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white matter lesions
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white matter lesions

I had a MRI after complaining of multiple symptoms including chorea, starting to pass out when I stand up, muscle fatigue, including the jaws when chewing or tongue when talking, personality changes, cognitive difficulty, incessant tingling/internal "itch" in my neck and lumbar area and vision changes including double vision.   The MRI showed "Multifocal T2 hyperintensities are seen within the white matter both cerebral hemispheres.  These are most concentrated in the frontal lobes.  I count approximamtely 5 or 6  lesions bilaterally.  The largest is located deep to the insular cortex of the left frontal lobe and in the anterior limb of the left internal capseule and measures 6 mm.  Diffusion weighted immages are  normal.  There are no pathologic areas of enhancement.  There is no evidence of edema, hemorrhage or mass effect.  The ventricles are normal in size.  There are no lesions seen in the brainstem, cerebellum, thalami, or basal ganglia.  IMPRESSION: Nonspecific multifocal white matter disease.  None of the lesions enhance.  The differential diagnosis include arteriolosclsrosis, demylenating disease, toxin exposure, post infections state, vasculitis, prior trauma and other etiologies."
Neurologist seemed nomplussed, almost didn't go further, and said it is probably just some fluid, but is ordering a tilt table test and lumbar puncture.  Routine visit to regular doctor-looked at test results and said I had white matter disease in an alarmed tone.  Asked reliable pharmacist if this could be high blood pressure.  Have had that but is under control, and actually has dropped below normal lately.  He put his head down on the counter and shook it, looked up sympathetically and said not to this extent, nor arteriolosclerosis.  Thouoght the lumbar puncture would be looking for cancer  - i said probably looking for MS.
Wasn't so worried until my local doc and pharmacist reacted.
My question is this: In comparison, is 10 or 12 lesions a lot and a concern?  What about the location?  If two are 6 mm, is that large in comparison?  I would love some input.  Thanks.
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Thank you for your question. Although without being able to placing your findings in context with clinical features and the results of other investigation such as hematological, MRI, I can not offer the specific advice & treatment you need. However, I will try to provide you some relevant information about your health concern.

It sounds like that you may have white matter disease. In white matter disease there is pathology associated with the brain white matter, either exclusively or in combination with grey matter changes. It occurs due to metabolism errors, exogenous toxins released by virus, autoimmune disease, leukodystrophy, demyelination, and radiation effects. Spasticity, muscle weakness, paralysis, hyper-reflexia and movement disorder may be the clinical features associated with white matter disease that need to be evaluated thoroughly. However, it is sad to say that there is no permanent cure but conservative treatment & physiotherapy exercises that would help you to regain your normal function and stopping the further progression of the disease. Please consult a neurologist in this regards. Hope this helps.



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