white matter changes in brain

Hi!! I have had many many symptoms (and tests ) over the last 3 years. My pRIMARY symptom has been balance problems/ postural when standing and fasiculations in the feet. I am 41. Two years ago I had  a workup . The results were:
BAER /ok
SER ok
TAP / clear; ok
brain mri : pineal cyst "inconsequential"
mRIs of all spine / all ok; small cyst in lumbar region.
Symptoms wax and wane!!
Symptoms have become progressively worse over the last several mos. and include almost constant muscle twitching in the feet, headaches and pain in cervical spine, sever balance problems and gait difficulty. A recent MRI showed nonspecific deep white matter changes. Any ideas of what to explore? No MRIs had gad.Thank you!!

[CCF Neuro[P] MD, RPS]

Dear Susan:

Sorry to hear about your problems.  Deep, nonspecific white matter changes can mean many things.  If you have high blood pressure that is not treated, smoke, and are obese, these may mean small lacunar strokes, or they can be nonspecific changes associated with ageing (aging) (although you are alittle young for these to be appearing).  So, alot depends on the state of your health, the co-morbid factors of your lifestye (smoking, drinking, drugs, obesity, heart problems or whatever), systemic diseases such as lupus, arthritis, etc.  The significance also depends on where the lesions are located, especially in relationship to your symptoms.  Since you stated that they were non-specific, I will assume that they are not in a location that would be worrisome for a specific disease.

As far as the other symptoms you are experiencing, I would check with your neurologist.  Sounds like you may need an EMG to better define whether these are benign or from a possible disease state.  

Sorry, I can't be more specific.  See your neurologist and try and see if the neurological exam fits a pattern that might suggest an etiology of your symptoms.

Sincerely,

CCF Neuro MD