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Differential diagnosis of white matter lesions
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Differential diagnosis of white matter lesions

I finally found a fairly complete list of conditions that can cause white matter brain lesions in a Neurology textbook. (I do know that Celiac Disease is missing from the Inflammation category.)  Not that this is very useful for people already diagnosed with Lyme, but interesting nonetheless.


Differential diagnosis of white matter lesions

INFLAMMATORY

Multiple Sclerosis
Acute disseminated encephalomyelitis
Nueromyelitis optica
Vasculitis (including SLE [Lupus] & Sjogren’s)
Sarcoidosis
Behcet’s disease
Primary angiitis of the CNS
Vascular
Small vessel disease
Antiphospholipid syndrome
CADASIL (hereditary stroke disorder)

INFECTIOUS

Progressive multifocal leucoenephalopathy
HIV encephalitis
Viral encephalitis
Lyme Disease
Whipple’s Disease
Syphilis
Subacute sclerosing panencephalitis
Intracerebral abscesses
Tuberculosis/fungal infections

METABOLIC

Pontine/extra-pontine myelinolysis
Phenylketonuria Vitamin B12 deficiency
Hyperhomocysteinemia
Cerebrotendinous xanthomatosis
Leucodystrophics
Adrenoleucodystrophy/adrenomyeloneuropathy
Globoid cell leucodystrophy
Metachromatic leucodystrophy
Vanishing white matter disease
Alexander’s disease
Canavan’s disease

OTHER

Tumor (glioma, lymphoma, metastases)
Mitochondrial disease
Susac’s syndrome

4 Comments Post a Comment
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1763947_tn?1334058919
I found it really interesting. My LLMD is getting copies of my MRI of the brain from when I was in Texas and was told I have brain lesions and some of my white matter was destroyed and will never come back. The doctors there won't give you a copy so my LLMD is getting it from the facility that took the pictures.
Thanks for this.
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1917408_tn?1329427500
Yes, thank you so much for this post! Very helpful!
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I'd like to bring this up because a new member (in the UK) was asking about a definitive dx from an MRI.

All I know what ''it's difficult" and needs to be looked at by someone who can really read them, interpret them etc.
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What's missing from this list is Bartonella.  

Several years ago, some researches cultured Bartonella Henselae bacteria from a biopsy of small white matter brain lesions.

Since neurologic Lyme Disease doesn't always cause brain lesions, some LLMDs believe it's the coinfection of Bartonella that's actually causing them.
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