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Not all spots are Demyelinating Plaques caused by MS
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Not all spots are Demyelinating Plaques caused by MS


Many people come to our forum because they are told they have "white spots, or lesions on their brain, and the doctor will not dx them with MS, thought they feel they have met the Criteria by their own research or what they have learned here.

We’ve discussed at length why MS is so difficult to dx, the mimics, and how not all lesions are created equal, or by the same disease process.

We state that there are other causes of brain lesions, or white spots, discuss the differential diagnoses and provide resources. I hope this list further helps to bring about awareness of why the doctor may not dx you with MS. And, this info is in our health pages too - so for newcomers who have not had the opportunity, please browse through them.

Injuries can cause brain lesion, immune disorders, diseases, viruses and I’ve even read that some exposure to certain chemicals can cause brain spots, or changes. Sometimes the doctor simply cannot identify the cause.

Here are just a few (and, I'd like to add to this - so those w/differential dx w/lesions or spots - please list your dx) We'll compare this list to the health page, and add if it's missing:

ADEM
Vasculitis
Chronic Hypertension
Enlarged Perivascular Spaces
Lymphoma
Non-specific UBOs
CADASIL

-Shell
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11 Comments Post a Comment
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338416_tn?1260996698
I always like to look at the Radiology Assistant.  It has some great examples of MS lesions, sarcoidosis lesions, lesions caused by ischemia, and more.  It's what I looked at when I was trying to read my own MRIs (not recommended!)

http://www.radiologyassistant.nl/en/4556dea65db62
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198419_tn?1360245956
Bumping for new members in limbo, and/or a frustrating, seemingly forever, workup :( or wait and see approach.
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Avatar_f_tn
Wanted to add glioma or brain tumor. That is my current differential diagnosis at he moment for my brainstem lesion.

Corina
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198419_tn?1360245956
Thanks, Ccorina!
Will add it!

Differential dx'ers - please add when you can.
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Avatar_n_tn
In my case Multiple Myeloma - (bone marrow / blood cancer)

I should qualify this though and say Myeloma is rare, and in my age group (mid 30's) really rare!  MS seemed like a much better explanation (my symptoms were systemic and include both signs such as irregular reflexes and symptoms such as fatigue) But the one issue was no MRI spots (well when reading the MRI later there was evidence of Myeloma but it was missed since it is bone spinal lesions, not spinal cord lesions.
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987762_tn?1331031553
These aren't my differencial dx but ones i know about that are not on your list, maybe worth adding.

Neuropsychiatric diseases:
schizophrenia
Bipolar

Alzheimer's disease
Huntington's chorea

Chronic white matter disease:
commonly associated with diabetes, high cholesterol, atherosclerosis, and high blood pressure.

cheers



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987762_tn?1331031553
lol I just thought of two more

alcoholism
drug addiction

Cheers again...........JJ
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987762_tn?1331031553
dont kill me but i just thought of a few more lol

Lupus
Smoking
age 60+

And i do remember one of our ozzie members had lesions and a differecial dx but i can't remember what it was called, i will remember lol

Cheers again again.........JJ
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198419_tn?1360245956
Seems we have many limbolanders, and some who are mention they are uncertain of their diagnosis.
Please know there are many causes of lesions - this list is compiled from the above mentions - and, there are more.

I cannot stress enough that not all lesions are caused by MS, or even a disease process.

ADEM
Vasculitis
Chronic Hypertension
Enlarged Perivascular Spaces
Lymphoma
Non-specific UBOs
CADASIL

Neuropsychiatric diseases:
schizophrenia
Bipolar

Alzheimer's disease
Huntington's chorea

Chronic white matter disease:
commonly associated with diabetes, high cholesterol, atherosclerosis, and high blood pressure.

sarcoidosis lesions, lesions caused by ischemia
glioma or brain tumor
alcoholism
drug addiction
Lupus
Smoking

Multiple Myeloma - (bone marrow / blood cancer) I should qualify this though and say Myeloma is rare (Sumerlvr)

Be sure to visit the link in this discussion:
http://www.medhelp.org/posts/Multiple-Sclerosis/Differential-diagnosis-of-suspected-MS/show/1415930

There are also 36 major red flags that point to non-MS dx (in the link in the above discussion), 11 minor red flags that suggest possible dx and 32 clinical paraclinical and lab and imaging findings/examples.

-shell
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Avatar_f_tn
throw in small vessel disease too
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Avatar_m_tn
Migraines.
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