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Question about MRI findings in relation to MS
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Question about MRI findings in relation to MS

I guess I should give you a little history:
My daughter was diagnosed with Chiari and Syringomyelia a few years back when she was about eighteen.She had a PFD that resolved her syrinx and then had a SFT that resolved many of the other symptoms.  Her balance still seemed to be less than on par and she was still prone to falling.  We actually asked about MS and we were assured that it would be revealed in an MRI, if present, and she did not have it.  Here recently she has been falling much more regularly, having regular bouts of nausea sometimes leading to full vomiting, and her vision has been going blurry.  These are all symptoms that she had been experiencing years ago prior to her original Chiari diagnosis.  She is also having an issue of it taking a long time for her to be able to start peeing.  Her doctor ordered an updated brain MRI.  It of course mentions post surgical changes and whatnot.  However, it also says:
"There are a few white matter punctuate signal foci noted about the parietal, frontal, and occipital lobes...This is best demonstrated on the FLAIR images.  These typically represent small vessel ischemic changes."  It is three weeks before we can get into the neurologist; in the meantime would the findings on the MRI and the symptoms correlate with a diagnosis of MS?  One of her last MRIs noted PVLs which I was told was no big deal due to her prematurity, but this MRI does not mention any PVLs and does note these foci (and does not mention that they are unchanged).  Is it possible that these are the same findings noted in a different manner (Both scans were done at the same hospital)?  I am not sure why, given that I have done really well at not 'freaking out' over the years with Tasha's conditions, but for some reason, the idea of MS has me totally overwhelmed.
Thank you for your time, and any help and insight you can give me.
JuneauTracy
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Dear JuneauTracy,

I understand your concern regarding your daughter.

I have gone through your daughter’s history.

I understand that she is suffering from Arnold chiari malformation with Syringomyelia (operated and resolved).

Symptoms of giddiness, nausea, vomiting, delay in micturition etc. may be secondary to Arnold chiari malformation as such.

Multiple punctate small white matter ischemic changes can also explain these symptoms but mostly these small punctate lesions in MRI can be differentiated on a good quality MRI of the brain.

MRI in Multiple sclerosis shows demyelinating changes which are different compared to ischemic changes.  Additionally diagnosis of MS (Multiple Sclerosis) is based on waxing & waning of neurological symptoms which is specific in distribution. So in my opinion, the current findings and symptoms that you describe do not typically correlate with MS.

Hope that this information helps and hope that you will get better soon.

Thank you for using MedHelp's "Ask an Expert" Service, where we feature some of world's renowned medical experts in their fields. Millions have benefitted from our service to get personalized advice for them and for their loved ones.

Best Regards,
Dr. Shiva Kumar R                                          
4 Comments
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Hi I am a 22 year old College basketball player and I am a new member to this site I joined because I am very concerned I might have Multiple Sclerosis I have very few people I can talk about this to in my life if anyone on this site reading or has knowledge about this or feed back please help me as I am worried sick please here me out! Here is my story..

It all started just this past summer (July 2011) when I noticed my hands were having slight tremors not shaking but just twitching when holding them up (just for the record I do worry about my health allot I have had this problem my whole life when something is out of the norm i worry allot) anyways I brought this twitching/ little hand shaking up to my parents they thought i was just my usual self worrying about nothing and they thought nothing of it. I also went to my family doctor i brought it up to him and he did not seem to show much concern.  So I just left it alone and stopped worrying about it. Months pass and September rolls around and my training camp starts up for basketball, in the middle of September i began feeling these muscle twitches in random parts of my body they would come and go and they would be felt in all different parts of my body legs, feet, butt cheeks, face, back, arms, chest everywhere. They wouldn't be painful but i could feel my muscle twitch sometimes even see it like in my chest when it would happen. This really began to scare me I started googling it on the computer and knowing how i get worried all the time I started thinking I had parkinson's or brain cancer or god forbid M.S I was starting to lose my mind because my aunt on my moms side was diagnosed with M.S 20 some years ago. So I thought I would phone my parents and tell them what was going on they did not seem concerned but I told them this was a big worry for me, I told them to fly me home so I could see my family doctor for some piece of mind they flew me out the next day when i went to see my doctor I burst out in tears convinced I had it when i was explaining it to him, but he said he did not think in any way it was M.S he said he could put me threw to see a neurologist but it would take up to 7 months and I told him I cant wait that long he checked my eyes and my reflex and sent me on my way he said if I was really worried I could go to the hospital and maybe they can run some more test or speed up the process if they think it something. So I go to the ER I finally see a doctor and explain him my story and without him doing any examination on me he tells me that I am going CRAZY and that I should talk to a therapist he says not to worry about the twitches and to stop reading on the internet. So i fly back to my college my parents and now doctors thinking i have gone crazy, fast forward a month and now I have had a couple other problems about a week ago i had a very slim barley noticeable very dence dence vibration in my right foot it would come and go 4 or 5 times during the day it got me worried again then about 2 days ago i had this slight tingling sensation in the middle of my left leg that would come and go every 6 second in different parts of the day. That has now stopped, but with all these things happening to me the vibrations the tinggling the twitches i have convinced myself again I have M.S I am so scared because I cant tell anyone without people thinking I am crazy is this normal??? I just cant stop worrying about the fact that I might have M.S it just seems impossible to think I have anything else! Could it just be stress could it be low blood sugar please if anyone is still reading this post or if anyone has the same symptoms as I have please let me know what I should do if their is anyone I can talk to or go to please let me know as I am worried sick and am losing my mind as each day goes by please please help me!  
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A related discussion, Ms or not???? Your opinion was started.
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A related discussion, mschvusangel was started.
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