MS Lesions - Shape and Location on MRI

My neurologist thinks I have multiple sclerosis, though she is not sure.  So far, I've had:

Brain MRI:  Multiple lesions (I counted 20 when they were pointing them out to me) throughout the brain - many in the back of the brain.

LP:  Slightly Elevated IgG - all other proteins normal.

C-Spine and T-Spine MRIs - normal.

EEG:  - normal

EKG:  - normal

VEP: - normal

Echocardiogram: - normal

My second opinion thought I had been having mini-strokes (thus the echo and the EKG).  

My symptoms are tremor, muscle twitches, fatigue and vertigo (which has caused me to physically collapse at times).  I have abnormal reflexes (jumpy is the word she used) and a stiff leg.  My eye tracking is also abnormal.

I have no history of migraine and I'm a 28 year old female.  My family history is unremarkable when it comes to neurological disease.

My second opinion (an MS Specialist) does not think it's MS because of the location and shape of the lesions on my brain.  My current neurologist is still insisting that it is MS and really isn't exploring other possibilities.  

My questions...for all those MS sufferers out there...are the lesions always in the location and shape they are supposed to be?  Do I believe my second opinion that it is not MS?

What would cause the IgG to be elevated if not MS.  If you google it all you come up with is MS, LOL.

Should I believe my first neuro and start treatment for MS?

Do I need to seek yet another opinion?

This has been frustrating.  And, I personally thank anyone who responds to this.

Robin

[hm2007]

Get a 3rd and 4th opinion.  MS is almost a guess game for many doctors.  You should really see another specialist.  Whatever it is, it much be treated and I believe many of the drugs used for MS and used for other disorders too.

[kitlyn]

Hi I don't know the exact medical on the shape and sizes..of spots  i am a patient not a dr. i am in similar boat as you. Had severe ,,,severe head pressure in summer, and led me to MRI (out of blue for me < nothing that preceded this except MVP (Heart). and my MRI of brain found only 2 spots one in frontal lobe and temporal, 1.2 and 1.4 cm. Tumor ruled out, as of course he wants me to see MS specialist. but first i have to go downtown to get a script for lumbar puncture , and other. New MRI shows my spots less prominent. BUt neuro was hoping for more spots. Apparently that s better than my findings of two. Sorry didn't mean to talk about me. I hope you get to bottom of this. Its a longg process. Were there any differentials on your MRI report, stating other things , besides possible MS/? for soem reason i don't think mines  MS , maybe more vascular, i look pretty and healthy and everyone thinks i am fine..very annoying. Kit

[rdb25]

Kit,

My MRI report stated multiple punctuate areas of hyperintisities in the subcortical and white matter regions - shown mostly on the FLAIR sequence.  It also said that many were on the right parietal lobe.  I'm not sure if I got the wording right - I don't have the report in front of me.  But it did say that it is not typical distribution for MS, but MS must be investigated due to my age.  It also suggested vasculitis and migraine.  I have no history for migraine.  As for vasculitis, though they haven't completely ruled it out, they've checked for most underlying causes for vasculitis (lupus, etc.) and couldn't find anything.  

Thanks for your response and I wish you luck.

[attheendofmyrope]

Just to let you know, my neurologist told me that you can be having migraines and not know it. I do have migraines, but my neurologist told me that I am actually having them even when I do not feel them. Sounds crazy to me too.

[meemaw58]

4 years ago I had migraines then MRI -had lesions they thought MS I had spinal tap and was normal. Last year I get zapped out and dizzy I go and Have another MRI I am sent to a neuroligist. She sends for a spinal-normal. But MRI has lots of lesions-she thinks MS. I get 2nd opinion he says no. Mini strokes. I hurt so bad in my hips and muscles I can hardly walk-confused 3rd opinion maybe. Good Luck

[Skye76]

Just wondering if you've had anymore resolution on this? I too have subcortical punctate foci - impression: does not fit any o McDonald criteria.

[weeblelady]

Hi Robin....sorry you are going thru this....I have been dealing with same for 2 yrs now.  It's very frustrating and you don't know who to believe..I'm sick of doctors....I can't walk right anymore and I have ataxia and disequilibrium.  Before I got sick I was walking 5 miles a day!  Was the 2nd MS specialist from a major center?  Mayo, Cleveland, John Hopkins??  I think they still are not sure how to diagnosis the usual cases of MS.  good luck