MRI Incidental Findings

[Panos1978]

Hello - I am 35 male and very frustrated and i am trying to read a lot of articles to get a clue. Your opinion will be very helpful.
3 years ago i had an MRI because of migraine and came back with 2 small lesions in the perivetricular white matter area but the radiologist didnt even mention anything ...
2 years ago i had another MRI because of a face so-called numbness and came back with the same lesions and still the radiologist and neurologist said that these are "normal" findings and shouldnt worry me
6 months ago another MRI reporting 2-3 small lesions in the same area - that shouldnt worry me
Last week i read a few articles and started to panic so i made a new MRI in a 3T machine and the result was "small number of small lesions in the periventricular area - Those lesions dont seem to have any changes from previous MRIs"
Additionally i had VEP that came back normal and several neurological exams that were all normal.
My blood pressure in the past was high and i used to be heavy smoker and had quite a lot of migraines.

If i think of symptoms i would say that generally i have had mild neurological symptoms over the years.
Mainly some tingling in both feet at times - Since i started thinking of MS i started to pay attention to every single change in my body and every single small abnormality in the nerve feelings. I am feeling occasionally some minor "pin and needles" in the feet and some kind of "tireness" on my right leg but only after driving...

My question is this. Do you think that 3 years since the time we found these lesions (might have been there for much longer) is enough to rule out MS? Thanks

[supermum_ms]

If you are dealing with anxiety and it is centred on health, it is very common to experience cycles of anxiety where you are compelled to seek out reassurance after reassurance, until the anxiety settles down again. One of the problems with anxiety is that, once your thought process is fixated on what you are anxious about, it is very difficult to stop your self thinking of the what if's, ands or buts.  

You could effectively read hundreds of articles on the medical condition you are fearful of, and 99.99% will disprove what your thinking but that 0.01% is what you won't be able get out of your head, because anxiety makes you fixate on anything that supports your way of thinking, feeding the anxiety and does nothing to help alter the anxious thoughts.

Do you honestly believe, you still have a rational and logical reason to continue researching MS and it's not because your anxiety is demanding and controlling your thoughts? Seriously if you have health anxiety it is not a good idea or in your best interest to do so, because you are only going to be fuelling your anxiety and that's the last thing you should be doing.

With anxiety its better to avoid any activity that feeds it, distraction to keep busy both mentally and physically and to be consciously challenging any negative thought patterns and most importantly to seek appropriate medical support. Do what's in your best interest and that just may be to get help for those hidden things behind your anxiety!

Good luck.................JJ    

[Panos1978]

Hi,

I hope you are doing well.
Could you please send me some links based on the studies that you mentioned? "there are many research studies that indicate around 5+ MRI lesions per year (untreated)"

Would be great to check this.

Cheers

[HVAC]

No test rules MS in or out. The neurological exam is much more important than a MRI. That is reflexes, following the finger with your eyes, etc. A Neurologist can find out if you have damage to your Central Nervous System and exactly where the damage is with those simple tests. MRIs are nifty machines but sometimes they show too much. I liken a MRI to shadow puppets. They show shadows which they call lesions. When corellated with symptoms and a abnormal neurological exam the lesions can mean something. By themselves they may just be shadows.

If in the future you have lots of Neurological symptoms I would follow up with a Neurologist. If my neurological exam was clean I personally would not worry at this moment.

This is why doctors have to do the diagnosing. They have the expertise and all the information.

Alex

[Panos1978]

There are so many things hidden behind this anxiety and surely there is a need for someone qualified to help.
At any case what a neuro told me is that you can become much more disabled from a psychological point than you could ever become even if you had MS.
So i agree with your response

[immisceo]

Health anxiety is quite common and immensely understandable. I don't think a single person on the forum would consider it any kind of a weakness. In fact, acknowledging health concerns are potentially becoming a disproportionate worry shows enormous strength.

With the explosion of information available to the layman, the power to inform can easily take a bit of a darker turn if it starts to eat into your quality of life. The hyper-monitoring of one's physical self can become a vicious cycle.

There are many ways to approach dealing with this, if your actual bill of health is good and you feel it might be becoming a bit of an issue. Finding someone qualified to talk to is a great start.

[Panos1978]

Thank you very much for your encouraging and well explained response.
My fear shows huge weakness and i am not proud at all...
This is the main thing i need to work and change for myself and for everyone who loves me.
Life is always full of good and bad surprises and we cant get anything for granted.

Thank you once again

[supermum_ms]

Hi and welcome,

Honestly, i'd have to agree with immisceo but would also add that you seem to have become worried about the possibility of MS and i can't quite understand where MS even came from. What I gather your saying, is you had 3 MRI's due to migraines, no suggestive test results, no clinical evidence and consistently being told by neurologists not to worry but you still had the last MRI on a 3T after recently reading about MS.

My concern is that you are more likely, over reaching and becoming unnecessarily anxious, the more you worry the more you've become aware of everything your body is doing and you've started assuming more than what is evident. There really isn't anything you've mentioned, to suggest what you've experienced is a neurological condition like MS, and i would recommend you take a step back for a moment and think this through.

Unfortunately there is no single test to dx MS, but there are many research studies that indicate around 5+ MRI lesions per year (untreated)  and then there are clinical signs of lesions, that do actually show up during neuro tests long before an MRI can often pick the lesion up. So to answer your question, it would be more typical in MS over that time frame, to have accumulated some clinical abnormalities and or MRI lesions in other locations to make MS even a likely possibility.

It would make more sense to attribute your situation to what you already know, than to worry about something like MS, so please try not to worry!

Cheers................JJ
  

[Jifr]

Hi there Panos.

I have a MS diagnosis and to be perfectly honest - the neurologists never seem very much concerned with me, my diagnosis, presentation of symptoms, etc.  :-)  I'm not sure what it is about MS that makes them like that.  So, I would take that kind of disposition with a grain of salt.

You know, when I was diagnosed, the neuro told me that MS was a diagnosis of exclusion.  Meaning - they excluded everything else.  I got the impression that they decide it's MS if there is enough evidence to rule out everything else because there isn't a "MS" test.

In your case, it sounds like there might be enough "other" stuff going on with you that they might be able to rule "in" a different diagnosis?  Does that make sense?  Soooooooo many things can cause tingling.

When people find out I have MS and ask me If I think they have MS because they have numbness or tingling, I want to help them try not to panic.  :-)  So, please know, if it is MS?  #1 - you'll be okay.

Jen

[Panos1978]

Thanks for your post. I've visited quite a lot of neurologists.
Honestly none of them seemed too much concerned.

The only realistic finding is the lesions in the periventricular white matter area which remain stable over the years and were never Gd enhanced.
Additionally when i had my initial MRI these lesions were still there but the radiologist didnt mention anything and gladly i found those in the CD of the MRI which was given to me.

My concern is if this is some kind of beginning of MS... I am also experiencing some kind of mild neurological symptoms and thats why i feel much worried.
I wish there could be a test to confirm or rule out MS immediately...

[immisceo]

I'm not sure that anything you've mentioned rules MS 'in', if you know what I mean. Everything seems to be quite explicable with the other health issues you've mentioned (blood pressure issues, migraine).

For MS to be suspected, if would be more typical for changes to be seen in your MRIs over time or signs to show up in your exams or symptoms in addition to tingling as you describe it (bilateral, such as with your feet, or situational based such as your leg after driving do not point to MS presentations of tingling).

I am not a medical professional, but given the weight of evidence you have, I wouldn't be overly concerned with MS at this point. What are your doctors suggesting as the reasons for your issues?