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16038702 tn?1477505453

Is there a significance for a single punctate focus of FLAIR hyperinensity?

In June 2015, I finally had my first brain MRI. I'd been suffering with unexplained, sudden fatigue, and wide-spread pain, which, at the time, was presenting bi-laterally. My PCP, at that time, was a specialist in neurology. When he ordered the MRI, however, he ordered it looking for headaches. I'm not a frequent headache sufferer; and that wasn't what my complaint had been when I'd seen him. At that point, he was actively considering MS as the diagnosis for my issues.

So, my report came back with the reason for the exam as headaches, and the impression: "Essentially unremarkable study aside from a single punctate focus of FLAIR hyperintensity within left frontal deep demispheric white matter, nonspecific in appearance." Which equated to me being perfectly fine and normal.

I'm 38; this all started when I was 36. I can't walk for long periods of time, I'm unstable, I have severe cognitive issues (especially when tired), I have moderate to severe fatigue, and my pain is no longer bi-lateral. In fact, if I'm feeling weak, it will be on the left side. I do not smoke; I drink, but not as much as I used to. Prior to October 2014, I was a power lifter and training for a 5K. Car accident in April of 2013 gave me a severe sprain in my right ankle, plus soft tissue damage in my calf (and that's why you don't put your foot on the dashboard when riding in a car with a passenger's side airbag!). I had surgery on my ankle in January 2014, recovered quickly, hiked around Europe for 6 weeks, came back, and 3 months later, BAM! Pain & fatigue from out of nowhere.

I'm just curious if the MRI findings *are* actually significant, given the pathology listed. I know *something* is wrong, but my O+ blood loves being annoying and not showing anything in lab tests (except that I, at some point, had 5 of the 6 coxsackievirus group Bs, and EBV, despite never being sick). I seem to have an elevated SED RATE, and I'm on the high end of normal on several other factors. But, I'm still normal...so, I'm fine.

...maybe I just want to know I'm not alone in any of this and it's not just in my head (though, it partially is, according to the MRI).
2 Responses
987762 tn?1331027953
COMMUNITY LEADER
Hi and welcome,

I don't think your brain MRI finding are 'significant' to what you've been experiencing, basically the only thing found was 1 non specific white matter lesion in the frontal lobe, likely between 1-3 millimeters if the report doesn't mention it's size.

These types of small ischemic lesions are generally incidental findings on an MRI, normal micro vascular bleeds that happen for various reasons throughout your life time eg bumps on the head, mono etc etc keep in mind that a small number of non specific white matter lesions is perfectly normal but if there are a chronic number of them, or specific location pattern etc ischemic lesions could be significant to some medical conditions eg migraine, hypertension, vascular conditions etc    

Coxsackieviruses usually just cause mild flu-like symptoms and goes away like many viruses, EBV mono is often the same, it's estimated that up to 90% of the general population test positive for mono so it's not unusual to test positive for either of these and never known...

In regards to neurological conditions like MS, unless your neurological assessments have found some abnormal clinical signs, and possibly additional tests eg spinal MRI, nerve conductor tests etc are abnormal in someway, you wouldn't have any objective evidence to correspond and or corroborate the symptoms you;ve been experiencing as suggestive or consistent with a neurological causation, so what you've been dealing is more likely to be something else.  

Hope that helps........JJ
1 Comments
It's not helpful.
987762 tn?1331027953
COMMUNITY LEADER
Wow, that's actually a first......i'm not sure what information you were expecting, but if you'd like to our MS community to have a go at trying to give you what you are wanting, please just ask.
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