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Pre Diagnosis MS - what do all my MRI's & EEG mean?
1st MRI January 2016 'Flair Hyperintense signal changes within the deep white mater of both cerebral hemisphere particularly in the bifrontal lobes are slightly more than expected for patient's age. This is a non-specific finding and may represent chronic small vessel ischaemic change.
2nd MRI May 2016 'Minor cerebral white matter changes. The distribution, predominantly bifrontal, is typical for migraine related vascular disease but not entirely specific for this. The number and size of these lesions has not progressed in the four month interval since the previous study'.
EEG July 2016 'Mildly abnormal EEG, on the basis of slight excess of intermittent slow wave activity most apparent in the right posterior region. This patter is not specific but is consistent mild diffuse cortical dysfunction. It would be worth correlating the findings to neuroimaging with respect to right temporo-occipital regions'.
Now a 6 week wait for another MRI and then back to see doc. Symptoms include headaches, joint pain, fatigue, muscle pain and cramps, neuropathy (numb/tingling/burning), dry mouth and eyes, mouth ulcers, low immunity. Doc is investigating for primarily MS but also looking at Lupus and Sjogren's Syndrome. Wish this wasn't such a long process to either dx or rule out.
2nd MRI May 2016 'Minor cerebral white matter changes. The distribution, predominantly bifrontal, is typical for migraine related vascular disease but not entirely specific for this. The number and size of these lesions has not progressed in the four month interval since the previous study'.
EEG July 2016 'Mildly abnormal EEG, on the basis of slight excess of intermittent slow wave activity most apparent in the right posterior region. This patter is not specific but is consistent mild diffuse cortical dysfunction. It would be worth correlating the findings to neuroimaging with respect to right temporo-occipital regions'.
Now a 6 week wait for another MRI and then back to see doc. Symptoms include headaches, joint pain, fatigue, muscle pain and cramps, neuropathy (numb/tingling/burning), dry mouth and eyes, mouth ulcers, low immunity. Doc is investigating for primarily MS but also looking at Lupus and Sjogren's Syndrome. Wish this wasn't such a long process to either dx or rule out.
I'll add only that EEG findings are a test result that points away from an ms diagnosis.
Not that one can't have that and a condition such as (for example) CNS lupus, BUT it's less likely and will slow down a diagnosis.
Ms lesions are more likely to be found in certain areas that weren't mentioned in your mri report (although as JJ said it could be due to the vague description).
As JJ said, none of your symptoms are specific to ms and a number are not found in ms. (Low immunity, dry mouth and eyes, joint and muscle pain (prior to gait issues), mouth ulcers) I would make sure, if your neurologist isn't well acquainted with Sorjgens and it's ruled out, that you search out a specialist who is. Lesions occur in more conditions than ms and I'm glad you're neuro is being careful. A misdiagnosis is worse than no diagnosis, as difficult as the wait is.
some of your symptoms "could" be associated with deficiencies. Have you had vitamins B12, d, magnesium levels checked?
I also had mouth ulcers; in my case they were related to gluten consumption. If you have any issues with gluten (celiac, non celiac gluten sensitivity) or casein, you may also have deficiencies. Mouth ulcers could also be a side effect of meds you are taking (I've also had ulcers as an adverse effect of two meds).
It's very tricky to unravel, and still could take some time. My own diagnosis (of ms, with a few rabbit trails because of vitamin deficiencies and med reactions) took 3 years. (((Hugs)))
Not that one can't have that and a condition such as (for example) CNS lupus, BUT it's less likely and will slow down a diagnosis.
Ms lesions are more likely to be found in certain areas that weren't mentioned in your mri report (although as JJ said it could be due to the vague description).
As JJ said, none of your symptoms are specific to ms and a number are not found in ms. (Low immunity, dry mouth and eyes, joint and muscle pain (prior to gait issues), mouth ulcers) I would make sure, if your neurologist isn't well acquainted with Sorjgens and it's ruled out, that you search out a specialist who is. Lesions occur in more conditions than ms and I'm glad you're neuro is being careful. A misdiagnosis is worse than no diagnosis, as difficult as the wait is.
some of your symptoms "could" be associated with deficiencies. Have you had vitamins B12, d, magnesium levels checked?
I also had mouth ulcers; in my case they were related to gluten consumption. If you have any issues with gluten (celiac, non celiac gluten sensitivity) or casein, you may also have deficiencies. Mouth ulcers could also be a side effect of meds you are taking (I've also had ulcers as an adverse effect of two meds).
It's very tricky to unravel, and still could take some time. My own diagnosis (of ms, with a few rabbit trails because of vitamin deficiencies and med reactions) took 3 years. (((Hugs)))
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Thank you - re the EEG - my googling gives me the idea that my results point to Optic Neuritis? Apart from dry eyes I also get foggy vision sometimes (not too bad just hard to look at computer screen and read) and sharp pains in one eye occasionally.
Will ask the doc to test for difticiencies - I'm pretty sure those haven't been tested. I already take triple recommended dosage of magnesium to stop muscle cramps.
Not taking any regular meds and never really have & no issues with Gluten though I don't really eat much of it anyway - ulcers mostly appear when I'm also flaring with other symptoms.
Still got 3 weeks until MRI which will hopefully rule out MS (hoping for no new lesions), and then another wait to see specialist for results :-(
Will ask the doc to test for difticiencies - I'm pretty sure those haven't been tested. I already take triple recommended dosage of magnesium to stop muscle cramps.
Not taking any regular meds and never really have & no issues with Gluten though I don't really eat much of it anyway - ulcers mostly appear when I'm also flaring with other symptoms.
Still got 3 weeks until MRI which will hopefully rule out MS (hoping for no new lesions), and then another wait to see specialist for results :-(
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Hi and welcome fellow ozzie,
One thing i've noticed with our Australian MRI reports over the years is that they often don't provided as much specific details or information as the states, your MRI doesn't actually mention anything that would be generally be suggestive or consistent with MS, bifrontal lobe lesions don't exactly rule MS out but they don't put it at the top of your potential cause list either.
4 months is a long time with conditions like MS, you have the same lesions pattern, size (micro vascular lesions are 1-3mm) and number as found before so your brain MRI is not at this stage particularly suggestive of anything. You also mention symptoms that are not generally associated with neurological conditions like MS eg joint pain, dry mouth and eyes, mouth ulcers, low immunity so it's highly likely that what your dealing with is something other than MS, top of my list of possible conditions would actually be Sjogren's Syndrome, then Lupus, though Lupus is known to be one of the greatest mimics and often as difficult to diagnose as MS.
I hope that helps.......JJ
One thing i've noticed with our Australian MRI reports over the years is that they often don't provided as much specific details or information as the states, your MRI doesn't actually mention anything that would be generally be suggestive or consistent with MS, bifrontal lobe lesions don't exactly rule MS out but they don't put it at the top of your potential cause list either.
4 months is a long time with conditions like MS, you have the same lesions pattern, size (micro vascular lesions are 1-3mm) and number as found before so your brain MRI is not at this stage particularly suggestive of anything. You also mention symptoms that are not generally associated with neurological conditions like MS eg joint pain, dry mouth and eyes, mouth ulcers, low immunity so it's highly likely that what your dealing with is something other than MS, top of my list of possible conditions would actually be Sjogren's Syndrome, then Lupus, though Lupus is known to be one of the greatest mimics and often as difficult to diagnose as MS.
I hope that helps.......JJ
1 Comments
Thank you, been tested a few times for Sjogren's and Lupus but apart from high inflammation & a high d-dimer nothing else shows up on blood tests. Just had more bloods done 2 weeks ago for Lupus/Sjogren's/Lymphoma/ Myeloma - haven't heard back so I guess they were clear too. Have read a lot of AI diseases take years to dx - could be a long time before I get answers :-(
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