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MRI result
Hi all,
I'm going to copy and paste my MRI result. I have had a plethora of symptoms that are similar to MS. I went to a neuro doc who ordered blood work and MRI. End result after testing...No MS, I'm frustrated and am not sure where to go next. I was 44 at the time of the MRI. I'm an RN, and I know that this is not me making stuff up (kind of the impression I got from my post testing visit with my neurologist. Any suggestions are much appreciated!
Cerebrum: Multiple small T2 hyperintense lesions are seen in the cerebral white matter, excessive for age. Most of the lesions are scattered randomly, but small periatrial periventricular lesions are present. No
mass effect is appreciated.
Cerebellum: No lesion seen. Mild cerebellar tonsillar ectopia is noted.
No frank Chiari malformation.
Brainstem: Unremarkable.
Ventricles: Normal volume.
Sulci: Appropriate for age.
Post contrast images: Following the administration of IV contrast, no
mass or enhancing lesion is seen.
Diffusion weighted images: There is no restricted diffusion to suggest
acute infarction.
Hemorrhage: There is no evidence of hemorrhage on the gradient echo
sequence.
A persistent right trigeminal artery may be present, an anatomic variant.
The vertebral and basilar artery flow-voids are small. Extensive
mucosal thickening and possible minimal fluid in the right maxillary
sinus. The nasal septum is deviated to the right.
IMPRESSION:
1. Multiple small nonspecific white matter lesions, excessive for age.
Differential diagnosis includes chronic small vessel ischemia and
demyelinating disease/multiple sclerosis.
2. No contrast enhancement to suggest active demyelination the brain.
3. Right maxillary sinus disease.
I'm going to copy and paste my MRI result. I have had a plethora of symptoms that are similar to MS. I went to a neuro doc who ordered blood work and MRI. End result after testing...No MS, I'm frustrated and am not sure where to go next. I was 44 at the time of the MRI. I'm an RN, and I know that this is not me making stuff up (kind of the impression I got from my post testing visit with my neurologist. Any suggestions are much appreciated!
Cerebrum: Multiple small T2 hyperintense lesions are seen in the cerebral white matter, excessive for age. Most of the lesions are scattered randomly, but small periatrial periventricular lesions are present. No
mass effect is appreciated.
Cerebellum: No lesion seen. Mild cerebellar tonsillar ectopia is noted.
No frank Chiari malformation.
Brainstem: Unremarkable.
Ventricles: Normal volume.
Sulci: Appropriate for age.
Post contrast images: Following the administration of IV contrast, no
mass or enhancing lesion is seen.
Diffusion weighted images: There is no restricted diffusion to suggest
acute infarction.
Hemorrhage: There is no evidence of hemorrhage on the gradient echo
sequence.
A persistent right trigeminal artery may be present, an anatomic variant.
The vertebral and basilar artery flow-voids are small. Extensive
mucosal thickening and possible minimal fluid in the right maxillary
sinus. The nasal septum is deviated to the right.
IMPRESSION:
1. Multiple small nonspecific white matter lesions, excessive for age.
Differential diagnosis includes chronic small vessel ischemia and
demyelinating disease/multiple sclerosis.
2. No contrast enhancement to suggest active demyelination the brain.
3. Right maxillary sinus disease.
Why not just get a lumbar puncture? I don't have all of that time to take off work. That's part of the reason I keep putting it off, but ignoring it doesn't make it go away...
COMMUNITY LEADER
Hi and welcome,
There is definitely something going on!
Whether it's a neurological condition like MS is actually hard to say.....your brain MRI to me, is indicating it isn't exactly normal for your age but it's not specific enough to pin it down either. I would of thought you should of also had a full spinal MRI too, if you haven't had a spinal MRI to assess your structural spine and spinal cord i would recommend you get one.
It might be an idea to get your hands on your neurological assessment, and see if there were any neurologically abnormal clinical signs found. I also agree with the suggestion of getting a physiotherapy assessment, because often getting your individual issues tested can really help pin down causation eg urological (bladder), ophthalmologist (vision), vestibular disorder specialists (vertigo type -Labyrinthitis, vestibular neuronitis, BPPV etc)
Hope that helps.........JJ
There is definitely something going on!
Whether it's a neurological condition like MS is actually hard to say.....your brain MRI to me, is indicating it isn't exactly normal for your age but it's not specific enough to pin it down either. I would of thought you should of also had a full spinal MRI too, if you haven't had a spinal MRI to assess your structural spine and spinal cord i would recommend you get one.
It might be an idea to get your hands on your neurological assessment, and see if there were any neurologically abnormal clinical signs found. I also agree with the suggestion of getting a physiotherapy assessment, because often getting your individual issues tested can really help pin down causation eg urological (bladder), ophthalmologist (vision), vestibular disorder specialists (vertigo type -Labyrinthitis, vestibular neuronitis, BPPV etc)
Hope that helps.........JJ
This is a diary I was keeping until he said because there are no lesions on my C-Spine, there is no MS and no need to follow up.
My symptoms tend to change, for instance I will have numbness and tingling for a few days or weeks, then it goes away and my eyes start getting blurry, then I will have a week or more of severe muscle cramps. I have had episodes of dizziness and unsteady gait. I have constipation and cannot hold my bladder for longer than an hour, often dribbling from the urgency. I have had episodes of choking, where fluid mostly goes down my trachea rather than my esophagus. I can't remember things that just happened a half hour before, or find words that I should know. I often forget how to do something, like I will put the car in drive instead of reverse or forget to turn my car off. I have gone to the bathroom and forgot to pull down my underpants and voided, it isn’t until then that I realize what I have done.
Fine hand tremors in the morning
4/7: dizziness, muscle cramps in my feet, urgency
4/8: L hip pain, dizziness, a feeling of bees in my feet, extreme fatigue, urgency
4/9: R eye pain, headache in my eye, extreme fatigue
4/10: R arm numbness/tingling, forgetfulness, general feeling of “fuzzy”
4/11: urgency, dizziness to the point that I thought I was going to fall out of my chair
4/12: good day, just tripped a lot
4/13: numbness/tingling in both upper and lower extremities L sided, floaters, exhaustion
I gave up on my list because my MRA didn’t show any lesions….I was so frustrated, but I know this isn’t all in my head.
7/15: Over the last 4 weeks, I have fallen 4 times. Once I lost my footing and fell, and 3 times I’ve tripped all d/t my right foot not working and moving the way it should. My memory is that of an 80 year old, or that is how I perceive it. I have been talking to my daughter on 2 occasions and randomly put words in my sentence that didn’t even make sense. Let’s go for a walk in the forest…what forest? She was cleaning the pig pen and asked for my help, and I said “For what, do you have allergies?” I meant to say, why are your arms not working?
My symptoms tend to change, for instance I will have numbness and tingling for a few days or weeks, then it goes away and my eyes start getting blurry, then I will have a week or more of severe muscle cramps. I have had episodes of dizziness and unsteady gait. I have constipation and cannot hold my bladder for longer than an hour, often dribbling from the urgency. I have had episodes of choking, where fluid mostly goes down my trachea rather than my esophagus. I can't remember things that just happened a half hour before, or find words that I should know. I often forget how to do something, like I will put the car in drive instead of reverse or forget to turn my car off. I have gone to the bathroom and forgot to pull down my underpants and voided, it isn’t until then that I realize what I have done.
Fine hand tremors in the morning
4/7: dizziness, muscle cramps in my feet, urgency
4/8: L hip pain, dizziness, a feeling of bees in my feet, extreme fatigue, urgency
4/9: R eye pain, headache in my eye, extreme fatigue
4/10: R arm numbness/tingling, forgetfulness, general feeling of “fuzzy”
4/11: urgency, dizziness to the point that I thought I was going to fall out of my chair
4/12: good day, just tripped a lot
4/13: numbness/tingling in both upper and lower extremities L sided, floaters, exhaustion
I gave up on my list because my MRA didn’t show any lesions….I was so frustrated, but I know this isn’t all in my head.
7/15: Over the last 4 weeks, I have fallen 4 times. Once I lost my footing and fell, and 3 times I’ve tripped all d/t my right foot not working and moving the way it should. My memory is that of an 80 year old, or that is how I perceive it. I have been talking to my daughter on 2 occasions and randomly put words in my sentence that didn’t even make sense. Let’s go for a walk in the forest…what forest? She was cleaning the pig pen and asked for my help, and I said “For what, do you have allergies?” I meant to say, why are your arms not working?
2 Comments
Was your Neuro an MS specialist? I'd be tempted to seek another opinion or at least further explanation about what your results mean. Probably the former as you don't seem to have been handled very nicely by this one!
Sorry you are having so many horrible symptoms
Nx
Sorry you are having so many horrible symptoms
Nx
So what I had to do, KGBRN, is address all my issues with specialists in those particular areas. I would absolutely see a physiotherapist about your falling/walking issues -- that assessment will be helpful.
How long did the swallowing trouble last? If it happens again, get into an ENT for a swallow study.
All the infernal rule outs drove me crazy, but sometimes it takes a village to get a diagnosis, whether ms or a mimic.
The problem with ms neuros is as soon as they think it's not ms, they tend to lose interest, which means it will be up to you and your pcp until the "next" thing happens. But you can do lots in the meantime :).
How long did the swallowing trouble last? If it happens again, get into an ENT for a swallow study.
All the infernal rule outs drove me crazy, but sometimes it takes a village to get a diagnosis, whether ms or a mimic.
The problem with ms neuros is as soon as they think it's not ms, they tend to lose interest, which means it will be up to you and your pcp until the "next" thing happens. But you can do lots in the meantime :).
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