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Undiagnosed brain lesions
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Undiagnosed brain lesions

Hi

Firstly I wanted to say thank you for this great service.

I am a 30 year old female without any prior ill-health. In January this year I began experiencing a number of symptoms; dizziness, fatigue, tingling and muscle weakness. I was then referred by my GP to a neurologist. At this time I was sent for a range of blood tests (eg. Vit B12, ESR etc) all of which came back negative. However, my MRI (w/out contrast) did show the following (sorry have to quote the radiologist from here):
'..A tiny (2mm) lesion abutting the right lateral ventricle, a large (1cm) subcortical left parietal white matter lesion as well as 3 or 4 subcortical lesions in the frontal lobes...A moderate periventricular white matter hyperintensity capping the frontal horns with a tiny left sided periventricular lesion abutting the roof of the left trigone..The white matter changes are not entirely typical but fairly suggestive of demyelination.'

My neuro recommended a second MRI in 6 months but suggested this was either a vasculitis of the brain or MS. I've just had my second MRI, after a long 6 month wait, (with contrast) and the results showed that there were no new lesions nor abnormal enhancement. My concern is that on returning to the neuro, I was still experiencing some symptoms; muscle stiffness, fatigue, burning. He has now said that my symptoms don't fit in with MS and that he is not sure that it is vasculitis as if it had been I would more than likely have been hospitalised.

Anyway, if you could shed any light of the cause of these lesions it would be appreciated.

Many thanks
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Avatar_n_tn
The diagnosis of MS is made when an individual has two seperate neurologic deficits involving two different regions of the brain (at two different times). The probable diagnosis of MS can be made if one neruologic event occurs and an MRI shows classic findings of MS. Without seeing your MRI it is not possible for me to comment on them.

Lesions in the brain can be caused by many disorders including: high blood pressure, atypical or complicated migraine, vitamin B12 disorders, other inflammatory disorders (such as lupus or vasculitis), and MS to name a few. The fact that your 6 month scan showed no new or enhancing lesions is good. However it may not completely exclude MS as a possibility. Some other tests which could be performed to help evaluate this problem include: visual evoked potentials and a spinal fluid analysis.

You could discuss this with your neurologist, and if you still are not satisfied consult with a neurologist who specializes in MS. If you are in the area we have an excellent MS center called the Mellen Center.
6 Comments
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Avatar_n_tn
Your short story sounds all to familiar. My wife started with a similiar situation back in 1995 in NJ. It took until 1999 for doctors to even consider a diagnosis of Lyme disease. Many doctors do not like to treat this and its better to not diagnosis this then to treat it because treatment for this is not text book. You may need to see maybe physians before it is consider.Hope this helps.
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Avatar_n_tn
I am sorry for your problems. I have MS and your lesion locations are typical for MS from what I have studied. The symptoms you stated are also typical of MS.  If you are currently having symptoms you should have them give you a spinal tap when the time is right. To be one of the lucky people diagnosed with MS early on is a wonderful thing. There are four different drug therapys for the treatment of MS one of which is Copaxone. I have been on it for three years and am in total remission. I am 35/w/female and cant tell you how happy I am to be born in a time where there are great specialist, technology and drugs that have helped me. MS is not that scary and if you have to have a neurological demyelinating disease MS is the lowest on the todem pole (meaning the best one to have) in my opinion when caught early.  Requst an MS specialist. Its very important. Since you have lesions and the symptoms they may not require the spinal tap. Mine did not. One thing: get your insurances in order. Make sure your life insurance is in order, health insurance etc... because once you are marked with MS or any other neurological disease you will have a problem getting insured.
Good luck to you and feel free to email me any time. Also "search this site" and go to multiple sclerosis. There are tons of previous questions and answers that will help you.
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Avatar_n_tn
Hi

I just wanted to say thank you to the people that took the time to email in with their comments & ideas. I appreciate all the suggestions and will be seeing another neurologist to pursue some sort of diagnosis.

Thanks again
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Avatar_n_tn
I also have been to 4-5 doc's, within the last 10 months.  My problem is speech, writing, coordition, spelling.  my neuro dr. said he thought it looked like MS, but wasn't sure. after that I have seen 3 more, 1 said it might be a tumor, but sure.  Now, they are sending to Univer. Denver again to see yet another Doc.
I is very frustrating, my last MRI shows it has worsend.  I first it was a spot, now it looks like a squiggly line.  It is on my left side of brain.  obviosly it going thru speech path. It very hard to type now, so bare with me.
ANY IDEAS OR HELP!
Thank you
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Avatar_n_tn
I implore ANY of you who exhibit MS like symptoms, brain lesion et al, to please be tested for Lyme Disease.  Make sure you visit an LLMD or infectious disease specialist who will make sure your serum is tested under the most specific conditions.

I had been given a "likely" diagnosis of MS, and by chance began to read all the other diseases that result in brain lesions.  If you have any history of tick bite, or live in an endemic area, it is a road worth traveled, as Lyme Disease has a very high cure rate when handled properly, unlike MS, where there is no cure, just remission.

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