possible ms?

I had a CT and MRI ran which showed up white spots on my brain, but my EMG study test showed up normal. I have numbness/tingling in my feet and my fingers goes numb, mostly on my right side, i get lightheaded/dizzy, neausa, weak, have trouble remembering things at times, have "attacks" or 'spells" at times, most seem to occour in the afternoon, when these happen, i have to have help walking, i feel as though i am drunk, i staggar. can concentrate and have noticed that the back of my neckbone hurts then also. Have had severe pain with spasms in my right foot and toes, had one episode where my toes drawed straight up with severe pain. fingers feel stiff and hard to type now

[Christopher R Newey, DO]

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 a doctor.

Without the ability to examine and obtain a history, I can not tell you what the exact cause of the symptoms is. However I will try to provide you with some useful information.

First of all, there are multiple causes for so called plaques or white spots in the brain. Most often, these 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 include headaches, multiple sclerosis (when in the right clinical context), etc.

Secondly, there are two types of nerves in the body – small and large. If the small nerves are affected, which can be the case in diabetes, the EMG/NCS will typically be normal. In these cases, there are other tests of the function of small nerves that can be ordered, such as QSART testing which looks at how much sweat the skin makes, since sweating is in a sense of function of these small nerves.

You should discuss with your physician the sensory changes you are experiencing. You may benefit from having a thorough lab workup including evaluation for diabetes, vitamin deficiencies, autoimmune disorders, and other metabolic derangements.

Thank you for this opportunity to answer your questions, I hope you find the information I have provided useful, good luck.