Go to neurologist now?

[MDeStef84]

I'm a 27year old woman and I've been presenting with many symptoms, fainiting, dizziness, lightheadedness, strength loss in right extremeties, worsening vision, blurred vision, pins and needles in back, neck and legs, sometimes numb feeling, memory loss, increased anxiety, and a few others. I had a brain lesion that was discovered 4/2011. I was told by my neurologist that she believed I had a "small stroke" and the lesion on my brain was causing sensory seizures. I was put on Keppra .. wasnt effective, then tried tegretol for 4 weeks, that was not effective either. I also have had cardiac testing and my cardiologist says he sees nothing within the heart, etc that would cause a small stroke to occur. I was also refered to a orthoped surgeon for the numbness,pain and pins and needles in my neck and back and legs and poor strength on right side of the body. Had an L spine, that was fairly negative for anything. Then the Orthoped sent me for an MRI of my cervical spine. I recieved the results of my cervical spine today...they are as follows:

Findings : There is mild reversal of the normal cervical lordotic curve. The vertebral body heights are maintained. The cranio-cervical junction and C-12 articulation is normal. There is Patchy Diffuse Signal abnormality seen on the images throughout the spinal cord. The signal intensity of the intervertebral discs is normal. There is no significant disc pathology. There are no paraspinal abnormalities.

Impression : Questionable abnormality seen diffusely throughout the cervical cord. This could represent multiple sclerosis or other demyelinating process. The prior brain MRI demonstrated a solitary white matter lesion. Repeat brain MRI without and with IV contrast and post contrast images of the cervical spine.

So I guess my question is, should I just skip even going back to the Ortho and take these results straight to my neurologist? I'm a little anxious and hoping to not waste my time if I have to go back to the orthoped for him to just tell me to go see my neurologist.

[MDeStef84]

Thank you very much for your response! I will make an appointment with both doctors! thanks a bunch!!

[S. Kaul, MD]

Hi there!

Well, the primary abnormality on the MRI i.e. a ‘diffuse signal abnormality’ suggestive of a diffuse demyelinating lesion, is neurology related. And you would need to see a neurologist anyhow. However you would also need to see your orthopedician for ‘the mild reversal of the normal cervical lordotic curve’. You could choose who to see first, as per your convenience. As suggested by the radiologist ‘Repeat brain MRI without and with IV contrast and post contrast images of the cervical spine’ may be required to form a definite opinion about the spinal lesion. You could talk to your neurologist in detail about this.
Hope this is helpful.

Take care!