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brain lesions, no MS band in spinal fluid
I have a lot of symptoms for MS. My Doctor was pretty sure that is what I have but I did a spinal tap and my fluid does not show for MS. I am now being sent to a University Hospital for a second Opinion. The test that I have received show that my body is fighting something, but they're not sure. Apparently they show inflammation and my protein levels are double of what they are supposed to be. Does anyone have any experience with this or suggestions on what I should have the Doctor look for?
MEDICAL PROFESSIONAL
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 examine you and obtain a history and review your imaging, I can not tell you what the exact cause of your symptoms is or the implications of your imaging findings. However I will try to provide you with some useful information.
You state that your MRI shows brain lesions, and that you have "symptoms for MS", I am not sure what you mean exactly by this, and the different possibilities for what the cause of your symptoms is depends to a large extent on what your symptoms are. MS is diagnosed based on specific imaging findings, history, examination, and lumbar puncture testing. If your lumbar puncture does not support the diagnosis of MS, but there are still so-called plaques in the brain, there are several potential possibilites. (I am assuming by brain lesions above that you mean there are some spots on the brain since MS was a consideration).
Most often, what are called in lay terms white spots or white plaques in the brain are due to what is called "chronic small vessel disease", literally meaning diseased small vessels that supply blood flow to the brain. This is not an uncommon process in the brain and increases with age. This is not a disease in and of itself but rather is a reflection of unhealthy blood vessels, damaged by years of plaque build-up. This is most often due to a combination of several factors including the following: high blood pressure, diabetes, smoking, and high cholesterol. If these factors are well controlled, the damage to the brain can be stabilized and further damage prevented.
Other causes of plaques in the brain can be migraine. People with migraine often have plaques on their MRI that are of unclear cause or significance.
Other causes of plaques on MRI can usually be distinguished based on history and symptoms, such as symptoms of neurologic deficit (for example arm weakness or difficulty walking etc). These can also be distinguished based on the MRI appearance. These include, but are not limited to other demyelinating diseases besides MS, certain infections, and inflammatory processes such as vasculitis.
The different causes can be determined to some extent by interpretation of various sequences of the MRI. It sounds like your neurologist does not think the pattern of white spots in your brain are typical of multiple sclerosis. Other investigations are sometimes necessary to distinguish the various causes of white matter lesions. In some cases, when there is not a clear identifiable cause, repeat imaging of the brain to reassess after several months is indicated. It sounds like you are on the right track with plans for evaluation by a neurologist at a tertiary care center.
Thank you for this opportunity to answer your questions, I hope you find the information I have provided useful, good luck.
Without the ability to examine you and obtain a history and review your imaging, I can not tell you what the exact cause of your symptoms is or the implications of your imaging findings. However I will try to provide you with some useful information.
You state that your MRI shows brain lesions, and that you have "symptoms for MS", I am not sure what you mean exactly by this, and the different possibilities for what the cause of your symptoms is depends to a large extent on what your symptoms are. MS is diagnosed based on specific imaging findings, history, examination, and lumbar puncture testing. If your lumbar puncture does not support the diagnosis of MS, but there are still so-called plaques in the brain, there are several potential possibilites. (I am assuming by brain lesions above that you mean there are some spots on the brain since MS was a consideration).
Most often, what are called in lay terms white spots or white plaques in the brain are due to what is called "chronic small vessel disease", literally meaning diseased small vessels that supply blood flow to the brain. This is not an uncommon process in the brain and increases with age. This is not a disease in and of itself but rather is a reflection of unhealthy blood vessels, damaged by years of plaque build-up. This is most often due to a combination of several factors including the following: high blood pressure, diabetes, smoking, and high cholesterol. If these factors are well controlled, the damage to the brain can be stabilized and further damage prevented.
Other causes of plaques in the brain can be migraine. People with migraine often have plaques on their MRI that are of unclear cause or significance.
Other causes of plaques on MRI can usually be distinguished based on history and symptoms, such as symptoms of neurologic deficit (for example arm weakness or difficulty walking etc). These can also be distinguished based on the MRI appearance. These include, but are not limited to other demyelinating diseases besides MS, certain infections, and inflammatory processes such as vasculitis.
The different causes can be determined to some extent by interpretation of various sequences of the MRI. It sounds like your neurologist does not think the pattern of white spots in your brain are typical of multiple sclerosis. Other investigations are sometimes necessary to distinguish the various causes of white matter lesions. In some cases, when there is not a clear identifiable cause, repeat imaging of the brain to reassess after several months is indicated. It sounds like you are on the right track with plans for evaluation by a neurologist at a tertiary care center.
Thank you for this opportunity to answer your questions, I hope you find the information I have provided useful, good luck.
I now also remember that after I had the baby I had I rash all over my stomache. It was a bunch of little red colored dots. Neither my Doctor or OB Doctor knew what it was
1 of biggest compaints is that I constantly feel tired/fatigue. I get at least 9 hours of sleep a night.
August 2009 - Oct. 2009 high blood pressure
Oct. 2009 - 3rd baby was born then I was re-admitted to hospital for pre-eclampsia
Nov - Dec. 2009 - lost track of everything due to mental side effects of blood pressure medication.
Nov 2009 - hospitlaized with vertigo
Dec 2009 - hospitalized with fever of 104, had urinary tract infection. Mri presented white unknown substance
Could not walk straight - felt intoxicated (not nearly as bad anymore,I'm pretty sure I can walk straight)
Felt dizzy
Jan 2010 - blood pressure normal (do not take any blood pressure meds any more)
Now feel like head is full of pressure
Feb 2010 repeat MRI showed white spots (what the neurologist called lesions)
Now, received test result back and all the Doctor said is that he does not want to start treating me for MS, he wants to see what else is going on because of the negative lumbar punture result showin no MS band which typically show up. I am now going to the University to have a second opinion. Is there anything I should ask him to check for? I would appreciate any information. Thank You!!!
Oct. 2009 - 3rd baby was born then I was re-admitted to hospital for pre-eclampsia
Nov - Dec. 2009 - lost track of everything due to mental side effects of blood pressure medication.
Nov 2009 - hospitlaized with vertigo
Dec 2009 - hospitalized with fever of 104, had urinary tract infection. Mri presented white unknown substance
Could not walk straight - felt intoxicated (not nearly as bad anymore,I'm pretty sure I can walk straight)
Felt dizzy
Jan 2010 - blood pressure normal (do not take any blood pressure meds any more)
Now feel like head is full of pressure
Feb 2010 repeat MRI showed white spots (what the neurologist called lesions)
Now, received test result back and all the Doctor said is that he does not want to start treating me for MS, he wants to see what else is going on because of the negative lumbar punture result showin no MS band which typically show up. I am now going to the University to have a second opinion. Is there anything I should ask him to check for? I would appreciate any information. Thank You!!!
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