MRI Explanation

[scharm]

I experience intense tingling and numbness all over body, cold burning in thighs, vertigo, hard to remember things, ringing in ears, left eye blurred at times and double vision that comes and goes.  MRI shows hyperintensive lesions in left optical and bilat frontal lobe white matter.  What does the MRI mean?

[scharm]

Thank you for your opinion.  I have never gone back to this MS clinic, just because the doc seemed so quick to decide that it was caused from HBP.  He gave me the feeling that he had no intention of following me (or helping me).  Even though I had given him the family history and my past neurological history.

I have had so many tests over the years, MRIs, LPs, EMGs, EEGs, Retina scans, CT scans, hearing tests, special eye exams (I think were the VEP), etc.  Neurological  symptoms keep appearing and disappearing.  They keep telling me they don't have an explanation for these attacks.

Two summers ago, I experienced double vision, which subsided within 48 hours, increased whole body numbness and tingling, off balance/vertigo, slurred speech, hard to focus and concentrate, unable to recall things, fatigue, and depression.  I was under extreme stress at the time, full time job and part time school.  Was referred to an eye specialist.  The eye specialist stated that the double vision I was experiencing was from birth.  I contacted my normal Ophthalmologist, who has cared for me for over 20 years, and he told that he disagreed with the dx, and that there has never been any evidence of double vision prior to this time.  In his opinion, it is neurological.

1988 I experienced left sided weakness, lost sight in left eye (which did return in about 3-4wks), tingling and numbness over body - some patchiness worse than other areas, incontinence, vertigo, legs rubbery and burning, left side of face - mouth and eye drooping, slurred speech, and depression (there may be more symptoms, just can't remember).  Stroke ruled out.  Neurologist told my husband they did not know what was going on, that they don't know everything about the brain.  I have had recurring attacks over the years, but not to this extreme.

Things keep happening, with no explanation.  I have started asking questions via Neurology forums and most have the opinion that it points to MS.  I would like to be proactive if it is MS and have the option to slow the progression.  Anymore, it's really hard to have faith in our medicine.  Just don't know where to turn anymore.  

Thanks for listening.  
Sincerely,
Frustrated

[COBOB]

OK.  The areas with visible lesions are not those areas typically associated with MS.   MS lesions that most neuros look for are "Peri-ventricular white matter lesions with the lesions perpendicular to the ventricular wall."  These are the so called "Dawson's Finger Lesions."
Lesions on the optic nerves are common in MS patients but are very hard to visulaize on most brain MRI.   I would be surprised to see just frontal lesions associated with HBP.  Lesions due to HBP tend to be more diffuse throughout the brain.  

Since you don't have Peri-ventricular white matter lesions or lesions on the corpus callosum, you will have an uphill battle with any neurologist that is a lesion counter and diagnoses from the MRI.

MS is diagnosed by excluding other diseases, looking at the clinical signs and symptoms and using diagnostic tests like VEP, MRI, and Lumbar puncture to support that diagnosis.  You don't diagnose from the MRI.  

These are my opinions, and I can bet your neurologist would disagree.

Bob

[scharm]

This is exactly what the report says:  PROCEDURE:  R-MSRN:  MULTIPLE SCLEROSIS-RETURN/NEW
PROC BOX:  MULTIPLE SCLEROSIS-RETURN/NEW dx mri shows hyperintensive lesions, in left optical and bilat frontal lobe white matter.  Non specific demyelination process.. db

I was then referred to a MS clinic.  I did a follow up visit regarding the MRI with a not so nice doctor from a known MS clinic, who told me that the MRI and my symptoms were from HBP.  I totally disagree with this doctor.  And he told me that I would never have to come back to his clinic.  (Mind you my sister visited him early on in her disease, and he told her the same thing).  After that, I visited my PCP who said to me that all we can do at this point is treat the symptoms, as I am not in harms way.  Which I agree with.  She never really came out and said "you have MS".  All I want is an explanation of these weird things that have been going on, and getting worse over time.

I have suspected that it may be MS, for quite some time.  My father had his first attack in 1978 and my baby sister was diagnosed in 1987.  My father did not have any permanent damage from subsequent attacks until 2000.  In 2000 they finally had concrete evidence by performing the LP.  He avoided doctors until such time, because they always insinuated that it was in his head.  My sister has had many attacks over the last 20+ years, with lesions increasing in the brain.  Both are now taking either Avonox (sp) or Copaxon by injection.

Today, the symptoms are present 24x7.  The symptoms worsen and then get better but are not totally gone.  I suspect I may be entering another attack.  

Just want closure.

[COBOB]

It means that there is evidence of demyelination (lesions) in the frontal lobes of your brain.  The reading isn't very specific, so your neurologist will have to look at the study.  Can you post the complete report?

The locations described don't scream MS, but if you have the correct clinical picture, the MRI only supports the diagnosis, it does not make the diagnosis.

Bob