White matter lesions?

[nat2006]

My current neuro saw small white matter sub cortical lesions on an MRI from a couple years ago. I am 26, is this normal? And how does he rule out MS if there are lesions? Can lesions heal? Or become invisible on other mri's?

I have sharp stabbing pains in random places that last for seconds, muscle burning in one area at a time, muscle twitches all day and night, vertigo, delayed muscle relaxation especially in neck,  ribs, hands and ankles, muscle will feel like it's about to fall asleep even though I am not in a position that would cause it to fall asleep( with pins and needles), occasional skin prickling, very small translucent "target" shaped circle in my left center vision, cheekbone/eyebrow/jaw/behind ear stabs which I believe are called Trigeminal Neuralgia.

Recent EEG cleared epilepsy (which he was concerned about), Visual evoked potentials was normal, all my blood work was normal, and this last MRI in September the neuro did not say if the original hyper intensities were still visible, but he said he didn't believe it was MS. He said for me to read about Ion Channelopathies....

Has anybody been in a situation similar to this? Any input would be appreciated

[nat2006]

Thank you for your response. I am unclear myself with what is going on. It doesn't help that my neuro is so over booked that the next earliest appointment I could schedule with him is March... So I get the tests done and never hear back. I called for the results and the nurse read me his notes which is why I do not have any clear explanations.

Since I started this search, my symptoms initially sounded like MS but I am starting to feel it is after all something else. I'm starting to feel like doctors are at a loss with me as well.

He was concerned about epilepsy but I rarely get headaches and have no personal or family history of seizures or epilepsy. So I didn't understand why he was running that test, but if like you said, it was the position of the lesions-that would explain his decision.

I looked into ion channelopathies through Google and mostly found medical journals which I have to read twice to grasp. Needless to say, I have a very shallow understanding of an ion channelopathy being the issue.

He has sent a perscription of topamax for me to try as a "trial" to see if that impacts the muscle pain but I am hesitant to start it. In my visit with him he said I am a complicated case because my symptoms are sensory and peripheral...(I think I remember that right). Anyway, thank you for your response- I'll look into that link tomorrow.

[supermum_ms]

Hi there,

Sub cortical lesions are not one of the MS Mcdonald criteria's identified areas (peri-ventricular, juxta-cortical, infra-tentorial, spinal cord) but they are associated with migraines, and considering the advice to read about Ion Channelopathies which are associated with inherited genetic neurological conditions eg migraines, epilepsy etc your neuro is definitely not thinking MS.

This is a very informative research article on Iron channelopathies which you might find interesting reading...... http://jp.physoc.org/content/588/11/1823.full

If you look to the right your screen, you'll see a section on most viewed health pages and there you will find a few very easy to understand health pages relevant ones are "How MRI's show lesions in MS" and "Lesions vs. Symptoms" though to be honest i suspect your dealing with an MS mimic and not MS its self.

I don't think your 08 MRI was particularly abnormal for conditions like migraine but normal would be a stretch for your age group if any lesions are found but if they were caused by MS, your latest MRI would be expected to of gained lesion load in that time frame. Yes lesions can disappear or heal but for all of them to heal, would be very unusual, also unless your latest MRI was on a lower strength, open vs closed etc it should be comparable.

Your sx's are wide spread and bilateral which would be highly unusual for MS especially in someone so young, MS more typically causes unilateral sx's which is why i'm thinking it's probably not MS. I would recommend getting a copy of your MRI's, and consider getting a second opinion, or an actual opinion because i'm not exactly clear that you have been told what is going on.

Cheers...........JJ