White spots on MRI -minimal other symptoms

[Poster123]

I went to the doctor complaining about two symptoms
1 Numbness in my hands and legs when I touch my chin to my chest
2 Intense numbness in my back when I have a glass of wine

other symptoms that may have been present for a long time that I didn't bring up are
sore lower back at times, very sore neck most of the time, "creaky" joints -assumed that all of these had to do with my own bad habits, ie not enough stretching before/after exercise, etc...

The Neurologist did a nerve conductivity and muscle test and found nothing abnormal there.  I had an MRI of C-Spine and Brain and it showed one or two "white dots" above C-2, and 3 white dots on the left side of my brain.  I have no idea what that means.  The neurologist says, "probably MS"

I have had a visual evoked response test, haven't heard results yet.  Lyme disease and Sarcoidosis (via ACE) came back negative.

other than the minor symptoms I have reported above, I feel in perfect health.  I am a 30 yo male.  I have had some general stress over the past two years, but no trauma or injuries that i can think of.  (i did get punched in the head once, about 2 years ago, but these symptoms started only 6-8 months ago...

what are the other possibilities besides MS?
How conclusive could the MS test be?

[CCF-Neuro-M.D.-CS]

Without examining you, takin your history, and reviewing the MRI I cannot make a diagnosis. The white spots in the brain indicate areas which have been damaged. If the MRI was not done with contrast, it may be helpful. The visual evoked potential is another method to detect damage to the white matter of the brain. Another test which may need to be performed is a spinal tap with analysis of the fluid. This test can look for signs of inflammation and abnormal anti-body production (suggestive of MS). Other disorders to consider include lyme and sarcoid. In addition your B12, markers of systemic inflammation (sedimentation rate), and a marker for connective tissue disease (such as an ANA) may need to be tested. Good luck.

[Chrisbo]

I also had an MRI showing some 13 "white spots" (Lesions) but with a negative Visual Evoked Response Test and a negative Lumbar Puncture and no real clinical signs of MS, It was considered extremely unlikely that it was MS and the white spots were simply put down to UBO's (Unidentified Bright Objects) with unknown cause.  A diagnosis of MS is extremely difficult to make without having serial MRI's showing a changing or specific pattern of the "white spots" with the corresponding MS symptoms. A positive VER test and a positive Lumber Puncture showing Oligoclonal bands in your Spinal Fluid are also strong pointers to MS. Unless all these tests are positive then my understanding is that the diagnosis becomes inconclusive.....hope this helps.

[Poster123]

thanks, that is helpful.  Why did you get the MRI in the first place?  

From what I understand, a diagnosis of MS is just made based on a  collection of symptoms or conditions correlated with those symptoms. -In other words, there is no definiton of the disease, like "presence of XYZ virus".  

Are White Spots on the Spinal Cord and Brain MRI's definitely indicative of demyelination? or could other factors cause inflamation (inflammation) of those areas and create white spots on the MRI?

[Chrisbo]

I had an MRI following symptoms including frequent headaches, fatigue, tiredness, lightheadedness, pins and needles etc. and when the radiologist suggested the white spots were consistent with demyelination I then had further tests for MS.  

You are right in that there is no definitive test for MS, the diagnosis is made on the clinical symptoms backed up by at least 1 MRI, VER test and Lumbar Puncture.

"White spots" are not definitive of demyelination and basically represent a lesion or an area of scarring which can be caused by such diverse conditions such as TIA's (mini-strokes), normal aging, lupus or even migraine.

MS "White Spots" tend to have characteristic features in terms of numbers, shape and location.

[pam ella]

What are the specific characteristics for an MS lesion?  My brain MRI said the hyperintense signals are not ovoid and not perpendicular to the wall of the ventricle.  They were "not classic of demylenating lesions."  There are also ill-defined areas of increased signal in the spine although, both MRI's had no evidence of enhancement(contrast).  Thanks for your thoughts on this.

[MLWTR]

You might want to ask your neurologist or a rheumatologist about the possibility of lupus. Like MS, it can cause white spots that show up on a brain MRI, and can be accompanied by paresthesias (pins and needles sensation). Make sure to mention your sore joints/back/neck, since lupus is a rheumatological condition that can cause joint inflammation.

Doctors tend to be less suspicious of lupus in male patients, because 90% of adults with lupus are female. Nevertheless, men account for 10% of cases.

Good luck.

[bhrama]

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[murraybr]

I know this is a little late in coming and may be old news but I have just learned about something called L'Hermittes Sign.  This is the shocking/burning/tingling feelings you get when you bend your neck forward with chin to chest.  This is a symptom of MS and also a handful of other conditions.  I looked it up on the internet to get more info. I have this too but normal MRI's and EMG test along with other blood tests like VB12, Lyme and arthritis.  Go to my first neurologist's appointment the end of the month to see what he may offer in way of information about what is going on.  

Take care and good luck!

[CKMrkCoor]

For the last several months I had headaches that were increasing in intensity.  About 6 weeks ago, I was out shopping and experience the worst set of sharp shooting pains to my head.  With every step they got worse.  Two days leter my mom rushed me to the ER because I was so sick and in pain from the headaches.

The ER found an abdormal CT scan and MRI then my subsequesnt visit to the neurologist found a positive ANA (being sent to another specialist), and I am going to find out what the MRI and MRA finding are on the 24th of January.

My headaches have not gone away and throughout the day I will have moments that last between 15 min. and 2 hours in which I experience extreme headaches, tiredness, no temperature but my face feels like it is burning up, and just a general sense of feeling unwell.  I have no numbness or tingling anywhere in my body.

I am usually a very active, fit, and healthy person.

Just wondering what to expect from my visit and if anyone else has had these symptoms, and what the pronosis ended up being?

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