MRI has lesions not typical of ms, then what?

I have been experiencing tingling sensations, some burning.

Had an MRI this week and have the report in hand, neurologist has said over the phone that it does not confirm MS...but we meet in person next week to discuss further.

Here are some things the report metions.

No enhancing lesion is seen in the brain.

Is seen on FLAIR sequences is a subtle focus of bright signal within the left corona radiata approximately 6-7 mm.

There may be a 5-6 mm focus of bright signal at the vertex of the left posterior frontal lobe level of the precentral gyrus.

Within the deep white matter posterior to the trigone  of the left occipital lobe hyperintense lesion is seen measuring about 4-5 mm. The similar sized lesion is noted posterior to the left occipital horn. None of these lesions show enhancement. These signal hyperintensities are relatively nonspecific in appearance and do not fulfill diagnostic criteria fo rdefinite demyelinization from ms by MRI.

Impression: Nonspecific T2 signal hyperintensities within hte white matter as described. These do not fulfill McDonald's criteria for ms by MRI at this time. No enhancement of restricted diffusion is seen.


this was on a T1.5 machine. I have to wonder if it had been a new machine if it would have picked up more abnormalities. My bloodwork came back normal except an elevated ANA the SSA auto-antibody was less than 8. They say it could be sjorgens. I have no symptoms of that. Any thoughts?

I am getting a western blott done tomorrow. Could lymes cause lesions on an MRI?


Thanks, Vanessa

[Christopher R Newey, 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 a doctor.

Without the ability to examine and obtain a history, I can not tell you what the exact cause of the symptoms is. However I will try to provide you with some useful information.

Multiple Sclerosis (MS) is an inflammatory demyelinating disease that affects the central nervous system. To make the diagnosis there are specific criteria, in which objective neurologic findings are present affecting 2 or more locations in the nervous system in 2 or more episodes. In order to make this diagnosis, a detailed history and neurologic examination is required. MRI is very helpful and needed as it helps determining the presence of white matter lesions in 2 or more locations, however there are multiple conditions producing MRI changes that could be mistaken for MS (e.g., longstanding high blood pressure, tobacco abuse, migraines), and the MRI should be reviewed properly and correlated to the symptoms. When the diagnosis is in doubt, LP to study the CSF is helpful, and if there is still some doubt, there are other tests such as evoked potentials that can help.

Lyme's disease can produce lesions on MRI, but these may appear vasculitic (that is narrowing of the vessels which may produce stroke or stroke like symptoms).

I would suggest you continue following up with your neurologist. The diagnosis of MS may take time to fulfill criteria.

Thank you for this opportunity to answer your questions, I hope you find the information I have provided useful, good luck!