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Neurology (Expert Forum)
ms
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ms
by kstoriern, Feb 13, 2007 12:00AM
My question is in regards to a MS diagnosis. I am currently having all tests completed to rule out/in MS.
This MRI - white matter changes associated with the inferior margin of the corpus callosum and along the margins of the corpus callosum. These appearances are not specific but consistent with ms.
Small striations along the undersurface of the c.c. to the right and left of the midline. Is this consistent with MS findings?
Cervical/thoracic spine MRI's - normal.
Spinal tap in a couple of weeks with VEP/SEEP's.
Is this consistent with MS? Normal spinal MRI - but evidence in the Brain MRI?
This MRI - white matter changes associated with the inferior margin of the corpus callosum and along the margins of the corpus callosum. These appearances are not specific but consistent with ms.
Small striations along the undersurface of the c.c. to the right and left of the midline. Is this consistent with MS findings?
Cervical/thoracic spine MRI's - normal.
Spinal tap in a couple of weeks with VEP/SEEP's.
Is this consistent with MS? Normal spinal MRI - but evidence in the Brain MRI?
Doctor's Answer
by CCF-Neuro-M.D.-SH, Feb 22, 2007 12:00AM
First of all, keep in mind that I am unable to diagnose you because I am unable to examine you, this forum is for educational purposes.
The MRI findings that you describe are those that are typically found in multiple sclerosis (MS). There are a number of different pathologies that can affect the white matter on MRI including hypertension, age, migraine headaches, old strokes, MS, etc. Lesions that are characteristic of MS tend to be periventricular (around the ventricles) particularly involving the corpus callosum. These white matter lesions tend to be perpendicular to the ventricles (as opposed to the lesions in hypertension, migraine, etc-which tend to be more subcortical). All the technical speak aside, I sounds like your Brain MRI could be consistent with the diagnosis of MS in the right clinical context. MS does affect each person a little differently, some people have only brain lesions (a least early on), while others begin with mostly cervical spine lesions. I agree with getting the spinal tap and the Visual evoked potentials/somatosensory evoked potentials to round out your diagnosis, but either way it sounds like you should consider disease modifying therapy (such as avonex etc).
I hope this has been helpful.
The MRI findings that you describe are those that are typically found in multiple sclerosis (MS). There are a number of different pathologies that can affect the white matter on MRI including hypertension, age, migraine headaches, old strokes, MS, etc. Lesions that are characteristic of MS tend to be periventricular (around the ventricles) particularly involving the corpus callosum. These white matter lesions tend to be perpendicular to the ventricles (as opposed to the lesions in hypertension, migraine, etc-which tend to be more subcortical). All the technical speak aside, I sounds like your Brain MRI could be consistent with the diagnosis of MS in the right clinical context. MS does affect each person a little differently, some people have only brain lesions (a least early on), while others begin with mostly cervical spine lesions. I agree with getting the spinal tap and the Visual evoked potentials/somatosensory evoked potentials to round out your diagnosis, but either way it sounds like you should consider disease modifying therapy (such as avonex etc).
I hope this has been helpful.
Please be advised that I am not responding to you as a physician and that what I write and share is not meant to replace medical advice, to give diagnosis, etc.
With that said, I read your post and it is unfortunate. The findings could be responsible for MS but are non-specific. Perhaps Lyme disease of Vasculitis, to name a few.
In the event that oligoconal bands are found, this too, is non-specific as Lyme disease can produce similar findings.
I hope that I have been helpful,
JCmcc.