Perivascular Spaces On Mri?

Hi CCF,   I recently had another brain mri with and with contrast.  With the contrast my mri showed several perivascular spaces and was wondering if this could indicate MS?  

I have several years now with r/r pattern of neurological impairment.  Intermittent blurred vision, nystagmus, ataxia, hyper-reflexes throughout.  Have problems with balance and can't walk a straight line if my life depended on it.  Plus, not to mention struggling with it seems constant fatigue.

What would these perivascular spaces indicate on my mri scan? I have white spots in several areas on my scan.  It has been two years since any other tests have been done.  I have been told by several doctors in the past that my clinical exams point to MS but my laboratory findings have been negative up to now.

Thanks for your assistance,

Sincerely Annie

[CCF Neuro[P] MD, RPS]

Dear Annie:

Perivascular spaces are a normal finding on MRI.  These are areas around vessels.  They are found in most of the scans and are usually not commented on by the neuroradiologist.  They are not associated with any disease.

Sincerely,

CCF Neuro MD

[Linda C]

I had spine surgery in May 1999 to remove pieces of chipped disk that was pressing on nerves.  I've still had pain and numbness in my left leg/foot since then.  Have been on all kinds of meds and nothing seems to help.  I am now having pain and weakness in my left arm and sometimes the entire left side of my body with tingle like feeling on left side of my head.  My orthopaedic surgeon wants me to have a "nerve study" done and says he may have to refer me to a neurologist.  He says the nerve study may be a little "uncomfortable".  My question is what will this test show and is it painful to have?  I'm scheduled to have this done next Monday and would like to know what to expect.

[CCF Neuro[P] MD, RPS]

Dear Linda C:

I think the surgeon is thinking that your symptoms are so wide spread that a few bone chips would not cause the symptoms.  The EMG has two parts. The first part is using electricity to see how fast the nerve conducts current.  It involves an electrical shock to be given to a nerve and measurement of speed of transmission through a nerve.  The shock is alittle uncomfortable but tolerable.  The next part of the EMG is the needle exam.  This is alittle more uncomforable as a thin needle is stuck into the muscle.  This records the muscle irritability to the needle.  One can tell if the muscle has lost it's nerve connection or the problem is in the muscle itself.  Together the neurologist can use these two tests to see if the problem rests in the nerve or muscle.  Although these tests are not comforable, they are tolerable if you go into them with the correct mindset.  

Sincerely,

CCF Neuro MD