Bright spots on MRI

[mygoldpaws]

Hi,

I just had an MRI done and I am being told that there are bright spots on the MRI.  My Dr ordered this MRI because of recurrent headaches - not necessarily migraines.  

I also have not felt well for about 6-8 months.  Unrelenting fatigue that only days in bed helps, vision disturbances ( I will go completely blurred in my right eye), over sensitivity to heat (water or temperature), tremors in my right hand and depression.  I am working full time but it is all I can do to get through a week.  I usually miss a few days every 6 weeks.  

I have been reading alot and it sounds like I may have MS.  I wil definitely take my MRI report to a neurologist if my internist doesn't address the whole thing but I am just curious in the meantime.

thanks


I am afraid that my internist is going to say that the bright spots are a result of the past migraines.  She doesn't seem to want to address my other symptoms.  

[sllowe]

Hey, Welcome Satori!

I'm sure this post will be missed attached to this thread.  Can you copy what you've written here to mygoldpaws and paste it on a new post  so you get the full welcome you deserve!

Don't lose hope, you'll find support and lots of information here,
be well,
-SL

[Satori1952]

Hello.  I am new here, but when I saw your post I really understood how you are feeling.  In fact it is what I have read on this site that made me want to participate.
I experienced my first symptoms of weakness in arms and legs, with difficulty walking back in 1988 when I was 36.  At the time my husband was active duty Army and the only thing that I was told by a military doctor was that it was my ‘nerves’ and stress (you know a typical woman).
In 1998 I had an MRI because of headaches and I was also experiencing trouble walking due to an unsteady gait, extreme fatigue, weakness in my arms and legs with tingling that I describe as ‘cold electrical shocks’ that would run up and down my legs, arms, and face.  I also temporarily lost sight in my right eye for 24 hours, after which the vision returned, but I still, to this day, suffer from double-vision and blurring in that eye off and on. This MRI showed ‘brightspots’ I was told by a neurologist not to worry about the ‘brightspots” most likely they were due to my diagnosis of migraines.  Just a note, the person who read the MRI at the hospital wrote in the report that demyalating disease could not be ruled out.  The retina specialist I went too asked me if I had been diagnosed with MS, which I had not, he said my optic nerve is definitely not normal, he did a number of test to make sure I didn’t have any disease of the eye- I didn’t.  The neurologist didn’t seem to be concerned with the loss of vision in my eye at that time, she suggested I see a phyciatrist, after putting me through test to see if I had everything from Lupus to Muscular Dystrophy, to Lymes Disease - I didn’t.  After about 6 months I was much better, with the exception of the vision problem in the right eye.  Well, I have had several bouts of these symptoms over the next years - some worse than others, sometimes I needed crutches to get around; it would last anywhere from to 6 to 8 months.  But after that first experience with the military doctor and with the neurologists I just coped as best I could when these symptoms appeared.  I have been very lucky to have found a GP (family doctor) who is very understanding and has told me not to give up on trying to find out what is wrong.  I am currently going through another bout of these symptoms and my GP is sending me to another neurologist (all copies of MIRs in hand including the one made last week).  I don’t know what is going to happen, but I am going to try and not to lose hope that I will find a neurologist who will help me find the answers.  Because, as I am getting older the symptoms just aren’t all leaving like the once did.

[Quixotic1]

Actually my paws are mostly black, a couple white ones, and four beige ones.

Welcome to the forum!  I see how you came to our site.  I am Quix.  I am one of the official town greeters, a physician in a former life, and I hope this site can be a good source of information for you.  You are going to need it in the near future.  First, I want to say that no one here can diagnose MS or anything else online.  I will talk about the things you have told us, tho, in the context of MS, 'cause that's our topic here.

First, you had an MRI because of headaches.  Good, that means your internist is on the ball.  You know it showed bright spots.  How do you know this?  Do you have the report?  If not, you need to go to where ever they did the MRI and request a copy of the report.  That will give you a lot more information.

Bright spots are usually areas that are more intense on the images done with the T2 technique.  They are also called hyperintense.  Until we hear how the radiologist described them we don't know much.  Did you have an MRI using the contrast they inject in your vein?  Sometimes, ad DB mentioned, "bright" might refer to an enhancing spot, but we can talk about that later.

Your concern that your internist might disregard the spots because of a history of headaches is legitimate.  Yes, people do acquire "bright spots" as they age (40's and up), with longstanding migraine disease, with high blood pressure, and a few other reasons.  And too often doctors will dismiss any spots as being normal for a person's age and health problems.  That is a problem when the person also has severe symptoms that are suggestive of neurological disease.

It doesn't make any sense to do an MRI to look for lesions or problems, then find lesions or problems and disregard them????  That's like investigating a burglary, looking for a broken door lock, finding it and then saying that maybe it was broken by a strong wind.

Your history of severe, unrelenting fatigue, heat-intolerance, visual problems, tremors, and depression could certainly be consistent with MS.  However, that is jumping the gun a little.  There are many diseases that look like MS.  To start the diagnostic process you will need a thorough neuro exam.  This should be done by a neurologist.  Certainly your internist can start the process with a neuro exam and put the three things together - your history of problems, any abnormalities on exam, and the results of the MRI.  Before they could give you a diagnosis of MS they would have to rule out the other known causes of multiple neurologic symptoms and possible brain lesions.

But, really, no matter what the internist finds, you should get a prompt referral to a neurologist.  If MS is even a reasonable possibility, I agree that an MS Specialist is a great idea, but if your internist won't go for it and has a VERY GOOD neurologist in mind you can start there.  This is not a situation that, in my opinion, should be handled completely by an generalist.  There are too many pointers to a neurological problem.  If your doctor doesn't want to deal with the other problems then get to a neuro!

Too often docs try to dismiss odd symptoms off to depression.  In reality, depression won't cause most of the problems you complain of, but when the docs hear "depression" and "fatigue" in the same visit, they may try to bundle everything into depression and just write a prescription for an anti-depressant.

Don't get me wrong.  I believe depression often needs treatment.  But, one should also look for causes of depression.  Given the multiple other symptoms, MS should be considered.  MS causes depression directly - as a primary symptom.  A depressive episode may be the first manifestation of MS.

Can you tell us more about how the symptoms started?  Did they all start together?  Have they come in batches?  Have any improved?  How old are you?

I hope you stick around, with all four of your golden paws, and we can help see you through this.  You find this is a very warm place - sometimes slow on the weekends and holidays, but so is everywhere.  We hope to hear your answers soon, and others will chime in to help.

Quix

[doublevision1]

Hi there

Your symptoms do seem suggestive of possible MS, as well as a host of mimics.

I would suggest you seek out the opinion of a MS specialist, who will be more knowledgeable and experienced in diagnosing and treating MS than an ordinary neurologist.

Do you have a copy of your MRI report?  If so, can you share exactly what it states?  "Bright spots" sounds like enhancing lesions, which can mean active MS lesions.  It would be helpful to understand in technical terms what the radiologist reported.

db