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Chronic Migraine VS MS lesions on MRI?

Hello, I am not (at least not yet) diagnosed with MS. I'm a 25 year old female, and for the past couple of years, I've been receiving treatment for Chronic Migraine and unrelenting muscle spasms in my face, shoulder, arm, neck, and back.

My doctor recently ordered an MRI of my brain because he thought I may have MS due to some other symptoms I was having, but when I went in for my appointment, he couldn't find my MRI report (or possibly hadn't received it yet from the radiology place).

I have another appointment in April when I'll speak with him about the MRI, and also receive Botox injections. He's also referring me to see an neurologist.

Anyway, in the mean time, I have a copy of my MRI report from the radiologist, which reads in the conclusion section: "Abnormal hyperintense signal predominantly within the periventricular white matter as well as within the left centrum semiovale. Some of lesions have a perpendicular configuration relative to the lateral ventricles. Findings may represent sequelae of demyelinating disease and further evaluation with gadolinium-enhanced imaging is suggested. At that time, saggittal T2 FLAIR imaging should be considered." Unfortunately, my insurance wouldn't cover the MRI with contrast.

I was wondering if anyone else has had experience with having both Chronic Migraine and MS, or possibly of receiving a diagnosis of Migraine before a diagnosis of MS.

Moreover, I know that migraines can sometimes cause lesions, so is there a way for me to tell from the report if the locations of mine are more indicative of migraine versus MS?

Any help would be greatly appreciated. Thanks!
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Avatar universal
Thank you!
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572651 tn?1530999357
let me add to the welcome you got from ess.  The report sounds suspiciously like MS, but I'm no medical expert.  getting to an MS specialist sounds like the best plan and I hope you have luck finding one in your area.

Don't be too worried about your insurance not covering the MRI w/contrasat.  That is not necessary to see brain lesions - it is used to see if there are active disease going on and the contrast helps to identify lesions that are very new (less than about 40 days old).  Many people never see active lesions on their MRI due to this timing.

Good luck and in the meantime take the waiting period to learn more about MS - it is a miserable disease for some people but most of use function pretty well with the right treatment.
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Avatar universal
Thanks! I do want to make sure I get a neuro who knows what he/she is doing when it comes to MS, so this is very helpful.
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Avatar universal
Go to mscare.com. This is the site of the Consortium of MS Centers, and they have a locator that possibly could help. Any neuro can call himself an MS specialist, but that's not the same as actually being one. Your local MS society might help too. If there are groups that meet locally, go to one of the meetings and ask for recommendations. You'll get the good, the bad and the ugly.

ess
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Avatar universal
Thanks for your quick reply!

I think with my insurance I don't need a referral, so I'll likely take your advice to schedule an appointment with a neurologist as soon as possible. My biggest challenge will probably be finding one that specializes in MS in my area.
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Avatar universal
Your radiology report's language is pretty classic for MS, locations and perpendicular configuration. Not saying that's what you have, of course. Chronic migraines can also leave their marks on the brain, though the lesions in migraine are generally described as punctate, meaning very small, pinpoint size.

If you don't absolutely need a referral to see a neuro, I suggest you seek out one on your own, one that specializes in MS. These things always take a long time to schedule as it is. General neurologists don't necessarily know a lot about MS.

And welcome to the forum!

ess
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