Spots on MRI - always MS?

[Rhianlikespies]

Hello
I was wondering if anyone could offer me some insight. At a routine post-partum check up, I told the doctor about my numb big toes. They went numb when I was about 6 months' pregnant, and I assumed it was something to do with the extra weight I was carrying. As the numbness hadn't gone away a year later, she sent me to a neurologist, who sent me for an MRI of my brain and spine. He said the MRI showed two small white spots on my brain, but the rest of the scan was clear. He then told me that they could mean nothing at all, or they could mean MS.
Thing is, the only symptom I have is numb big toes (they've been permanently numb for a year and a half now), and a twitchy eyelid (if that even is a symptom...).
I feel pretty anxious about all this. Did anyone else here have numb toes as their first symptom of MS? Also, do white spots on MRI ever mean 'nothing', as my neurologist suggested?
He was pretty flippant about it, so I've been left pretty confused.
Hope someone can help. Thanks for reading.
R

[Casasybra50]

They are flippant with ther results, but I had 9 little spots and 1big one 5 years ago, and was told it was probably ms ,but also told they could have been there years, and to come back in a year, I didn't as didn't have any symptoms , went back after 5 years , my symptoms were put down to menopause, done loads of blood tests, exams on my body, and told that not all whit spots ,werent ms, I think unless you have really bad symptoms,it can relate to it ,but as you say ,you think that after been told about white spots, you then see things differently ,and analyse them more,hope this helps,for 5 years I put a lot down to it, I'd tired,

[Rhianlikespies]

Thanks both

Bob - the lesions are on both sides. One on each side.

Carrie - I will have a look at that thread, and ask my doctor about Lyme disease. I'm not sure how common it is in the UK though...then again I did grow up in the country and have had more than my fair share of insect bites. Could definitely be another thing to look into.

Your answers are greatly appreciated.
Cheers
R

[carrie235]

Hi Rhian:

I have 20 plus lesions on my brain.  They are not typical of MS.  My Neuro asked me "have you had lyme disease" when he first saw the MRI.  

I thought I had MS for an entire year, but was finally dx with Lyme Disease with a co-infection in January.  I've had many symptoms including a numb left toe (on the top of my toe...almost felt like my toenail was coming off).  This would come and go along with a numbness feeling in the arch of my foot and then random sort of numbness in my lower leg area...hard to describe.

Those are so a few of my symptoms...there are many more.  Anyway, I saw a post by WeakandFalling that was very good on this MS forum (it's just a few posts below yours).  You should read that post and then be tested for Lyme Disease.  Lyme Disease absolutely can cause lesions on the brain AND cause the symptoms that you are describing.  So that I don't repeat everything WeakandFalling did, read her post about seeing an LLMD, getting tested at Igenex (very important).  

Hope you get some answers soon!

[COBOB]

Most likely the lesions described are T2 weighted "frontal cortical White Matter lesions."  Are they one both sides (unilateral) or on both sides (bilateral?)   This is one of the areas of the brain that is commonly effected in migraine disease and is considered less of "an initial area of interest in MS."  Some doctor's are looking for peri-ventricular and infratentorial lesions.  

Frontal lesions can cause symptoms that effect "executive functions." Changes in emotional response, appropriate decision making, etc.  It is an area effected by MS, but many doctors seem to be looking for activity in other areas first.

Bob


    

[Rhianlikespies]

Oh, and I got my report from the docs. It says - 'One or two (the neurologist showed me two) very small highly nonspecific frontal subcortical white matter lesions.'

Is this an area where you'd normally get MS lesions?

It doesn't mention anything about T1 or T2 (?), as Bob described. So I'm afraid I still don't know what that would mean.

Hope someone can help. Thanks
R

[Rhianlikespies]

Hi Sharon
If you don't mind me asking, how long was it between your toes going numb and the beginning of your other symptoms. Also - did your toes stay numb? Or does it come and go?

I was also wondering if anyone knows anything about the effects of breastfeeding and MS. I am still breastfeeding my one year old (only at night and first thing now), and am a bit concerned that (if it is MS) I might suddenly start getting loads more symptoms when I stop.
Any theories?
Thanks again
R

[nrseprn41]

I understand your confusion and anxiety.  Mine started with numbness in my toes.  Since then it has been followed by multiple other problems.  My feet and legs were spasming so much last night I could not even walk.  Make sure you are comfortable with your MD.  I finally had to change neurologist before any follow up could be made.  My first MRI was normal.  My second showed " scattered lesions of high T2 signal ".  this could be everything or nothing.  Good luck to you and keep us posted.

Sharon

[sllowe]

Excellent! I'm glad to read she'll seek the 2nd opinion for you!

-Shell

[Rhianlikespies]

Hi
Thanks all. And cheers for the welcome.
I have ordered a copy of my scan so I can see what was written in the report, and my doctor has said she'll sort out a second opinion for me. I'll have a look at that link too.
My only symptoms are the numb toes and a twitchy eyelid, yes. However since the MRI, I keep being convinced other things are going on...dizziness, hand/leg pains etc., but as I hadn't noticed them before, I'm thinking they're probably psychosomatic. Guess I'll just have to wait and see.
Thanks again and hope you're all having lovely evenings. R

[jensequitur]

To me, it sounds like you need to do some follow-up.  Are the numb toes and the twitchy eyelid your only symptoms?

I went to my PCP with a tingling chin.  I didn't mention to her that I was getting dizzy every day at the same time.  I got my MRI, and it showed a lesion in my cerebellum.  Then everything kinda snowballed, and by the time I saw the neuro, I had a lot of problems.

[sllowe]

Hi there,

Adding on a big welcome to you.  Lesions are not exclusive to MS. MS is among the many diseases where lesions are identified. Having said that, not all lesions in MS follow a the typical pattern. Have you had a chance to peek at our health pages (top right corner of forum)?  When you can you'll find they are jammed with information on how MS is dx'd and how MRIs show lesions in MS.

In the end, MS is a clinical diagnosis. And, it takes a thorough neuro to find the true culprit of the cause. If you don't fit the bill for MS, then I sure hope your neuro is willing to investigate further to help you.

This discussion includes a link to a write-up I find useful in realizing just how difficult a job it is to dx MS:

http://www.medhelp.org/posts/Multiple-Sclerosis/Differential-diagnosis-of-suspected-MS/show/1415930

Hope you'll stick around for others to chime in with welcomes, support and advice.
Thanks for joining us!
-Shell

[COBOB]

There are all kinds on things that show up on MRI.  If you mean hyperintensities on a T2 sequence,  Microangiopathic ischemic disease and MS are common causes of multiple lesions.  Migraine disease may cause a few lesions in a localized area. Hyperintensity on T1 (without GAD) is typically associated hemorrhage.  There are other spots: T1 black holes, air, etc.

You really have to whether the signal was hyperintense or hypointense and what the sequence was, T1W, T2W, PD, STIR, FLAIR, etc. There are time when T2 Hyperintensities are just called UBOs (unknown bright objects) and are just benign. That's why you always want Neurologists and neuroradiologists to read MRIs.  General radiologists only pick up the big obvious things.

Bob

[Rhianlikespies]

Hi Alex
Thanks for answering.
He hasn't sent me for any follow ups. Is that weird? I'm not sure whether to consider that a good sign or not...
He pretty much scared the b'jesus out of me then sent me on my way. He basically said 'it could be MS, or it could be nothing', when I asked if it were most likely nothing, he gave me a sad look and said 'well, you're not making your symptoms up.' He left me with this cheery goodbye: 'have a nice life. I hope I won't have to see you again.'
He is as mad as a bag of fish though...I've asked my doctor if I can get my reports looked at by someone else. Partially so I can ask the questions I was too baffled to ask last time.
I'm not sure how much to push for further tests, as I don't want to come across as a massive hypochondriac, especially just for some numb toes...

Thanks again
R

[HVAC]

Welcome. I do not have medical experience so I will not tackle the MRI question. I do get you are anxious and confused that is normal in the world of Neurology. Diagnosing MS is not easy and the way Neurologists approach it is by ruling everything else out. There are hundreds of Neurological disorders and at least thirty illnesses which are not Neurological which mimic MS. It is my experience Neurologists approach things differently than other Doctors. For example it is not MS until it is. This is confusing to patient unless you have had a lot of exposure to them. They are not flip or crazy this just how they work.

The anxiety you are feeling must be hard. Many of us have felt anxious, scared, and angry in the process of trying to figure out what is wrong.

Have they done any other tests? Blood work? Is he seeing you again in say six months?

Alex