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Neurology (Expert Forum)
Lumbar Polyradicolopathy, left hemibody numbness........Explain MRI report please!
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Lumbar Polyradicolopathy, left hemibody numbness........Explain MRI report please!
by chick1, Mar 02, 2007 12:00AM
I've had 2 MRI's on head, 1st one was Oct, it showed small solitary hyperintense lesion in left frontal white matter. I've had lumbar puncture, and numerous blood work,(CBC, Elisa, Western Blot,ANA,B-12,Factor V, and a host of others that I can't recall....all was basically normal.I'm 42 yr/o female don't have high blood pressure,I'm not overweight nor drink alcohol or smoke. Neuro said "come back in 3 months for repeat MRI". Had 2nd MRI on head accompanied with MRI of lower lumbar region. HeadMRIshowed "There are 3 right-sided and 2 left-sided white matter hyperintense lesions in the frontal white matter on FLAIR imaging. There is prominent capping of the anterior horns of the lateral ventricles. There is no mass or hemorrage identified. After the administration of Gadolinium there are no areas of abnormal enhancement" Impression: Most consistent with microangiopathy. Clinical correlation is recommended.
I don't understand "prominent capping" or it's signifigance.Lumbar MRI showed "There is disc dessication between L1-2 and L2-3. There is mild disc protrusion at L4-5 that is eccentric to the left but without significant canal or neural foraminal stenosis. Impression,: Mild lumbosacral degenerative disk disease. I've had NCS and EMG, NCS was normal, EMG was not. Neuro said it is LumbarPolyradiculopathy. Can it be related to left hemibody numbness associated with headache,dizziness, visual(tunnelvision,random square wave nystagmus)with mild hoarseness,and lowerpitched voice?
I don't understand "prominent capping" or it's signifigance.Lumbar MRI showed "There is disc dessication between L1-2 and L2-3. There is mild disc protrusion at L4-5 that is eccentric to the left but without significant canal or neural foraminal stenosis. Impression,: Mild lumbosacral degenerative disk disease. I've had NCS and EMG, NCS was normal, EMG was not. Neuro said it is LumbarPolyradiculopathy. Can it be related to left hemibody numbness associated with headache,dizziness, visual(tunnelvision,random square wave nystagmus)with mild hoarseness,and lowerpitched voice?
Doctor's Answer
by CCF-Neuro-M.D.-SH, Mar 05, 2007 12:00AM
First of all, keep in mind that I am unable to diagnose you because I am unable to examine you, this forum is for educational purposes.
A lumbar polyradiculopathy (pinched nerves) cannot explain the symptoms of hemibody numbness (it could only explain numbness/weakness in the leg), visual problems or headache/dizziness/voice changes. The MRI findings that you relate are non-specific, but can be related to many things including hypertension, migraine angiopathy, multiple sclerosis, vasculitis etc. (Although given the report, hypertension seems the most likely). The 'capping' of the anterior horns of the lateral ventricles is a finding that suggests white matter disease in the frontal regions of the brain (similar implications to the hyperintense lesions found in the white matter of your frontal lobes). The symptoms that you describe can be found in migraine headaches, and a trial on a migraine preventative medication may be helpful (such as topamax, elavil, nadolol, etc.). It sounds like you have already had much of the workup for possible other causes. To assess for multiple sclerosis I would suggest a lumbar puncture (with IgG index and oligoclonal bands) and visual evoked potentials (to look for past evidence of optic neuritis).
I hope this has been helpful.
A lumbar polyradiculopathy (pinched nerves) cannot explain the symptoms of hemibody numbness (it could only explain numbness/weakness in the leg), visual problems or headache/dizziness/voice changes. The MRI findings that you relate are non-specific, but can be related to many things including hypertension, migraine angiopathy, multiple sclerosis, vasculitis etc. (Although given the report, hypertension seems the most likely). The 'capping' of the anterior horns of the lateral ventricles is a finding that suggests white matter disease in the frontal regions of the brain (similar implications to the hyperintense lesions found in the white matter of your frontal lobes). The symptoms that you describe can be found in migraine headaches, and a trial on a migraine preventative medication may be helpful (such as topamax, elavil, nadolol, etc.). It sounds like you have already had much of the workup for possible other causes. To assess for multiple sclerosis I would suggest a lumbar puncture (with IgG index and oligoclonal bands) and visual evoked potentials (to look for past evidence of optic neuritis).
I hope this has been helpful.
