MRI impression

My wife was given an MRI for sudden changes in her vision and loss of movement in some extremities. Since her doctor is out of twn for another week, we are quite anxious to learn what it could be. The doctor told her he suspected MS or a brain tumor.

Here are the impression from the MRI report: Persistent scattered foci of increased T2/FLAIR signal within the bifrontoparietal subcortical and deep white matter which are nonspecific in appearance. Differential diagnostic considerations include microvasvular ischemic change, vasculitis/infammatory disease, migraine headaches, post traumatic sequela, and demyelinating disease.

Could you tell me what the possabilities are? Does this sound like MS to you? We will be meeting with her doctor in a week.

Thanks

[Dr. A. Srivastava]

Thank you for your question. Although without being able to placing your findings in context with clinical features and the results of other investigation such as hematological, MRI, I can not offer the specific advice like it is MS or brain tumor & treatment you need. However, I will try to provide you some relevant information about your health concern.

As your report suggests that there is brain white matter changes that involve the brain white matter, either exclusively or in combination with grey matter changes. These include metabolism errors, exogenous toxins released by virus, autoimmune disease, leukodystrophy, demyelination, and radiation effects. Spasticity, muscle weakness, paralysis, hyper-reflexia and movement disorder may be the clinical features associated with white matter disease that need to be evaluated thoroughly. However, it is sad to say that there is no permanent cure but conservative treatment & physiotherapy exercises that would help you to regain your normal function and stopping the further progression of the disease. Please consult a neurologist in this regards. Hope this helps.

[brnstclr]

Thank You for your comments. My wife had a ASD implant for repair of a hole in her heart, over a year ago. She has not had any migrane (migraine) headaches since then. Although, she continues to have headaches. Two to Three weeks ago she lost use of her right leg. She couldnt walk. She has since regained use of it. This led us to a vascular specialist who tested her for insufficient vain disease. He found that she does have insufficent vains in both of her legs but said that this would not explain the loss of use. She went to an Optomalogist because her regular eye doctor suspected something wrong with her optic nerves suspicious of glacoma. The Optimologist is the one who ordered thr MRI that I referred to previously. She has an appointment with a neuroligist who specializes in MS on April 29, 2010. She just wants to know what is going on with her body. It just seems like one thing after another. I hope we can get some answers soon.

[Dr. A. Srivastava]

Thank you for your question. As you know that migraine appears with one sided throbbing (or sharp) headache & orbital pain (eye pain) with numbness symptoms, therefore need thorough evaluation with a neurologist. Other factors that may induce her migraine attack may be contraceptive pills, stress or depression (after the surgery or underlying leg disease), bright lights, loud noise and traveling. Few women experience headache more commonly during the time of their menstrual periods & at the time of hormonal imbalance. The mainstay of the migraine treatment is always to identify the triggering factors and to avoid them.  Other triggering factors could be different foods such as cheese, chocolate, alcohol and even few fruits. I would suggest careful record of events that have proceeded with the attack and avoid those factors. In addition, suggest her to try to rest in a dark & quiet room, meditate, have a balanced diet and avoid taking unnecessary drugs. Hope this helps.

[brnstclr]

Thanks again for your response. The advice on migrane (migraine) headaches will be very useful. With the symptoms that have been described above as well as the imiging results, would that be enough (in your opinion) to diagnose her with MS. She has had several documented attacks. If she has MS we would like to begin treatment to keep it under control. As well as the mental aspect of knowing what is wrong with her.

Thanks again