not stars).
About one month ago, I became quite ill for 2 weeks. I had some minor hallucinations (waving), nausea, and at some point my balance got thrown out pretty hard. Also, I lost some coordination in most every body part (I feel kind of like a robot). My fine motor skills suffered randomly. Sometimes my left hand gets clumsy, sometimes it's my right. Lately my hands have been spared. My gait became a bit hobbled... I walked like I had a jock injury. My eyeballs sometimes bounced around (nystagmus). I had/have pins and needles all over the place. My pinkie and ring fingers would be numb every morning... soon my right forearm was involved. I had some trouble breathing