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Can nonspecific T2 Hyperintensity Lesions still indicate MS?

ion and worry
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mikkie2876 posted:
Hi there,
I am new to the board and I was hoping some of you could comment on my MRI results. I am NOT a migraine sufferer, do not have hypertension and I am 38 years old. About 8 months ago I started to notice that I couldn't see to my right and left sides. Especially from my right eye. I'm not new to the ophthalmologist unfortunately. In 2008 I had a severe case of Keratoconjunctivitis Sicca. It lasted 2 months, I even ended up with a corneal tear. At that time there was no explanation for it except that, "it happens to people for a variety of reasons". In 2011 I went for a follow up exam and was diagnosed with mild optic atrophy. I was told that there was no need to worry and that it would "heal itself" and it did. I was told that it just need monitoring. I also have bouts of blurry vision that comes and goes although I usually just think it's from being tired. I wasn't able to follow up because I lacked insurance up until recently. I went to another ophthalmologist because I am currently working in Brazil. I miserably failed a peripheral vision test.. My retinal test was okay, so he referred me to a neurologist. He asked me a bunch of questions and one was if I had any numbness. When he asked, I realized the significance of the question because I have been having tingling off and on in in my left hand and left toes. Sometimes I also have a pinched nerve in my neck or behind the shoulder blade that lasts for a few days and goes away. It's very painful. I thought it was the way I was sleeping. He sent me for an MRI. The results came back and I am worried. Maybe someone could shed light on this: "T2/FLAIR hyperintensity- discrete nonspecific foci that are scatted across the Supratentorial region" Now, it took me three days to translate this from Portuguese lol because of the medical terminology. As I researched, I came across MS. And I was floored at what I was reading. So many similarities to my struggles. I dropped off the results at the neurologist office on Friday. He wasn't there and he won't be back into the office until tomorrow. I'm on pins and needles!
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338416 tn?1420045702
What was the text of the MRI report? Non-specific foci across the supratentorium can indeed be MS, but it doesn't exclude disease activity from stroke or other ailments.
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Avatar universal
Absolutely non-specific lesions can be MS, because non-specific in MS terms only means non-classic. There are certain locations and shapes of lesions that make diagnosis fairly easy, all other things being equal, and then there are th rest of them. However, there aren't many illnesses that cause lesions of any sort in someone 38 years old.

I don't have eye symptoms myself, and am not up on all the possibilities. However, from all I've read, what you describe doesn't sound like the results of MS. Others here, I know, will jump in and advise you further.

Please don't conclude that you *do* have MS. Dr. Google turns up many matches, because MS can have dozens of symptoms. But if this neurologist comes up empty-handed in terms of diagnosis, ask to see one who specializes in MS. Neurology is a big field.

ess
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Avatar universal
I didn't copy any of it down because at the time I didn't understand the significance of all that information on the MRI reports themselves. The only thing I copied was the typed report that accompanied them (the conclusion). Here in Brazil, things are a little weird.. When a doctor orders any tests of any kind (blood, ultrasound, MRI, etc) you have to pick them up from the labs and take them to your doctor. They aren't sent over. So the patient sees the result without the doctor seeing them first.. LOL a little nerve racking!
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338416 tn?1420045702
Here in the States we're allowed to see our report, and even the MRI if we ask for it. I can understand why you would find it nerve-racking!

Have you heard from the neuro yet? As ess says, if he isn't very helpful, you can always seek another opinion.
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1831849 tn?1383228392
Hi Mikkie -

Durning what I know know was my first MS relapse, 25 years ago, the transfer of results/images from testing center to Doctor was much as it seems to be in Brazil today. I was sent for an MRI anf given the images to bring to my neurologist.

When I got to my car I couldn't help myself. I pulled one of the films from the sleeve. THe first thing I saw, at the base of my skull, at the top of my spine was a giant black spot. OMG! I'm a gonner! Massive tumor!

I got to the doc and he threw that first film into the light box. He pointed right to my self diagnosed terminal brain tumor and said "Your blood flow looks excellent."

That was the last time I practiced radiology :-)

Kyle
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5265383 tn?1483808356
Not to sidetrack the conversation, but Kyle ... you made my day ... LOL.
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Avatar universal
I actually never bothered to look at the MRIs themselves. Since I am not a radiologist there was no point. The report I read was a typed report that went along with it.
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Avatar universal
I haven't heard anything back from him yet. I figured if he was coming into his office today after being out since last Wednesday I should be a little patient with hearing back from him. If he doesn't call today I am going to call the office tomorrow.
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338416 tn?1420045702
Yup, give him a call and see what's up.

I've looked at my own MRIs that I know what I'm looking at, but I don't recommend it!
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Avatar universal
I'm a little frustrated. His office called yesterday. The receptionist told my husband (who is fluent in Portuguese and I am not) that everything was "fine" with my results and to just make sure I follow up with the Nutritionist. My husband was confused because a Nutritionist was never even discussed during the consultation when he ordered the MRI. So my husband verified that the receptionist was talking about the same patient. My husband told her that he wanted a follow up in person for me because "everything is fine" is a very vague response considering there actually was an abnormality noted on my MRI. They only day he can see me before he takes a 1 month vacation is tomorrow. But I work. So my husband is going to go there and talk to him. I am going to give my husband a list of questions that I want him to ask. First, I want to know how common it is for someone as young as I am who doesn't smoke, have high blood pressure or high cholesterol to have this many lesions scattered through a large part of the brain? From what I understand, the supratentorial region covers a large portion of white matter. So if I am "fine" why do I have them? And why is he suggesting a Nutritionist? I take multivitamins, eat healthy and I am not overweight. So how does diet have anything to do with this? I also want to request a spinal MRI. If he can satisfy my questions and put my mind at ease with the spinal MRI showing no additional lesions then I will be satisfied. If his answers are ridiculous or he refuses the spinal MRI I will get a second opinion.
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