what do results mean

[rsimula]

I am female and age 44 and went to Dr. For blurred vision and vision issues, 1 episode of facial numbness around lip area, lightheadness, weakness and dizziness.

Dr. Indicated that it could be vertigo but ordered a brain mri.

Results:

IAC protocol used. Few small foci of increased t2 signal are identified in within the white matter of each frontal lobe. Largest noted near anterior horn of the right leteral ventricular and measures appox 4 mm. There is no associated abnornal diffusion signal or abnormal enhancement.

A non-specific finding -  The foci may represent small areas of ischemic change or a gliosis and can also be seen in the setting of chronis migraine headaches.

Is this a typical normal reading and I should be satisfied or should I persue further?

Thanks,
Ruth

[Deb61]

You're only 44, and your doctor is making you sound like you're much older.  If you're still having trouble, I'd get another opinion.  You may consider an MS specialist.  

What's the source of your symptoms, then?  Vertigo is a symptom and not a disease.  What about the blurred vision?  Sometimes an opthamologist is quite helpful, too.  It's possible, considering you have brain lesions, that you could have optic neuritis (which can be associated with MS).    

[rsimula]

I went to neurologist yesterday and basically told me I have vertigo and gave me some exercises to try. We did look at my prior MRI together and the white spots he indicated were basically related to age. He said that we all get spots as we age on our brains. So I am putting to rest and will try some of the vertigo exercises and see if that eliminates the vertigo if not apparently there are meds that help.

Just wanted to put my followup post.

[rsimula]

I did check out the health pages on ms. I must say I was surprised. Blurred vision, dizziness (vertigo), weakness, even esophageal reflux was listed. I have been struggling with that as well for the past several months..  Pretty much all my complaints were listed there. I guess I will make the appt with the neurologist.

[Deb61]

I would see an opthamologist.  If you do happen to have MS, it's not uncommon early in the disease to have eye problems.  I first noticed that my vision was doubled--especially evident when I looked at street lights, digital clocks, or anything illuminated.  My eyes were blurry, too.  When I went to the the optometrist, he didn't think I had anything going on, but when I saw an opthamologist later on, I was diagnosed with optic neuritis.  

All sorts of things, as mentioned, can cause brain lesions and some of your symptoms.  A good neurologist is more likely to figure out what's going on with you than your GP.  It does sound like something is going on, and it's worth looking into.

[Lulu54]

Is it normal to have foci on your brian mri?  no.

Is it common - more so than you might imagine because there are so many things that will show up neurologically.

Since you doctor offered the neuro followup, I would definitely go.  Have yourself evaluated by someone trained in this field.  You may really like your family practitioner, but it sounds like even she knows you should see someone with more specific training.

good luck and stay in touch,
Lu

[rsimula]

Thanks for the reply

I do this have vision problems. I saw an Optimist and not opthomologist which I know now I should have saw. He indicated that I was having eye migraines which I had never heard of. I don't have migraine headaches. I have headaches sometimes but not to the point I would consider them migraines.

I do have dizziness daily which is why I went back to family practitioner. She asked If I wanted to see a neurologist. I told her I would let her know.

I think my biggest question is it common to have foci on an MRI? Is it pretty common or is it only when it shows signs that something is going on? Are these foci in the location where ms lesions would appear?

[Deb61]

It looks like the radiologist who looked over your MRI is suggesting migraines or another ischemic (blood vessels/veins) cause for the spots on your brain.  Do you have migraines?   However, he/she didn't completely rule out other causes by suggesting that it could be a gliosis (scarring that could be from other problems, like MS)  

My guess is that your symptoms are causing enough problems for you to pursue getting help--that's why you agreed to have an MRI.  There's evidence that something isn't right on your MRI.  I would find out what's causing the problems.

Have you seen an opthamologist?  If not, you need to see someone about your blurred vision because it could give your doctor a piece of the puzzle that you need.  What kind of doctor are you seeing?  Are you seeing a neurologist or your family practitioner?  I would for sure see a neurologist.  

[sllowe]

Hi there,

How's your vision now? Have you been back to the Dr.?

The language in the report does sound typical.  Radiologist report what they see on those films and since it was not specific, they annotated 2 things that it could represent and they also included a 3rd (gliosis) - all would have to be investigated clinically by your Dr. to identify a source.  

When they mention the setting, that's where your doctor comes in.  Did you receive a thorough exam and did the Dr. take a detailed history?

If your not feeling well, you should return and ask some questions.

Thanks for joining us,
Shell

[Lulu54]

Hi Ruth,
Welcome to the MS forum here - I took a quick look and see you posted a vision question about a year ago in the eye forum.  so obviously you have been bothered by these problems for at least a year.

That line "non-specific" says they don't know what it is they are looking at, and the ischemic or migraine dx's are both guesses, without anything to confirm it.

If your symptoms continue  to bother you, I would suggest you pursue more answers.  This would be best done by a neurologist who specializes in MS.  

In the meantime you might want to learn more about MS - its symptoms and the diagnosis process.  Both can be quite complicated.  You can find excellent information about both and much more in our health pages (yellow icon, upper right side of this page).

Please feel free to ask any other questions you might think of - we're here to help you sort this out if possible.

Welcome again.

be well,
Lulu

[jensequitur]

It sounds like you have some punctate lesions in your frontal lobes.  This could be the beginnings of MS, but then again, it could mean nothing.  It's up to you - if your symptoms are bad enough that you feel something serious is going on, then I would pursue it.