Multiple scerosis vs tumor

Good afernoon
My daughter, 24 years old, had some ocular troubles with headake  two months ago . She has seen an ophalmologist who say astigmatic and short sightness. She has had an RMN that shows one hysignal T2 and Flair in white matter at left and one hypersignal in right thalamus in pulvinar; After gadolinium there is not raisng of signal in T1 ponderation. My question is : is it possible that the lésion in thalamus belong to MS or not ? If not, and if there is not clinical context specific, can this lesion be another thing than tumor ?
Thank you for your answer

[Shazia Alam, 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 your doctor.

Without the ability to obtain a history from your daughter and examine her, I can not comment on a formal diagnosis or treatment plan for her symptoms. However, I will try to provide you with some information regarding this matter.

I'm not sure what type of ocular troubles your daughter was experiencing two months ago.  Astygmatism and short sightedness can very well cause headaches because of the eye strain.  Did she actually have deficits with her eye movements or did she have vision loss with pain?   I'm unsure what to make of the MRI results.  In your daughter's case, she has two non-enhancing lesions, which shows that there is nothing acute to the lesions and most tumors like to enhance on T1.  She has one possible clinical "attack" if we call her "ocular troubles" that.  In order to diagnose MS, she usually needs a second MRI at least 3 months later showing more lesions OR another clinical "attack"--which can be almost any neurological deficit that is seen in MS and these have to last at least 24 hours.  

A diagnosis of MS is made on the basis of clinical history or previous attacks, analysis of the CSF (spinal fluid), physical examination, and MRI, but not just MRI.

White matter signal changes on MRI may also be seen in patients who have infectious, vascular, and other inflammatory conditions. They have been reported in the MRI of patients with a history of migraines.  

I hope this answer helped.  Good luck.  

[brossi228]

Just a thought... does she drink Diet Coke? I have heard that the aspertain in it, once removed from the diet symptoms go away.

[francois2105]

thank you for yours answers.
No she does not take aspartam She has just an allergic whith a lot of medications (penicilline,aspirine...)
Yes the ocular trouble sthat she had can make headhake and it is not sure that MRI abnomalities can explain this troubles. My question is principally on the hypersignal T2 in thalamus because it seems to me that MS are localised in Whitte matter and not in grey matter. So , how can we explain this hypersignal ? There is nothing to think to a Lyme syndrome or Lupus. So is it possible that this hypersignal can be a gliome with no inhance in T1 ? How long must i wait to make another MRI to be sure that it is not ?
Thank you