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MRI results. Could it be MS?

MRI results. Could it be MS?

I need help with my MRI results.  I posted my question and concern after what the results are.

Clinical indication: Demyelinating disease. Follow up.
Two punctate foci of increased signal are again noted within the left posterior frontal white matter. There is punctate focus of increased signal in the right frontal white matter. These findings are unchanged from the previous study and appear stable. No new foci of abnormal signal are seen. The findings are nonspecific and could reflect foci of ischemia and/or demyelination. Similar findings have been described in patients with chronic migraine headaches.

I don’t think I’ve ever had a migraine headache.  I am sure I would know if I had one.  I get headaches but they are relieved from Advil/Tylenol or just waiting it out.  I have had many episodes of dizziness, have inner ear caloric issues and have B12 and D levels that are low and am on extra vitamins because of the deficiencies.  

My question is could this sort of demyelination be an early sign of MS?  Could I have the demyelination without being a migraine sufferer?  
Thank you in advance for your time.
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Avatar_dr_f_tn
Hi there.These MRI findings could be due to a chronic demyelinating condition called multiple sclerosis where the disease phase is characterized by active phase and remissions. It has multiple symptoms and signs and is a diagnosis of exclusion. The symptoms of multiple sclerosis are loss of balance, muscle spasms, numbness in any area, problems with walking and coordination, tremors in one or more arms and legs. Bowel and bladder symptoms include frequency of micturition, urine leakage, eye symptoms like double vision uncontrollable rapid eye movements, facial pain, painful muscle spasms, tingling, burning in arms or legs, depression, dizziness, hearing loss, fatigue etc. The treatment is essentially limited to symptomatic therapy so the course of action would not change much whether MS has been diagnosed or not. Apart from clinical neurological examination, MRI shows MS as paler areas of demyelination, two different episodes of demyelination separated by one month in at least two different brain locations. Spinal tap is done and CSF electrophoresis reveals oligoclonal bands suggestive of immune activity, which is suggestive but not diagnostic of MS. Demyelinating neurons, transmit nerve signals slower than non-demyelinated ones and can be detected with EP tests. These are visual evoked potentials, brain stem auditory evoked response, and somatosensory evoked potential. Slower nerve responses in any one of these is not confirmatory of MS but can be used to complement diagnosis along with a neurological examination, medical history and an MRI in addition, a spinal tap. Therefore, it would be prudent to consult your neurologist with these concerns. Take care.


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