MRI Results Query MS

[territorial]

I just received my results of my MRI via my family physician, not my neurologist. Follow up with him will not be for a month or two.

The findings have me baffled. At first I was worried, but now after a little research on my part, maybe it's okay?

"There are at least six T2 hyperintense foci identified within the centrum semiovale and corona radiata of each hemisphere. These all measure in the range of 2-3 mm.  There is no abnormal enhancement. These do not conform to a particular diagnostic entity."

It's normal to have hypertense foci at my age of 36 correct?  Am I missing something here?

My symptoms over the past has been pain in my neck, numb arms, legs, and face, numb tongue, fatigue.

[maramor]

As a fellow Canadian I can relate to the long waiting times you are describing. I've been having symptoms now for about a year and half. The MRI I had in October (without contrast) shows 15 small white matter lesions.....the radiologist report states that they are consistent with lesions of small vessel ischemic disease but demylination cannot be ruled out.

My symptoms include, numbness/tingling, spasms, intermittent weakness, R. hand tremor, very brisk reflexes, dizziness, cognitive/memory problems. My original neurologist was away so I went to emergency one day as my weakness and cognitive symptoms were really bad. I got referred to the urgent neuro clinic in Calgary several day slater where I saw a neurologist who seemed to have it in for me the moment she came in the office. She was very angry that I was not waiting to see my regular neuro. She refused to let me explain my symptoms or to read the list I had written out.

She stated that my problem was 'muscular' and told me that the 15 lesions were 'nothing'...merely due to aging. She says that the initial radiologist did not know what he was talking about and my MRI is essentially normal...that everyone has 'some' lesions as they age. (I'm 47...non smoker...never had high blood pressure),and ordered an EMG.

The EMG showed that it is not muscular and the dr. performing the EMG stated that he thought the problem originated from the central nervous system.

However, on my last appt. this abrupt neuro stated that she does not think my problem is even neurological and that the lesions are absolutely normal for a woman of my age. She will be sending this report to my GP and I'm really worried that this will shut down  further investigation of my issues...I've had problems with him as well taking my symptoms seriously...and as you well know, finding a new GP in Canada can be very difficult.

I'll be seeing him on Monday...(and taking my husband with me....he seems to take me more seriously if my husband vouches for my symptoms). I'm entertaining the idea of paying for an MRI with enhancement (if my dr. will agree to sign)....my original neuro has sent a letter to my GP stating that I should have an MRI again in a year...and obviously that just feels like way too long to me.

Anyway, just wanted to let you know that as a fellow Canadian I feel your pain regarding the lengthy waiting times and can relate to the process you are going through.

Good luck getting some clear answers without having to wait too long!

[territorial]

So since my lesions did not enhance they are old lesions?  Confusing!

My numb symptoms had gone away for a good week but then came back for one day, left leg and face so I called the Neurologists office to let them know that the symptoms were back and was pretty much dismissed and told I would be put on a cancellation list to get an earlier appointment, but for now I will be waiting approx 7 months unless my symptoms become more urgent.  Canadian Health Care is free, but it is slow! I was bascially told to see my GP if things return/get worse and then go from there.  My GP seems more concerned and has ordered a complete blood workup to check things out. Hopefully, I hear back from him soon to get the results.

Very frustrating.  Keeping a journal of any changes/occurences and will go from there I guess.  

Glad I found this site, finding it very informative.

Territorial

[Lulu54]

Hi territorial,

Bob is right in his advice as usual - that report makes little sense to me.  What you may be seeing is why GP's/PCP's do not do neurologic work everyday.  It is a complex process and most ony gloss over the subject in their training.  


the question of enhancement is always a bit confusing when you begin the diagnostic process.  Lesions enhance ONLY if they are less than about 40 days old - old lesions do not enhance, regardless of how much contrast they pump into us.  

36 years old?  You should not have that lesion load.  Period.

Lulu

[COBOB]

I think that is the right attitude.  Since MS is a diagnosis of exclusion, the neurologist should at least start looking for a cause to those lesions.  They should at least start to rule out the other causes of demyelination (Lymes, SLE, etc.)

Bob

[territorial]

Yes, it was done with contrast.  I am waiting for a followup with my neurologist and I guess I will go from there. Not going to worry about it until there is something to worry about.

[COBOB]

Nope.  Not normal.  Did they do your MRI with contrast?  T2 Hyperintense foci in those periventricular areas are typically the result of demyelination (in the absence of other disease processes.)  T2 Hyperintensities represent small areas with decrease water content.  The report fails to identify if the lesions are oval and perpendicular to the ventricles which is important.  At 36, you should not have microvascular or ischemic disease that would cause these foci.  You should consider a followup with your neurologist given your symptoms and these MRI results.

Bob