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White matter irregularities
My wife was at an endocrinology appt. for a pituitary follow up and when the Doctor looked at an MRI taken 3 months ago, he happened to mention that there were 20-30 white matter lesions which might be indicitive of MS, but "probably not", and if my wife was "his sister" he would tell her not to worry as it was unlikely to be so. This MRI study made comparisons to a prior MRI from 2003 which showed these lesions as well. Is it of such little concern that it is normal that no one actually told us of these lesions when the tests were originally evaluated in either 2003 or again 3 months ago? The doctor said 10% of people in the normal population have "mini strokes" which can look this way on a scan without being a problem, but when I search online I only find reference to this in the elderly (my wife is 41) and I have nowhere seen reference to 20-30 such lesions being normal. What ought I think? I am terrified.
MRI Technique: Sagittal T1 and axial T2 through the whole brain. Thin section coronal and sagitatal T1 before and after Gadollinium through the Sella.
Prominent perivascular spaces are again noted. In addition, there are a few foci of increased T2 signal in the periventrical white matter that are not quite as bright as the CSF. Most are stable in size. However there may be one ne tiny lesion in the left posterior centrum semiovale. No significant mass effect. No abnormal extra-axial fluid collections seen.
Please help to inform me as I am a person who needs information beyond platitudes. Thank you so much for being good good human beings and helping people like my wife and I. It means so much.
MRI Technique: Sagittal T1 and axial T2 through the whole brain. Thin section coronal and sagitatal T1 before and after Gadollinium through the Sella.
Prominent perivascular spaces are again noted. In addition, there are a few foci of increased T2 signal in the periventrical white matter that are not quite as bright as the CSF. Most are stable in size. However there may be one ne tiny lesion in the left posterior centrum semiovale. No significant mass effect. No abnormal extra-axial fluid collections seen.
Please help to inform me as I am a person who needs information beyond platitudes. Thank you so much for being good good human beings and helping people like my wife and I. It means so much.
I would recommed getting a different dr. talt to as many as you can, until you get answers you can live with. Because living is what we all want to do no matter what. Good luck to you and your wife.
I just read your post about your wife's consult with the neuro. He probably knows what he is talking about if he is chief of neurology (although not necessarily), but you really should ask him (or take your wife's films to another neurologist, preferably an MS specialist this time--which shouldn't be hard to find in the San Francisco area) to find out what all those white matter lesions are from! Did you say your wife has migraines/headaches? I don't know if migraines or other types of headaches could cause that many lesions, though. Someone else mentioned Lyme disease, I believe, but if she had that as the cause of the lesions then I think she probably would have a lot of symptoms to go along with her lesions (if she had neuro Lyme). I'm glad the neurologist doesn't think it is MS, and he is probably right, but since you are still worried about your wife you really should take her films to an MS specialist to be evaluated. If she starts to have symptoms (or more symptoms-can't remember if she had any symptoms to go along with the lesions--have to go back and read your initial post), then I would consider the lumbar puncture. It usually shows positive results in MS and evoked potentials (if she hasn't done those) and is one more piece of the puzzle to rule it in or out. Good luck to you.
Thanks again Siddy for your offering of perspective and advice. My wife has basically decided along the lines of invasive verses non invasive as to which tests to take. The Doctor laid it out in terms indicating "there is no cure for MS, only medication for symptoms, I don't think you have it and there is no immediate benefit of knowing...but I am willing to stick a needle in your spine if you'd like me to." My wife declined as might be expected. I am far more fearful than she has ever proven to be through this saga anyway (see my screen name). This Doctor never actually indicated if he thought they were TIAs or what they were. To be honest with all due regard for his credentials, he was a foreign national with a speech impediment and was not one with whom I could delve deeply into communication, though I of course did my best. My wife has decided she does not have MS and my worries were for naught. I am still apprehensive and unsettled but I am merely second in command as it were. IYou can bet I will be more than vigilant as to any symtoms indicating a change in status. Thanks again Siddy
You are far away, but near in thoughts. No doubt you have a good Neurologist so hang on in there.
These are my thoughts only as I have been through that process myself.
I think all other possibilities need to be ruled out. The VER may not result in anything significant. Mine didn't. .
In order to give the correct diagnosis, the spinal fluid is usually the "clincher" if there is any doubt. I know that is what sent my dx over the edge as pretty much everything else was negative except for the lesions/white spots on the brain and there don't appear to have been that many.
If I were you I would try to find more answers to the results of the MRI. It is not good enough to say it is TIA's and leave it at that. If it turns out to be TIA's then something is causing them and the specialist may consider an anti-platelet drug. Way too many lesions to disregard.
I personally do not take TIA's lightly. The fact is that they are often warning signs that a person is at risk for a more serious and debilitating stroke. About one-third of those who have a TIA will have an acute stroke some time in the future.
Look at it this way, if it is mini strokes then it is unlikely to be MS. If it is MS then it is unlikely to be TIA's.
To be perfectly honest, when I was dxed with MS it was almost a relief of sorts, because I had been more or less living in fear of "the big one" believing from my original Neurologist that I was having a series of TIA's (mini strokes) and already being weak on my left side. I would rather live with the truth than live in fear.
I was not a typical candidate for a stroke, being of low weight, non-smoker, low blood pressure and normal cholesterol, so that was the first clue for my diagnosing Neurologist.
No doctor or specialist is infallible. I think a good Neurologist would seek a second opinion from a Specialist.
Spinal Tap
To put your mind at ease, I was very nervous and apprehensive about my spinal tap after reading about other people's experiences (don't read them) but honestly they numb you first and you don't have any pain. You have to keep very still and in order to do that they won't want you to feel any pain. You just feel pressure and when it is over you lie there for about 45 minutes (I fell asleep) and try to keep as still as you can..
Your wife is very fortunate to have somone as caring and concerned as you are. Being British (Londoner) myself I have an extra affiliation with her. I am sure that it is going to turn out alright for you both. But, as you say, at present it is unresolved and you do need to get all the answers. Do keep us posted.
All the best!
Siddy1
These are my thoughts only as I have been through that process myself.
I think all other possibilities need to be ruled out. The VER may not result in anything significant. Mine didn't. .
In order to give the correct diagnosis, the spinal fluid is usually the "clincher" if there is any doubt. I know that is what sent my dx over the edge as pretty much everything else was negative except for the lesions/white spots on the brain and there don't appear to have been that many.
If I were you I would try to find more answers to the results of the MRI. It is not good enough to say it is TIA's and leave it at that. If it turns out to be TIA's then something is causing them and the specialist may consider an anti-platelet drug. Way too many lesions to disregard.
I personally do not take TIA's lightly. The fact is that they are often warning signs that a person is at risk for a more serious and debilitating stroke. About one-third of those who have a TIA will have an acute stroke some time in the future.
Look at it this way, if it is mini strokes then it is unlikely to be MS. If it is MS then it is unlikely to be TIA's.
To be perfectly honest, when I was dxed with MS it was almost a relief of sorts, because I had been more or less living in fear of "the big one" believing from my original Neurologist that I was having a series of TIA's (mini strokes) and already being weak on my left side. I would rather live with the truth than live in fear.
I was not a typical candidate for a stroke, being of low weight, non-smoker, low blood pressure and normal cholesterol, so that was the first clue for my diagnosing Neurologist.
No doctor or specialist is infallible. I think a good Neurologist would seek a second opinion from a Specialist.
Spinal Tap
To put your mind at ease, I was very nervous and apprehensive about my spinal tap after reading about other people's experiences (don't read them) but honestly they numb you first and you don't have any pain. You have to keep very still and in order to do that they won't want you to feel any pain. You just feel pressure and when it is over you lie there for about 45 minutes (I fell asleep) and try to keep as still as you can..
Your wife is very fortunate to have somone as caring and concerned as you are. Being British (Londoner) myself I have an extra affiliation with her. I am sure that it is going to turn out alright for you both. But, as you say, at present it is unresolved and you do need to get all the answers. Do keep us posted.
All the best!
Siddy1
Thanks Siddy, for your thoughts. As to the Florida Doctor, we couldn't really be farther away while still being in the mainland U.S. as we are in San Francisco. Our consult was however with the Chief of Neurology at the hospital we use, so hopefully it was a competent assessment. She never had a Lyme disease test, I wonder if that ought to have been done. I suppose we will wait for the V. E. R. and see what it says. The spinal tap was offered but the Doc said we "might want to skip something as invasive as that unless nore pushes the diagnosis toward MS". We decided to hold off on it therefore. Best of luck to you and your challenges with MS. I hope we are not called to face these same challenges with my wife, though I still consider that unresolved.
You might want to read my post because for several years of MRI's (before being dxed) I know I am older but MS can strike at any age. I had multiple white lesions on my brain which was thought to be TIA mini strokes. my MS Neuro ruled out 100% any strokes. Knee jerk reflex was great - even more than normal - which would not happen - he said - if I had experienced a stroke(s). There is an excellent MS specialist/neurologist in Tampa, FL if you live anywhere near. He Has been researching/studying for yearas and is more than familiar with all of it. He was my second opinion, although my first Neuro was dead on target.
Good luck with all this.
Good luck with all this.
We had the appt. with the neurologist. As promised I am back to update what was said. He was the Chief of neurology at the hospital so I expect it was an informed assessment. He said though it is "very unusual" for someone to have so many lesions (upwards of 30 or so) his instincts are that it is not MS. He said it yet may prove to be, but he thinks it unlikely. We are due to have a virtual evoked potential test soon as well as a blood test but we have opted not to go for the spinal tap at this time by way of the neurologist's consult. I am still left to wonder why all these lesions but I suppose it ought to be viewed as a reprieve at least for now.
We had the appt. with the neurologist. As promised I am back to update what was said. He was the Chief of neurology at the hospital so I expect it was an informed assessment. He said though it is "very unusual" for someone to have so many lesions (upwards of 30 or so) his instincts are that it is not MS. He said it yet may prove to be, but he thinks it unlikely. We are due to have a virtual evoked potential test soon as well as a blood test but we have opted not to go for the spinal tap at this time by way of the neurologist's consult. I am still left to wonder why all these lesions but I suppose it ought to be viewed as a reprieve at least for now.
Well, My wife's Thursday appt was postponed until the 19th due to the doctor being ill. This is uncomfortable for me to have to wait so much longer, but the good news is the appt was rescheduled with the hospital's Chief of Neurology, so the assessment ought to be as proffessional as we could expect. I post this because I was asked to keep an update as to our news. I didn't want to appear that I failed to inform as to the results of our canceled appointment. Be well all.
Please come back and let us know--if you care to share, that is--what you and your wife find out at the neurologist's regarding all her lesions. So many people don't ever come back to the board and share what they find out after testing, etc., and a lot of us are interested to know what people learn about the cause of their symptoms. Good luck to you and your wife--I hope it turns out to be something benign.
Wow, I was surprised to see that so many people had offered thoughts, upon checking back on the forum here. The question was raised regarding a vegetarian diet and why that might have seemed relevant to me. One reason was as you surmised, that being the B12 deficiancy possibilities. The other thing is that apparently omega3 is thought to play a large part in myelin formation. I have read that people from Europe (she being from the UK) get less sunshine/vitamin D and when lack of fish is added, there may be an increased risk of MS.
I negleceted to post the part of her MRI study which reffered to the "impressions". In it there is reference to prominant perivascular/paravenular spaces as well as a few of the lesions appearing brighter than in the prior MRI with one possible new lesion. (This being paraphrased as I don't have the report in front of me.
She only had the MRI to monitor a prolactinoma she has had for some years, not for related symptoms. Only in hindsight do we fear a connection to periodic hip pain, pins/needles in left hand, mixing of words and repeating questions.
Thanks again for the input. We have an appt. on Thursday with the Neurologist...maybe he can tell me I am just paranoid. I can't find information suggesting such however. I am still scared.
I negleceted to post the part of her MRI study which reffered to the "impressions". In it there is reference to prominant perivascular/paravenular spaces as well as a few of the lesions appearing brighter than in the prior MRI with one possible new lesion. (This being paraphrased as I don't have the report in front of me.
She only had the MRI to monitor a prolactinoma she has had for some years, not for related symptoms. Only in hindsight do we fear a connection to periodic hip pain, pins/needles in left hand, mixing of words and repeating questions.
Thanks again for the input. We have an appt. on Thursday with the Neurologist...maybe he can tell me I am just paranoid. I can't find information suggesting such however. I am still scared.
I am so sorry for what you're going though. The worry and not knowing is absolutely worse than a diagnosis and something tangible to deal with. I know from experience.
What have been your wife's complaints, symptoms, and what abnormalities have they found on exam?
I hadn't answered on this thread because I thought you were getting some good answers. Without knowing what problems your wife is having, I would say that simply "discounting 20 or 30 small lesions" is preposterous! They did the two MRI for some reason, right? Yes, there are many things that cause mulitple lesions, including multiple mini strokes (unlikely at her age unless she has a very rare condition known as CADISIL), long history of migraines, longstanding hypertension, multiple sclerosis, and unknown. (But I have never heard of putting that many lesions into the category of UBO - Unidentifies Bright Objects.)
Give us a little more information if you feel comfortable. Quix
What have been your wife's complaints, symptoms, and what abnormalities have they found on exam?
I hadn't answered on this thread because I thought you were getting some good answers. Without knowing what problems your wife is having, I would say that simply "discounting 20 or 30 small lesions" is preposterous! They did the two MRI for some reason, right? Yes, there are many things that cause mulitple lesions, including multiple mini strokes (unlikely at her age unless she has a very rare condition known as CADISIL), long history of migraines, longstanding hypertension, multiple sclerosis, and unknown. (But I have never heard of putting that many lesions into the category of UBO - Unidentifies Bright Objects.)
Give us a little more information if you feel comfortable. Quix
Hey there,
I don't know what happen either...
I wrote complaining about it but I bet I won't get an answer. Have to confess that I was really upset, I don't know if they thought the symptoms didn't change, if I wasn't clear on my post...
That was my 3rd post, within a 6 months of interval from each other (so I guess this pass the 2 post per year rule, hum??
I know it's a free service, but I didn't ask them to have it and have it for free... at this point I'd be willing to pay for some light... Also, I would like an explanation for why they simple deleted it... I was so anxious waiting for an answer.
By the end, I just guess that (most) of the doctors are the same, and the ones in this site are not different, looking for money or promotion... And forgetting about the most important, the patient...
If you have time and wanna help write to them asking about this post! The title was sensory symptoms.
Take care,
rcs2
I don't know what happen either...
I wrote complaining about it but I bet I won't get an answer. Have to confess that I was really upset, I don't know if they thought the symptoms didn't change, if I wasn't clear on my post...
That was my 3rd post, within a 6 months of interval from each other (so I guess this pass the 2 post per year rule, hum??
I know it's a free service, but I didn't ask them to have it and have it for free... at this point I'd be willing to pay for some light... Also, I would like an explanation for why they simple deleted it... I was so anxious waiting for an answer.
By the end, I just guess that (most) of the doctors are the same, and the ones in this site are not different, looking for money or promotion... And forgetting about the most important, the patient...
If you have time and wanna help write to them asking about this post! The title was sensory symptoms.
Take care,
rcs2
My thoughts are with you and your wife. Hope you can find what is wrong with her, I myself found that no knowing is probably as hard as some of the possible dx.
Good luck! Let us know how it goes.
Good luck! Let us know how it goes.
I don't know about the link between vegetarianism and MS (where did you read that?), but certainly if your wife eats a vegan or mostly vegan diet (no dairy) then she is definitely at risk for B12 deficiency. I've been a vegetarian since I was 8 years old and never had a problem with B12 deficiency, but when I switched to a mostly vegan diet a couple years ago my B12 level quickly dropped to the low-normal range. If your wife has B12 deficiency that could explain tingling/paresthesias in extremities, as B12 deficiency can cause neuropathy and needs to be supplemented with either B12 tabs or B12 shots (tablets did the trick for me). But she needs to ask the doctor who ordered the MRIs to go over her films and ask what all those lesions are due to! I don't know much about the different types of lesions to be seen on brain MRI (hopefully Quixotic will answer your question), but there are different things that can cause similar-looking white matter lesions on brain MRI in addition to multiple sclerosis--migraines and Lyme disease are two, I believe.
Hi there, I have been watching for the neuro to answer the question that you posted on the neurology forum, and now its gone. I wonder why. I was curious to see what advice he would give being that I suffer some of the same symptoms as you. Take care, Jen
thanks rcs2. She has in the past complained about pins and needles in her arm. She has also had bouts of mixing words and asking the same question three times within a minute. So of course I tie all of this together into one thing and worry for it. We have an appt with a neurologist on Thursday...fingers crossed. She is a long time vegetarian and I am reading some concern that this may increase the chances of MS or MS like problems through lack of omega3 (fish oil) and B12. Just throwing it out there for others to consider as well.
Hi there,
I am sorry you are going through this... does your wife havy any other MS symptoms?
I completely understand you being worried, and nothing you hear here will be good enough to make you calm down 100% (sorry for being blunt!). I would recommend seeing a neurologist, giving preference to a MS neuro or going to an university hospital (have to confess that wsn't happy with the regular doctors I saw, so went to an university. Seems that in these days it's really hard to find a doctor that cares more for the patients than for their time and money... as sad as it can sound.
My case is different, I have weird symptoms but all exams are clear.
About the MRI, yes, my neuro also said normal people (and young people) can show "abnormal" MRIs. But I understand the concern due to the number of lesions. Altough it's a good thing that it has't changed for the last 4 years! Maybe she was born with those lesions...
Hope you find the answers you are looking for!
Good luck,
I am sorry you are going through this... does your wife havy any other MS symptoms?
I completely understand you being worried, and nothing you hear here will be good enough to make you calm down 100% (sorry for being blunt!). I would recommend seeing a neurologist, giving preference to a MS neuro or going to an university hospital (have to confess that wsn't happy with the regular doctors I saw, so went to an university. Seems that in these days it's really hard to find a doctor that cares more for the patients than for their time and money... as sad as it can sound.
My case is different, I have weird symptoms but all exams are clear.
About the MRI, yes, my neuro also said normal people (and young people) can show "abnormal" MRIs. But I understand the concern due to the number of lesions. Altough it's a good thing that it has't changed for the last 4 years! Maybe she was born with those lesions...
Hope you find the answers you are looking for!
Good luck,
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