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Misdiagnosis of Labrynthitis?
What does MS look like on an MRI compared to Labrynthitis? I suspect that I have MS but my Neurologist keeps insisting no. I think he doesn't want me to worry about something that is not diagnosed. But something is causing the following symptoms and I need to know what and it is not Labrynthitis.
In December 2009 I began to have what I call 'dizzy spells'. I would run a low grade fever, develop a headache and dizziness with extreme nausea (in addition to the nausea caused by the gastro symptoms). These spells would come and go. Then in January I had my gall bladder removed. The day after the surgery I had a rash everywhere they had put betadine on my abdomen. So an allergy to iodine was suspected. Three days following the surgery, I developed constant vertigo in addition to the dizzy spells. After three days of this I went into the ER. They discovered that I had a UTI infection that had spread to the kidneys most likely caused by the catheter they inserted during surgery. What that has to do with vertigo I will never know?! So I was put on antibiotics and the UTI dissipated, but the vertigo remained. I saw my neurologist who recommended a series of tests, a hearing test, an ENG, an MRI, along with blood work.
(I need to say that in addition to the above mentioned symptoms I also have extreme fatigue that greatly effects my daily routine. I have lost 50 pounds since September 2009. I frequently have stool leakage and urine leakage - I have had two accidents where I did not even know that I was urinating until my pants were wet. I have frequent tingling and numbness in the fingers and arms - which worsens if I have my hands above my head for even the shortest amount of time. I have a hard time concentrating and I often find it hard to find the right words - it takes great effort. I feel like I am hearing through a fog in my right ear which came on suddenly about 2 months ago. I fall asleep very easily, especially while I am driving, hence I do not drive long distances and I tire easily. Also, four years ago I was diagnosed with Restless Legs syndrome, with it being severe at night, I have been on meds for it ever since. Three years ago I was diagnosed with PMDD and Adenomyosis and I have been on anti-depressants for the PMDD depression since. In November of 2009 I was diagnosed with Biliary Dyskinesia, Gastropareseis, and a Gastric Ulcer. I have had numerous ulcers since and in March I was diagnosed with Gastritis on top of everything else.)
The MRI showed what looked like labrynthitis in both ears, but the ENG and the hearing test came back normal (although I felt like she did not score the hearing test correctly as I had a much more difficult time hearing in the right ear than in my left). I have had blood work for Lyme - neg, Mono - exposed but not active, Parvo - exposed but sores in mouth have dissipated, thyroid - normal, RBC hemaglobin and hematrocrit - low but only slightly, Iron - low, and the test for inflammation in body - neg, herpes symplex (the type that causes cold sores) - exposed but not active, white blood cell count - normal. My doctors have ruled out: liver cancer, kidney stones and cancer, stomach cancer, small intestinal cancer, pancreatic cancer, colon cancer, cervical cancer, uterine cancer, ovarian cysts and ovarian cancer, Celiac, Chron's Disease, and Diabetes. My heart functioning is normal except for a slight murmur in the mitral valve and I passed all stress tests. I have had numerous UTI's and kidney infections over the years. I am now running a constant fever around 99.5 to 101, with my temp going up with activity. The headache is constant and so is the extreme nausea, vertigo, and dizziness.
So the doctors have come back to the MRI, it obviously showed something and I am wondering if they have missed something, like MS? I have the MRI images but I am unsure of how to upload them to you.
I have a husband and 5 children at home. I am almost 35 and yet I feel much older. My husband an I have had some severe marital problems our entire marriage, which has been a source of constant stress for me. But we are trying to work them out. We are in counseling for the 2nd time. All of my docs agree that this constant stress for close to 15 years has played a significant role in my current health problems.
So I come back to my original question, what does MS look like on an MRI? And what could possibly be causing the vertigo, headaches, nausea, and fever - besides Labrynthiitis, which I think is a misdiagnosis given the ENG was normal and the blood test for inflammation was normal?
In December 2009 I began to have what I call 'dizzy spells'. I would run a low grade fever, develop a headache and dizziness with extreme nausea (in addition to the nausea caused by the gastro symptoms). These spells would come and go. Then in January I had my gall bladder removed. The day after the surgery I had a rash everywhere they had put betadine on my abdomen. So an allergy to iodine was suspected. Three days following the surgery, I developed constant vertigo in addition to the dizzy spells. After three days of this I went into the ER. They discovered that I had a UTI infection that had spread to the kidneys most likely caused by the catheter they inserted during surgery. What that has to do with vertigo I will never know?! So I was put on antibiotics and the UTI dissipated, but the vertigo remained. I saw my neurologist who recommended a series of tests, a hearing test, an ENG, an MRI, along with blood work.
(I need to say that in addition to the above mentioned symptoms I also have extreme fatigue that greatly effects my daily routine. I have lost 50 pounds since September 2009. I frequently have stool leakage and urine leakage - I have had two accidents where I did not even know that I was urinating until my pants were wet. I have frequent tingling and numbness in the fingers and arms - which worsens if I have my hands above my head for even the shortest amount of time. I have a hard time concentrating and I often find it hard to find the right words - it takes great effort. I feel like I am hearing through a fog in my right ear which came on suddenly about 2 months ago. I fall asleep very easily, especially while I am driving, hence I do not drive long distances and I tire easily. Also, four years ago I was diagnosed with Restless Legs syndrome, with it being severe at night, I have been on meds for it ever since. Three years ago I was diagnosed with PMDD and Adenomyosis and I have been on anti-depressants for the PMDD depression since. In November of 2009 I was diagnosed with Biliary Dyskinesia, Gastropareseis, and a Gastric Ulcer. I have had numerous ulcers since and in March I was diagnosed with Gastritis on top of everything else.)
The MRI showed what looked like labrynthitis in both ears, but the ENG and the hearing test came back normal (although I felt like she did not score the hearing test correctly as I had a much more difficult time hearing in the right ear than in my left). I have had blood work for Lyme - neg, Mono - exposed but not active, Parvo - exposed but sores in mouth have dissipated, thyroid - normal, RBC hemaglobin and hematrocrit - low but only slightly, Iron - low, and the test for inflammation in body - neg, herpes symplex (the type that causes cold sores) - exposed but not active, white blood cell count - normal. My doctors have ruled out: liver cancer, kidney stones and cancer, stomach cancer, small intestinal cancer, pancreatic cancer, colon cancer, cervical cancer, uterine cancer, ovarian cysts and ovarian cancer, Celiac, Chron's Disease, and Diabetes. My heart functioning is normal except for a slight murmur in the mitral valve and I passed all stress tests. I have had numerous UTI's and kidney infections over the years. I am now running a constant fever around 99.5 to 101, with my temp going up with activity. The headache is constant and so is the extreme nausea, vertigo, and dizziness.
So the doctors have come back to the MRI, it obviously showed something and I am wondering if they have missed something, like MS? I have the MRI images but I am unsure of how to upload them to you.
I have a husband and 5 children at home. I am almost 35 and yet I feel much older. My husband an I have had some severe marital problems our entire marriage, which has been a source of constant stress for me. But we are trying to work them out. We are in counseling for the 2nd time. All of my docs agree that this constant stress for close to 15 years has played a significant role in my current health problems.
So I come back to my original question, what does MS look like on an MRI? And what could possibly be causing the vertigo, headaches, nausea, and fever - besides Labrynthiitis, which I think is a misdiagnosis given the ENG was normal and the blood test for inflammation was normal?
MRI can detect inflammation and other soft tissue details. Labyrinthitis will certainly "light up" on an MRI.
The MRI, in your case, could be a red herring. Simply because an inner ear (or plural) light up does not NECESSARILY mean there is pathology there. It has to be corroborated with clinical findings/other tests -- particularly when you're talking about normal structures with an increased signal versus an ABnormal structure (that shouldn't be seen at all). If the ear isn't behaving abnormally on an ENG and hearing test, it's hard to say that the MRI shows anything clinically relevant. There is a continuum here. Perhaps one radiologists thinks the inner ear is lighting up, but another may think it's within normal limits. A tumor should present with an abnormal mass on the scan. Getting another opinion about the scan is not a bad idea...
The MRI, in your case, could be a red herring. Simply because an inner ear (or plural) light up does not NECESSARILY mean there is pathology there. It has to be corroborated with clinical findings/other tests -- particularly when you're talking about normal structures with an increased signal versus an ABnormal structure (that shouldn't be seen at all). If the ear isn't behaving abnormally on an ENG and hearing test, it's hard to say that the MRI shows anything clinically relevant. There is a continuum here. Perhaps one radiologists thinks the inner ear is lighting up, but another may think it's within normal limits. A tumor should present with an abnormal mass on the scan. Getting another opinion about the scan is not a bad idea...
I appreciate the clarification. So my question is, if the MRI says one thing, but the ENG and the blood work say another which one is right? And if the ENG and the blood work are right then what can mimic Labrynthitis on an MRI? A tumor in the auditory canal maybe? I don't know much about these things and I am trying to find out as much as I can. So any words of wisdom you can give me would be helpful.
theflowergirl
theflowergirl
Are you saying that labyrinthitis CAN be seen on MRI? I thought MRI couldn't really see any inner ear conditions except acoustic neuroma.
What does the final impression read on the MRI report? Do you have a copy of the report?
I have unresolved labyrinthitis and this does NOT sound like any labyrinthitis. However, it is difficult to say that because you have so many things going on at one time.
Geez, alot going and not 35 yet. WOW!
I have unresolved labyrinthitis and this does NOT sound like any labyrinthitis. However, it is difficult to say that because you have so many things going on at one time.
Geez, alot going and not 35 yet. WOW!
MS is a clinical diagnosis. MRI should only be used to support the clinical findings.
The characteristic lesion demonstrated on MRI is the cerebral or spinal plaque. Pathologically, these plaques consist of a discrete region of demyelination with relative preservation of axons. Plaques suggestive of MS are typically found on MRI in the periventricular region, corpus callosum, centrum semiovale, and, to a lesser extent, deep white matter structures and basal ganglia.
Labyrinthitis will present with inflammation (increased activity) in the inner ear structures. Generally, labyrinthitis is a unilateral finding.
Clearly, the MRI findings of MS and labyrinthitis are very different and shouldn't be easily confused.
A normal hearing test and ENG would rule out labyrinthitis.
You certainly have a very challenging, difficult diagnostic dilemma. Sometimes having a fresh set of eyes look at you is valuable. That would be my best advice. Good luck!
The characteristic lesion demonstrated on MRI is the cerebral or spinal plaque. Pathologically, these plaques consist of a discrete region of demyelination with relative preservation of axons. Plaques suggestive of MS are typically found on MRI in the periventricular region, corpus callosum, centrum semiovale, and, to a lesser extent, deep white matter structures and basal ganglia.
Labyrinthitis will present with inflammation (increased activity) in the inner ear structures. Generally, labyrinthitis is a unilateral finding.
Clearly, the MRI findings of MS and labyrinthitis are very different and shouldn't be easily confused.
A normal hearing test and ENG would rule out labyrinthitis.
You certainly have a very challenging, difficult diagnostic dilemma. Sometimes having a fresh set of eyes look at you is valuable. That would be my best advice. Good luck!
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