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Is it just old age or is MS possible?

I am 55, have been experiencing 20 common MS signs over the past five years and have changed dramatically over the past two years. All I want to do is sleep even though my life does not allow me that luxury. I had an MRI without contrast and the findings were listed as mild punctate periventricular white matter disease, consistent with ischemia, migraine, or previous trauma. Is it possible that my many, disturbing MS symptoms are simply due to mild white matter disease? I have extreme fatigue, brain fog, lightheaded ness, tingling/burning in my scalp, buzzing in my head, clumsy, memory issues, trouble finding correct words and trouble speaking properly, right arm and hand go numb, balance problems, hearing loss, clumsy, trouble getting a deep breath unless I make a conscious effort, painful muscle spasms in my feet, and much more.
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987762 tn?1331027953
COMMUNITY LEADER
Hi and welcome,

One of the problem with a neurological condition like MS that affects the central nervous system, most of the symptoms associated with MS are also commonly associated with hundreds of other types of conditions, some also neurological but most are not....

The term "punctate' typically means minute spots, so when the term punctate is mentioned in brain MRI reports, it basically means the spots showing up are very tiny, microscopic, 1mm or less and vascular related.  

White matter hyperintensities (WMH’s) can get smaller or disappear and they are most commonly associated with vascular related medical conditions eg Diabetes, smoking, hypertension, migraine etc which is why WMH’s are considered to be part of small vessel disease.

I think it's only been in the last 4 or 5 years that research started making it clear that it's not true that WMH's are a normal part of ageing, yes they are more common in the older age groups 65+ but WMH are now being recognised as a clinically important marker though of what is not always evident....

Unfortunately the types of symptoms you've been experiencing could be a lot of different things, they're not the typical issues that would be specifically pointing towards a neurological condition like MS and because your brain MRI only found a small number of teeny tiny lesions in the periventricular, the diagnostic evidence typically suggestive and or consistent with MS as the cause of your symptoms just isn't there.    

That doesn't in any way mean what you are experiencing isn't being caused by something, just that what that something else is, is highly unlikely to be a neurological condition like MS. You are 'only' 55 so what ever is happening can 'not' be passed off as old age!

I would suggest you consider looking up the side effects of any prescribed or over the counter medication, and if you take more than one, look up if there any known combined side effects. You might also consider if there could be an environmental cause eg mold, carbon monoxide etc etc previous chemical exposure, or tick bite...

It would be in your best interest to see your family GP and ask 1) If it's not a neurological condition, what else could explain all the symptoms i have? 2) What additional tests do you think i need to get to help rule in or out every other potential cause?

I hope that helps..........JJ
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4 Comments
How can it be ruled out?  Early studies indicate 1 in 20 with no visible lesions have ms.  More recent studies suggest as many as 1 in 10 with no lesions have ms.  MRI’s are now known to have both false negatives and false positives.  The scans are often not even helpful for followup information.  The medical-industrial complex prefer us not to know that.  Millions invested in machines and docs’ briefer encounters need to be protected.  Eventually, doctors will return to the history and clinical exams for diagnosis.
I've tried to locate the MS research you might be referring too and couldn't find it, i even contacted the national MS society and asked if they knew about this and they couldn't find anything with this type of information either, the best we come up with were stats in relation to PPMS but ehe other thought i had was to do with ON conversion lol i'm always curious so would love to read the studies your talking about if you'd post the links :D  

Cheers.........JJ
Sorry—I have over 100 saves on the topic of MS and so much to do (with great difficulty).  The reports may even have been removed as I’ve failed to find them before.  I’ll keep trying google and bing.   I had originally intended to use anti-MRI studies in an open forum article on the topic.     Unfortunately, four years ago I lost the ability to write an extended essay which takes into account every possible counter argument.  One of the studies was at a deep South university like Alabama.  Another was possibly U. of Buffalo.   Here’s the thing—even the Mayo Clinic in Rochester has begun diagnosing MS based on patient history and clinical observation, but that doesn’t appear on their website!  This old style diagnosis is happening elsewhere, but doctors are reluctant to discuss it publicly.  Medical centers and hospitals have invested millions in MRI equipment, so it’s not a popular trend.   You’ll find it shared on patient experience websites.  The National MS Society has itself backed away from their acceptance of something less than the McDonald criteria of a few years ago.  By the time my lesions showed up, the neurologist said they were age-related in spite of 60 years is neuro symptoms described in my second comment—numbness, temporary deafness, dizziness, difficulty walking, trigeminal neuralgia, bizarre visual and auditory changes and an inability to respond while driving & on & on.  My 54 yr old daughter was recentlydiagnosed based on her lesions and numbness and begins three days of steroid treatments tomorrow.  We’re personally overwhelmed, and it’s a thorny issue, with so much at stake for so many.  It’s not a welcome topic.
I'm sorry to hear your daughter has just been dx-ed, with your experience it's understandable that this is an overwhelming time, look after your and yours.......JJ
Avatar universal
Elaine Hanson, I’m 64 and have had MS for 15 years. I have to say that all your symptoms are like that of MS. There’s another term listed for what you may have. It’s called “MS Lasiitude”. It’s the extreme fatigue common in MS. I take Nuvigil to stay awake. I must add though thatI also have Narcolepsy. Having both diseases is a double whammy on fatigue. I thought you may be unaware that the fatigue in MS has its own name. I’m unable to suggest answers about your MRI. But every symptom you mentioned, I have. Good Luck!
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987762 tn?1331027953
COMMUNITY LEADER
Feb 2019 information - Periventricular white matter lesions:

"Combining these three studies together, it is clear that small (punctate) white matter lesions are extremely common, they are found in roughly half of the otherwise healthy population in their 40's, and WML increase with age. In addition, as people age, they not only get more white matter lesions, but the WML start to merge together into bigger patches (confluent white matter lesions). People who have vascular risk factors (such as diabetes, smoking, hypertension), have more of these lesions.

Causes of periventricular white matter lesions:
Major causes of periventricular white matter (PWM) lesions include normal changes from aging (then they are called UBO's, for "unidentified bright objects), small strokes, and disorders related to multiple sclerosis (MS). PWM are also correlated with vitamin B6 (pyridoxine) deficiency. The phrase "normal changes from aging" is really a synonym for "we don't know".

Getting older: Age is certainly the single most common association of PWM. This is presumably a "wear and tear" phenomenon. You get older, and there is more water under the bridge. More fluctuations in blood pressure, more chance for small blood vessels to close, more chance of head injury, more chance for little emboli.

Nevertheless, while clinicians often suggest that changes in the brain that are similar to others of the same age are not important, and call them "incidental", data suggests that even a few of these PWM reduce cognitive performance (see below).

Small strokes: A period of hypertension is a common cause. In the authors experience, just a few days of extreme hypertension may be enough. This is the "stress is not good for you" connection. Progression of these lesions is associated with variability as well (Liu et al, 2016). This might suggest that small bleeds are the cause in some. There is a related disorder called "superficial siderosis" due to cerebral bleeds as well as cerebral microbleeds briefly discussed above.

Clinical studies of PWM also show association with diabetes, but not consistently with atherosclerosis. PWM are often reported in persons with migraine, and occur especially in women with migraine and aura. PWM are also more common in persons with frequent syncope and orthostatic intolerance (Kruit et al, 2013)

WM lesions are associated with retinal microvascular abnormalities. Persons with both WM lesions and retinopathy have a much higher risk of clinical stroke (20% vs 1.4%), (Wong et al, 2002).

MS and related conditions: Demyelinating disorders such as multiple sclerosis and relatives can cause PWM. These generally have a different look on MRI, as they often resemble "fingers" pointing towards the ventricles...."

https://www.dizziness-and-balance.com/disorders/central/pvm.htm

Hope that helps......JJ
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Avatar universal
I didn’t want to sleep a lot until I began blood pressure medicine.  Before, I spent up to 14 hours at times because of bladder weakness trying to get the 9-9 1/2 hours I needed.  The b p medicine sometimes makes me crave falling asleep as if it were an illegal drug.  My doctor is experimenting with new pressure meds to combat this.
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Avatar universal
I was told by one dr that I was too old at 50 to be diagnosed with MS, I think it may be in their textbooks somewhere. I wa just diagnosed at 58 finally! Btw I'd had quite a few symptoms prior to the vist at 50, find a new dr, current one looked at my MRIs from the past and basically said no sh$& it's MS! Like this new guy, he's weird and really smart LOL!  All the best, Janet
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