Hi and welcome,
Whilst Juxtacortical does mean 'adjacent to the cortex', and it is 1 of the 4 specific identifying lesion locations for MS, it's not just that they are adjacent to the cortex but they are suppose to be touching the cortex.
"Juxtacortical lesions are specific for MS.
These are adjacent to the cortex and must touch the cortex.
Do not use the word subcortical to describe this location, because that is a less specific term, indicating a larger area of white matter almost reaching the ventricles.
In small vessel disease these juxtacortical U-fibers are not involved and on T2 and FLAIR there will be a dark band between the WML and the (also bright) cortex (yellow arrow).
Temporal lobe involvement is also specific for MS.
In hypertensive encephalopathy, the WMLs are located in the frontal and parietal lobes, uncommonly in the occipital lobes and not in the temporal lobes.
Only in CADASIL there is early involvement of the temporal lobes."
It's highly possible that the white matter lesions are normal vascular ones or related to your dx thyroid condition, migraine and thyroid conditions can cause similar WML, what exactly does your MRI report state?
Without any other information to go by I'd simply expect that since you're a young women in her 20's, your MS neuro is erring on the side of caution, finding nothing wrong is exactly what you want to hear!
Hope that helps........JJ
Hmmm i don't know about being 'confident' lol i'll give it a go but it's getting late over my side of the world so i may not be able to finish it until tomorrow...
"Dark on T1-weighted image:
increased water, as in edema, tumor, infarction, inflammation, infection, hemorrhage (hyperacute or chronic)
low proton density, calcification
Bright on T1-weighted image:
slowly flowing blood
paramagnetic substances: gadolinium, manganese, copper
laminar necrosis of cerebral infarction
Bright on T2-weighted image:
increased water, as in edema, tumor, infarction, inflammation, infection, subdural collection
methemoglobin (extracellular) in subacute hemorrhage
Dark on T2-weighted image:
low proton density, calcification, fibrous tissue
paramagnetic substances: deoxyhemoglobin, methemoglobin (intracellular), iron, ferritin, hemosiderin, melanin
WMLs are best visualized on T2-weighted or FLAIR (fluid-attenuated inversion recovery) MR images, your MRI has found a small number of very tiny-minuscule-microscopic ("mild punctate") lesions specifically in the left frontal, and bilateral occipital lobes (left and right) and the only larger sized lesion is the 7mm parieto-occipital lesion adjacent to cortex and this later MRI did not find a tiny T1 pituitary lesion.
Typically, non specific lesions that are tiny (1-3 millimeters) are micro-vascular related, they are usually silent and not thought to cause symptoms, it's not particularly abnormal to have 'some or no' micro vascular lesions in your 20's, it kind of depends on your medical history and background and if there's a lot to be significant or not. The 7mm is also non specific so there isn't anything to indicate that it's unlikely to also be vascular or viral related, eg from a bump on the head during your life time or mono etc.
The issues you've mentioned (autonomic disturbances, disconjugate gaze, thoracic pain/dyspnea, physical and mental fatigue-- all intermittent, recurring, and heat-sensitive) are not specifically MSish and could very well be associated with your diagnosed medical conditions.
Autonomic dysfunction is not a common MS issue, yes it can happen but it's just not very common. Respiratory issues like Dyspnea (shortness of breath-air hunger) is also uncommon in MS....
"the most common cause of respiratory problems is loss of muscle strength and endurance. Just as a person can experience muscle weakness in the arms or legs, weakness can occur in the ventilatory muscles of the chest and abdomen that are involved in breathing. And like weakness in the other parts of the body, weakness of the ventilatory muscles can begin to occur early in the disease course and gradually worsen over time.
People with weakened ventilatory muscles have to work harder to inhale and exhale. This extra effort can be quite tiring, particularly for people who already experience a significant amount of MS fatigue." http://www.nationalmssociety.org/Symptoms-Diagnosis/MS-Symptoms/Respiration-Breathing-Problems
...and i think i noticed if another thread you actually mentioned fainting with exercise (?), which off the top of my head is more related to hyperventilating and possibly even sport induced asthma or the like, mental health issue like anxiety can also cause breathing issues too.
As far as i'm aware 'disconjugate gaze' is a type of accommodative convergence disorder and more to do with Strabismus, and if that's right strabismus is not an uncommon discovery in your 20's.
I've run out of time, but all told i don't think there is anything you've mentioned that would put a neurological condition like MS at the top of your possible list, so i think it's going to take more tests to work it all out.
Hope that helps........JJ
What do the findings say? That is the important part.