What does this mean?

[phglerum]

I have had some serious health issues as of late.  For the last 3 years I have had 2 plaque (lesions) on the pons of my brain, and now my CSF IGG index is elevated beyond the normal range. My Neurologist is very temperamental if you contact him before they contact you.

[BOK2Bjan]

Hi - sorry to hear you're having health issues. Since you went to a neurologist, I assume you have had neurological symptoms, but you didn't mention what types. Have you had a worsening of symptoms, or have they been exacerbating (made worse) and then resolved (partially or completely)?

You say you have had these 2 lesions for a while - have they changed ever? Have they enlarged or shrunk? Lesions in this area can be caused by several different processes. Vascular, infectious, parasitic, or immunological functions can be involved. High blood pressure, atherosclerosis, Lyme disease, ADEM, NMO, MS - can all have MRI results that show lesions in this area. They can also be idiopathic (particular to you/ of unknown cause).

You might have a good neurologist (knowledgeable and competent), but  who hasn't properly explained the complexity of the diagnosis. Personally - that's my #1 complaint of doctors! Going to med school doesn't make a person a good communicator or teacher. When you go see him/her - be sure to be prepared with good questions. Also a brief diary of your symptoms and the timetable of those symptoms would help.

A few suggestions for questions  - what are the diagnostic differentials for my symptoms and MRI results? What are the diagnostic differentials for my symptoms alone, and the MRI alone? Do you think those 2 things are related? (Are my symptoms compatible with the lesion location?) What further tests would you suggest? What do you need to know/ or see, in my clinical course,  or imaging, to better understand what may be going on?

I hope you get some answers. I wish you the best - I know how hard it is to not have answers. Blessings, Jan