Lesions of brain & spine

[NJgirl75]

In May I was diagnosed as B12 deficient. My number was 163. It's now at 505. In Sept, I went numb from just below the rib cage to my hip only on the right side, front to back, stopping just at my spine. I developed horrible back pain. The numbness subsided but the pain is everyday. I get a pressure in the middle of my spine, the pain can range from the shoulder blades to the lower back, muscles spasms or stabbing pains. I get a feeling of vibrations throughout my entire right leg if I walk to much or too fast. The pain in my back seems to get better if I rest and worse with any type of activity, even just walking in a store. I also have issues with my vision if my back is really hurting. Ice helps more than heat.

My neurologist did an EMG that I was told was normal, a lumbar MRI that was also normal. Blood work tested negative for ANA & Lyme, protein was normal.

A MRI scan of my brain showed "scatter foci of nonspecific T2 and FLAIR signal abnormality involving the subcortical, periventricular, and deep cerebral white matter, without associated abnormal enhancement seen following IV gadolinium injection. No localized area of mass effect in the brain detected. The diffusion weighted images did not suggest an area of acute ischemia or infarction. Possible slightly prominent perivascular spaces at the cerebral peduncles bilaterally."

A MRI scan of my cervical spine showed "Suggestion of subtle abnormality within the spinal cord at C2 and C3 levels, which in the appropriate clinical setting might be due to involvement by demyelinating process. There also may either be artifact or additional lesions within the spinal cord at approximately the T2 level. Incidentally noted is asymmetry of submandibular glands, which could be correlated clinically."

I see the Dr in 2 weeks, I know these can be caused by MS or the B!2 deficiency. Can the lesions cause my back pain & if so, can the lesions ever go away? Or will I always have this pain?

[NJgirl75]

Thank you Dr. Alam. I do plan to follow up with my doctor. I guess I am just anxious as to whether I would be left with this pain in my back for the rest of my life or not. I can deal with all of the other symptoms, but the back pain is affecting my daily life and if anything I hope it resolves. Thank you for taking the time to answer my question!

[Shazia Alam, DO]

Thanks for using the forum. I am happy to address your questions, and my answer will be based on the information you provided here. Please make sure you recognize that this forum is for educational purposes only, and it does not substitute for a formal office visit with your doctor.

Some changes in the spine can be seen with severe B12 deficiency and some of these can be reversible, some not. Some of these lesions could be the cause of some of the pains you complain of, including the parasthesias.  Unfortunately, most, but not all symptoms resolve with B12 replenishment.  

I do still think you should follow up with your neurologist to make sure there is nothing else going on as I am limited to the history you provide.  Options for relief include medications such as Gabapentin which can help with some of these pain.

I hope this information was helpful.