MRI experts need yr help

1.)  Punctate focus of nonspecific flair hyperintensity in the left subcortical white matter may be within the broad range for age or can be seen in the setting of migraines.  No specific evidence of demyelination

2.) Pituitary glad measures 8mm, upper limits of normal, with mild convexity of the superior margin.

3) Prominent adenoid tissue is noted, symmetric

Symptoms:  migraines, muscle tightness in left and right trap, numbness in both arms, difficult swallowing, dropping things....

[Momzilla]

How old are you, Jinxie?  I don't know much about this stuff, but the punctate lesion reference means it's very small, and since you have migraines, I suppose migraines could be the cause.  The location doesn't mean anything to me until I look it up on Quix's Lesion epic post.  Why don't you read that to give yourself a refresher.  I'll bump it to the first page for you.

Good luck, and feel well.  I'll catch up with you later for if you have more questions.  Post your questions on this thread, though, OK?  Not Quix's thread.

Take care

Zilla*

[jinxie007]

Thanks for yr reply

I am 32.

I am in  pain almost 24/7 due to very tight muscles in my right and left trap. I have hyper reflexes, migraines everyday, weird numbness in both arms and hand, trouble swallowing, and my finger sometimes move up and down at radom.  

My Dr thinks it may be MS.  When they did my MRI.  They asked me during my test if I had migraines.  How can they tell if the lesions are MS or from migraines can't it be form both?  I have normal BP.

[Momzilla]

Hi, again!  

What is your doctor doing to try to get the migraines under control?  That must be miserable!  

Your question about the lesions is a good one.  Migraine lesions, as I understand it, tend to be smaller and in a different location than MS lesions.  But, as we have stated so many times, if someone is having symptoms not produced by migraines, a lesion is more significant.  At age 32, you should have NO lesions "within broad range for age!"  Ridiculous!  

Migraines do not produce hyper reflexes or random jerking of fingers (perhaps myoclonus?).  They can produce abnormal sensations, like numbness and tingling in lims and difficulty swallowing, but those symptoms would not be long lasting, as I understand it.  They would be part of an "aura" which normally lasts at most a few hours and would be followed by a headache.  Normally.  As with MS, migraine disease can be very fickle.  

Migraines do NOT produce hyper reflexes.  They don't.  So, I think your doctor is on the right track, and should follow your MRI up with some other testing.  Evoked potentials would be helpful in a diagnosis for you.  If he doesn't offer -- ASK.  Insist.  

Your MRI is just one step in the diagnostic process.  They've found a very small lesion.  Pursue it.  Don't let it go.  You need to advocate for yourself if you r doc seems hesitant to go further with testing.  At least he is entertaining the idea of MS. You have to push for further testing, Jinxie.  

Let us know how things are going and how we can help.

Take care and feel well!

Zilla*

[jinxie007]

Thanks for your input!

I have been on numerous drugs for migraines, but none seen to work at preventing them.

I will pursue the Evoked potentials too.

I have one more question.  IS the left frontal and the subcortical the same?

In my MRI with contrast it says.

Punctate focus of flair hyperintesity within left frontal white matter on series 10 image 45 may be within broad rannge of normal.  Foci of flair hyperintestity can also be seen in the white matter in the setting of migraines.

Is this the same small lesion?

Thanks

Take care too

[Momzilla]

You're allowed more than one more question!

Sorry I don't know the answer.  Keep bumping your thread up, if you have to so someone who knows can answer.  'Focus' means one.  'Foci' is plural.  I hadn't noticed that before.  Sorry.  That's really significant, if you ask me.... which you are!  LOL!

I really want you to push for testing!

Take care!

Zilla*

[jinxie007]

bump

[Quixotic1]

Hi, you've gotten most of the correct information already.  The punctate lesions in the subcortical area are suggestive of migrainous lesions, but if you have neurological symptoms, one has to be suspicious that the lesions are something else.  The location is also most typical of "age" lesions (if you were well into your 50's) or of migraine lesions, but the subcortical  and deep white matter are also seen in MS.  Remember your regular doctor knows what you have been through and what your exam is like.  That forms the basis of considering MS, NOT the MRI.

The subcortical means the area right beneath the cortex of gray matter.  Most areas of the cerebrum have both subcortical and deep matter.  So, no, the regions aren't the same.  So the pinpoint area in the frontal sounds like a different spot than the tiny spots seen in the subcortical area.

Have you told us your whole story somewhere, so we have a context for this.  MS is not diagnosed form the MRI.  You start with the symptoms the person has had and the signs of abnormality on the neurological exam.

Stay with us.  We'll help answer questions.

Quix