Brainstem lesion?

[jensequitur]

Howdy, folks...  Just doing my usual thrashing around and wishing I'd remembered to bring my cervical MRI films to the neurologist.  As always, I'm telling myself I'm wasting my time and trying to do the radiologist's job, when I should just trust him and not worry about it.  But I can't!

So I won't bore you with the details.  Just chime in if you've had a brainstem lesion, and if so, have you experienced any unexplained shortness of breath or weird hearing loss.

[doublevision1]

I do have a brainstem lesion, and as far as I know the only symptom I have that is associated with it is my double vision.

No shortness of breath or weird hearing loss.

I believe one of the cranial nerves, the third I think, can affect hearing and is associated with brainstem lesions.  Cranial nerves III and up originate from the brainstem.

db

[jensequitur]

Hah!  Cranial nerves...  I just did some looking, and that mysterious white spot in my brainstem is right about where the facial nerve (VII) would be.  So either it's just vascular interference causing a white spot in the brain... which of course I'm too inexperienced to judge... or it's a lesion at the facial nerve.

[wingnut19]

I also have a brain stem lesion and as far as I know it is the cause of me having developed CENTRAL sleep apnea.....

I stop breathing between 20-30 times each night...   :(

I have been told that my brain doesn't send the "signal" to my body to take a breath while sleeping.  This is much different from Obstructive sleep apnea.  I have no external issues that inhibit my breathing. (Which means that something like CPAP would be totally useless in my case)

To be honest, I have no clue what other of my symptoms are caused by this lesion.

Tammy

[jensequitur]

Ooh, Tammy, that's not cool!

Of course, it's very difficult to trace symptoms back to specific locations in the body.  It's much easier to say that because you have this lesion, it explains why you're having a particular symptom.  (Like my tremor, for instance, is most likely caused by the cerebellar lesion.)

Hey, DB, I just learned that damage to the sixth nerve is responsible for double vision... so your lesion is pretty close to my mysterious white spot.

[jensequitur]

Just bumping this up...  I've asked this question on another forum, and a couple people have told me they've had breathing and hearing problems - but theirs is much worse than mine!

[doublevision1]

I asked my neuro about the 6th nerve as my orthoptist keeps saying I have 6th nerve palsy and that is causing my diplopia.  But my neuro says it is caused by INO, and is more complex, involving more than just the 6th nerve.

INO is caused by demyelination of the MLF (medial longitudinal fasciculus).  Cranial nerves III, VI, and IV are primarily involved.

Re: your hearing, I was wrong about the 3rd nerve. It is actually the 8th (vestibulocochlear) that I was thinking of.

db

[jensequitur]

Interesting... the vestibo... whatsis is responsible for hearing and balance, and I've had equilibrium problems for some time now.  (Keep tipping over unexpectedly, and I'm not sure how vertical I am with my eyes closed.

You know, maybe it really is time to look for a new neurologist, one who's more in touch with MS symptoms and problems.  I'm getting tired of trying to figure this stuff out, and when I ask the neurologist, he never wants to commit to any particular cause, or even try to venture a guess.

[Quixotic1]

A couple of months ago I wrote a post describing the cranial nerves II through VIII or so and what they did and some of the lesions that can result from them.  I hope someone can find it and send it up for me!!

All the 12 (and some researchers think 13) Cranial nerves exit directly from the brain (O, I and II) or from the brainstem.  Because this these nerves are considered part of the central nervous system even though some of them go out quite far into the body.

Lesions on the brainstem tend to be very symptomatic because of a couple factors.  One all the fibers passing through as "eloquent."  Also there are many "nuclei" within the brainstem.  Nuclei are gray matter clusters of cells that act as "transit hubs" for the intercommunication of many, many nerves.  The three cranial nerves that control the very exact movements of the eyes and the pupils (III, IV, and VII) all intercommunicate via these nuclei.  Also the brainstem controls a great deal of the balance and equilibrium functions of the body.  So ,little lesions, can cause big symptoms.  Yes, tipping over is usually a brainstem problem.  

DB is right.  INO is caused by damage to one of these nuclei that allow intercommunication between those three eye muscle nerves.

You may not see all the lesions that are causing problems.  Even tiny, "invisible" lesions in the brainstem can cause bigtime symptoms.  When I developed Trigeminal Neuralgia (neuropathic pain from the CN V) my neuro got new 3T MRIs.  He said, " Well, I dopn't see a lesion causing the TN.  That's good.  You don't WANT a big lesion in the brainstem!"

The point here is that the 3mm lesions counting toward the McDonald criteria (and even visible lesions at all) are big lesions.  This is a further remark toward the fact that most of our lesions are not visible.

Jen, If your neuro won't venture a guess, it's likely because he doesn't know.  You might, with your intellectual curiosity, be happier and more at ease with a more knowledgeable and forthright neurologist.

Hope this helps.  And thanks for your addition to the Welcome Thread!

Quix