worried about MRI results

42 male Brain MRI w/w/o contrast Sept 2005. Brain Parenchyma: 2-3mm T1 hypointense focus in the right periatrial white matter failed to reveal signal abnormality on the T2 weighted sequences.  Finding likely variant. No abnormality of enhancement corresponding to this lesion noted. Brain parenchma otherwise demonstrates normal signal. No signal abnormalities on the difussion weighted sequences or the post contrast enhanced images noted in the cerebrum or cerebellum. There is no evidence for mass effect. All other areas unremarkable. Cervical MRI without contrast May 2005 revealed degenerative disc changes with normal spinal cord signals. I frequently have buzzing/tingling/twitching feet arches,calves,right eyelid can be any extremity. Pain/sorness left butt/hip and back of thigh.  Neurological exams normal reflex strength vision etc. I have seen two different neurologist twice each in the past six months. I saw a spine surgeon that recommended physical thearpy to alliviate symptons-after two sessions said he did not think the cervical changes were enough to cause my symptons. My Gp has completed all the blood work and exams he feels are necessary including PSA b-12(400 something),Tyroid,lyme(elysa)HIV, monoclonal antibodies sed rate all normal. I am a dentist. My GP and first neurologist prior to Brain MRI recommended psychiritist for anxiety over these symptons. Do you feel this is all anxiety,that would be great? What could cause the hypointense T1 lesion? What does likely represent varient mean? Could other MS lesions be hiding in the rest of the spine? What next?

[CCF-Neuro-M.D.-PW]

My advice is limited by not seeing the MRI scans, so I cannot give you any formal opinions or clinical diagnosis over the internet

A variant is a medical term for a variation or slight difference in peoples brain anatomy that is still considered normal as opposed to abnormal - it is just a feature of our individuality in the general population.

Its not clear what the T1 hypointense focus is - it could just a 'perivascular space' also called a Virchow-Robin space - just some space around a normal blood vessel. Also potentially it could be an old stroke or MS lesion - but the lack of signal abnormality would go against this and would support that it is a normal variant. Hypointense MS lesions usually occur in advanced disease, so there would be other MRI and clinical signs of MS. It would not hurt to have your stroke risk factors assessed anyway. A repeat MRI in 6 months might be reasonable to make sure it has not increased in size. No change over time would also support a normal variant.

The leg symptoms are not classic for a lumbar myelopathy or radiculopathy (pinched spinal cord or nerves), a more sensotive test would be an EMG and nerve conduction study of the most symptomatic leg.

I would be encouraged that your tests have shown no significant pathology to date!

[DET]

Is this possible the begining progressive form of ms that attacks the spine more than the brain at first?  Should I repeat the cervical and have rest of spine imaged with contrast? Could this be lyme even with two negative elysa test? I have also had headaches in recent weaks with aslight tremor in left hand at times.  I do not have a history of headaches in my life.  Please help with an unbiased opinion.

[DET]

I also forgot to mention my left little finger for a couple weeks ago would twitch/fasciculate and become sore/burning in meaty area on palm side of hand.  Presently it remains sore at times esspecialy after using it to retract cheek after several fillings.  Sometimes it has a numb senation although not completly numb. Thanks for your help

[deenie40]

I would ask your neuro to look specifically for an Arnold Chiari Malformation. I had all the tests you did, and the ACM was missed on my MRI by two doctors and a radiologist.Good Luck

[mistyd41559]

Hello I am 31 year old female and I was in a car accident in feb. My back and neck are messed up and I am wondering if I should get a second opinion on my diagnosis? My Neurologist says I will not get any better. I am concerned with the pain medication I am taking . She has me taking one a day and 2 flexeril a day and 2 ultram. I am in constant pain and I am at my wits end at what to do because I run out of medication before I get a refill because the pain is so extreme when I get out of bed and when I go to bed. My diagnosis was L5 is  bulged almost on a nerve, I have been going to my chiropractor and he has been adjusting me to keep the disc off the nerve. I found out recently that I also have a disk in my upper back and it is on a nerve and I am just wondering if in fact it does continue to bother me, should I have back surgery? Thanks for listening, I will have to find my MRI results to let you know what disk it is exactly that is on the nerve, I know it is below my neck at the top of my back , I am not real familiar with the terms doctors use so bare with me.
Thanks,
Mistyd41559

[mcg99]

Det;

Have you checked into the possibility of mercury poisoning as the cause of your symptoms? While I know there is some misperception out there about the prevalence of this condition (many people think they have it when they don't), it has been proven to be an issue among dentists and people who works in dental offices. The symptoms you describe are consistent with mercury exposure. A simple blood test can reveal your levels. You may want to read more about this online just as a possibility, if you aren't finding answers elsewhere. I know how it feels to be having these symptoms without clear reasons--I'm in the same boat, and I wish you the best.  

[cacklebunny]

Hi DET:

It's amazing how similar your story sounds to mine.  

You can read the details of my problems at:
http://www.medhelp.org/perl6/neuro/messages/33611.html

It's now been eight months, and I still don't know what's going on.  I still endure the burning and pins-and-needles sensations in my feet, radiating up into my shins.  Some days, I feel almost completely normal and pain free.  But much of the time, I feel some sort of abnormality, whether it be pain in the arms and legs, sensation loss, loud tinnitus and muscle twitching.

Like you, many of the "specialists" I've seen have implied it's all due to anxiety.  It's frustrating, because prior to January I was perfectly fine.  The symptoms happened suddenly.

My GP has speculated that it may have been a virus.  Of course, he's also one of the doctors that has suggested it's "all in my head."  

Some of these doctors should really learn to show patients a little respect.  Just because they haven't found it on test, doesn't mean you're not feeling it.  I certainly sympathize with your issue and wish you the best of luck.

[Sunshine008]

Me too - very similar symptoms and no diagnosis as of yet.  I'm female, 42, in otherwise great health.  Sudden onset of buzzing/tingling/twitching in pelvis, legs, feet.  Especially my calves.  I also get cramps in calves.  MRI of brain, c-spine and l-spine -- all with and without contrast -- were normal.  All bloodwork normal.  Two EMGs - both normal.  The neurologist is at a loss as to why I have all these symptoms. I tried the anxiety med route - it did nothing.  This isn't anxiety related - at least it wasn't when it started.  I'm frustrated and tired of doctors telling me they don't know.  I'm concerned that it might be MS that has not yet shown up on my MRI, even though the docs say it's unlikely.  I haven't yet had a Thoracic MRI and I have heard MS can show up there first.  So, I'm asking for that next and maybe a lumbar puncture just to make sure.  This is so scary. I'm sure you feel the same way.  I hope you find answers soon and a treatment that helps.  Be sure to post an update since I might be looking at the same disease/problem as you.  The buzzing/tingling/twitching comment you made hit home.  The doctors look at me like I'm nuts, so when I saw that you wrote that I felt like someone finally understands.  

Good luck - keep me posted!

Sunshine

[DET]

Let me know how you are doing.  Thanks for the coments

[laenana]

44 yr old female
MRI report:
A single focal area of abnormal increased signal intensity is seen in the left frontal white matter measuring 10x5mm. No enhancement noted. Possibility of demyelinating process such as MS is raised. Less likely possibility of glioma not excluded. Evaluation of the single sagittal sequence of cervical spine reveals moderate degenerative spurring and disc narrowing from C4 through C7 left. MR spectroscopy beneficial in this case.
What does all of this mean? How likely am I to have MS? Any other ideas?

[carrieg99]

mistyd41559,

I could have posted your message...you sound so much like me.
I was in a car accident in Jan 2003 and have the same problems...chronic pain in my neck and back...Bulging disc in my lower back pressing on a nerve root & my pain extends to my hips and down the back of one of my legs.  I'm also taking vicodin & flexeril for pain management (doesn't really do too much but can help take the edge off of the booming migraines I get all the time.)  My neurologist told me that I have "traumatic fibromyalgia" and that is why am not going to get better.  He said that the impact of the car crash somehow jarred my body so bad that it caused this.  I currently am going to physical therapy for heat & stim treatments and massage therapy of the neck, traps, back, & hips.  It doesn't really make me "better" but it keeps my limber enough to move.  

I wish I had better news for you, but if you find anything that helps please let me know.  It's been almost 3 years and I have tried everything I can think of.  I hate the thought that I have to live this way for the rest of my life (I'm in my early 30's too.)

I wish you well!

carrieg99

[barinas]

In these days of easy access to information, including medical
information, it's very easy to get obssesive with symptoms that
the patient may feel entail certain diagnoses, and this is fine to a certain extent, since with appropiate investigations a cause may be found, but my friends the mind is a very powerfull
thing, it my cause you to feel symptoms that you dread. I remember back in the early 90's when the AIDS pandemic began to unfold, and the symptoms were described initially, a large number of people that were afraid of having the virus, started feeling the constellation of symptoms associated to AIDS, and despite repeatedly testing negative, these patients continued worring about having the disease, and experiencing worsening symptoms for years, it in fact became a syndrome of being affraid of havig aids, on the other hand it is very well known
that when medical students begin to study the nature of diseases, they too in a very significant number begin experiencing symptoms related to various illnesses, until they
learn better and the anxiety and symptoms dissapear.
In most of these postings, I see that there are some non specific symptoms, that patient are investigated for with a rather non-diagnostic work-up, however in view of mostly incidental findings, patients want to cling to these findings and somehow get a coclussive diagnosis, instead of just being re-assured that there is nothing dreadful.
MS is one of the conditions that a lot of people are concerned about, mostly when the complaints are what we call "a whole lot of nothing", many patients in fact become "MS wanna-be's", and continue seeking a diagnosis for years. My advice is: give yourself a break, stay away from medical facilities for a couple of years, do something that is entertaining, for example
play a sport, or pick up a hobby, go on a cruise, go to comedy
shows, in short enjoy life and you will see the good results
you get, ....good luck!!!

[laenana]

Are you telling me that I should not be concerned at all? I would love nothing more...

44 yr old female
MRI report:
A single focal area of abnormal increased signal intensity is seen in the left frontal white matter measuring 10x5mm. No enhancement noted. Possibility of demyelinating process such as MS is raised. Less likely possibility of glioma not excluded. Evaluation of the single sagittal sequence of cervical spine reveals moderate degenerative spurring and disc narrowing from C4 through C7 left. MR spectroscopy beneficial in this case.
What does all of this mean? How likely am I to have MS? Any other ideas?

[barinas]

Mmmm..., not really, but you are not mentioning whenther you have any neurological deficits, you do mention  about a
UBO (unidentified bright object)on mri, and some degenerative
changes of your spine, both very frequent in healthy subjects.
I don't know that MRS in such small area will be of any valuable yield, even in larger highly suspicious findings its dianotic value is rather limited (to differentiate between
inflammatory and neoplastic), if you had conventional work-up
that is negative, please refer to my final advice in my previous comment for a healthier, and happier life, yours truly,

barinas

[laenana]

The MRS results read:
Lesion in left centrum semiovale is identified hyperintense. Differentiation bet. low grade tumor and demyelinating process cannot be made.
What does that mean?
My symptoms are very weird. I feel strange sensations on my legs. My arms feel heavy and tingly at times. Also one of my hands will feel very cold and the other one feels normal. My energy level is fine though. I also feel pain, for example on my lower back or top of shoulder, but when I try to massage the area I cannot tell where the pain is coming from. It's all so strange. Any idea? I really appreciate your response

[brando10]

I had an MRI of my brain done and they found 20 lesions.  The neurologist I was seeing said he found only 1 or 2.  So I had the MRI reread and it again revealed 20 lesions with a question of MS.  An LP and a cervical MRI was completed both negative.  I had a VER that was read as borderline normal.  I have lost control of my bladder on several occasions and am constantly constipated. I have had over 9 bladder infections this year with blood in my urine each time. I get dizzy spells and see spots.  I have fallen on occasion because of numb legs and sprained my ankle.  At least daily my legs go numb and my arms.

[brando10]

ADDENDUM
I also get burning up and I always feel so wet inside my colon/bladder area--like I may be bleeding but I know that is not possible.

[barinas]

Hi there:

Are these really findings of an mrs, it looks more like an mri report. MRS attempts to distinguish between neoplastic(tumor)
vs. inflammatory such as MS, based on the relative abundance
of various molecular markers.
Your symptoms of pain without tenderness are more typical of nerve impingement near the cord, if symptoms in all four extremities it may be from cervical patology or combination of cervical and lumbar, it may be advisable to scan these areas, in fact your mri report mentions degenerative changes of the upper cervical segments.
Regarding the lesion in the left centrum semi-ovale, these are very difficult to categorize, your symptoms are not explained by
this finding, at least most of them. I can imagine, in view of the benign findigs, that it has been recommended to follow up in the future with brain mri, in the meantime stay positive, physical thrapy and moderate excercise may help.