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457212 tn?1213566171

Lesions

I was hoping to get some advice with my issues.  For about 6 months I have been having balance, coordination problems, my right leg feels numb most of the time, it seems like I don't have as much control over my right leg, some speech problems, memory problems, stiffness, muscle and joint pain.

The neurologist stated that my neuro exam was normal.  They did a nerve conduction test on upper body.  The lady performing the test stated "I have to warm up your arms to determine if what I am seeing is accurate".  She warmed up my arms with not much improvement.  

The MRI states "FLAIR imaging sequence demonstrates two focal abnormal bright intensity foci in the subcortical white matter of the left frontal lobe and about four to five subcortical bright intensity foci in the left parietal white matter.  A single lesion is seen in the right parietal subcortical white matter.  These are most likely due to chronic small vessel disease and ischemic changes".

When I seen the neurologist after the tests and MRI he state the nerve test, emg and neuro test were normal.  He told me the things that showed up on MRI are normal for people who have high blood pressure, diabetes, headaches etc.  (I do have headaches/migraines but no high blood pressure or diabetes).  He also said it is sometimes seen in people with MS but didn't think I had MS.  From what I have been reading about small vessel disease it is normal in the elderly.

The neurologist asked me "if I need to see him again".  Do you think this warrants a 2nd opinion or follow up?  What other things could be causing my issues?  Are these things on the MRI different that what is normally seen in MS?

Any information would be appreciated!!!!
10 Responses
393986 tn?1303829575
Hello and Welcome.  This is my advice, if you are not comfortable with the results from that neuro or unsure, get a 2nd opinion.  I would also ask to see a ms specialist because they read mri's differently than neuros.  MS is a difficult one to diagnose, question did they do an mri of your spine?  

Please take a look at our health pages, there is a lot of information in there. Do you take any medication to help with stiffness?  Do you have spasms? I get migraines often too.  Good luck with everything and please keep us posted.  

Take care,

Ada
457212 tn?1213566171
No other tests then the MRI, EMG and nerve test.  I do have muscle spasms all over and twitching (the neuro called it tremors) in my fingers and 1 toe.  My regular doctor has given me some medication for the pain (we have been discussing possibility of fibromyalgia because of the extreme fatigue and pain I have through out my body) but I only take it when I need it.

I guess I am not real comfortable with this neurologist (my sister was not impressed with him either, as she went with me to have the tests done) and am confussed why no other tests were done or any follow up.  He basically told me you are fine and don't worry about it.  It is hard not to worry about spots, lesions or anything else abnormal that is on your brain.  My brain doesn't work that well in the first place!!!!

Thanks for the response, I really appreciate the advice.

393986 tn?1303829575
Unfortunately, the good neuros are few and far between, I had one diagnose me last week with seizures when I don't have them, only because he felt a tremor in my upper body.  This is where I get mad, he wouldn't even consider ms unless I had nine lesions in the typical place, where that is I don't know.  

Please get help for the spasms because if they go on and on it will cause spasticity and then if that keeps going you can get a contracture the joint.  And it hurts like h***!  I seen my pcp and he was really upset my neuro wouldn't even do an EMG to see where the dysfunction is at in my right hip & leg.  You actually can gain muscle mass from the spasms and get deformed from it, I know I am.  Apparently they had some words....

Neuros are quick to dismiss people when the info in front of them isn't textbook.  Keep on looking for a new neuro that you are comfy with.    
457212 tn?1213566171
Is it possible to have spasms all over?  I get them in my legs, arms, ribs, stomach.  What is contracture of the joint?
195469 tn?1388326488
I have been diagnosed with MS for over a decade. (I'm sure the veteran Forum members are tired of hearing that...LOL) and I have never had spasms all over my body.  Mine are confined to my legs and I have had what they call the MS Hug, which is like a spasm around the mid-section of the chest.  I also have had spasms in my feet, but not sure whether these are just caused from the kind of cramps that most people get, they commonly call "Charlie Horses."

Does this mean that someone with MS cannot have spasms all over their body?  NO.

Ada can probably explain contracture of a joint, better than I can.  She is currently going through one right now in her hip.

Heather
335728 tn?1331418012
I have to agree with Ada in that you should get a second opinion from an MS Specialist!

An MS Specialist is trained and has the experience that a Neurologist or a Radiologist don't have in properly reading an MRI.  Do you know if the Neurologist actually took the effort to read the MRI or is he just reading what the radiologist reported?

An MS Specialist is the best way to go for a second opinion!

Rena705
Avatar universal
Summer, If you don't mind me asking, how old are you?  Amy
457212 tn?1213566171
I don't think the neurologist looked at the actual MRI, he was just reading the report, which I did get a copy of.  I am not so sure that my problem is MS, but I know that something has to be causing these problems.  A friend of mine does think that it is MS and said that it could take awhile to get a diagnosis if it is in fact MS.

It just seems like the neurologist should have maybe done some more tests, but I am no expert I just know some of these things are not normal.  I do work out about 3-5 days a week so it doesn't seem like I should have weakness and balance problems.  

Mayloo,
I am 39 years old.  Actually I turn 40 next Thursday!!!!  How depressing is that.

I apprecitate all the information from everyone!!!
335728 tn?1331418012
Hi Mayloo...I am going to say it again...I think you need to ask your pcp (US) or gp(Canada) to refer you to an MS Specialist for further testing.  As I said before, you need to have an MS Specialist read your MRI and you also need to have a Full in-office Examination done by and MS Specialist.  A neurologist will do an exam but I am willing to bet that yours did not last at least 30 minutes and probably more.  A proper exam will tell your MS Specialist about your mental status, cranial nerves, motor skills, coordination and gait, reflexes and senses.

Because your MRI may be inconclusive and if your in-office exam tells your MS Specialist things that may point to an MS diagnosis, the next natural step would be an Lumbar Puncture.  This is a test that involves removing some of the spinal fluid from your spine to be tested for Oligloconal Bands which may indicate MS as well as other testing which could discern various other diseases.  

So you see, being referred to an MS Specialist is very important should there be any suspicion of MS.

Lots of Hugs,

Rena
457212 tn?1213566171
I am lucky that I have a PPO plan so I don't need a referral (for insurance purposes) to see a specialist.  They just have to be "in-network".  I will check and see if I can find one here in Michigan.

You guys are amazing to give your time and knowledge to those of us in need.  Thank you so much!!!!
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