MRI results and Neuro visit

[RazCarver]

saw neuro today for MRI results.

Brain and c-spine w- w/o contrast order reason: Lack of coord/tremor

Cervical Spine: minimal, 2mm anterolisthesis of C5 and C6. Marrow shows normal signal intensity for age. There is no abnormal signal in the spinal cord. the cerebellar tonsils are normal. Minimal disc space narrowing at C5-C6 and C6-C7. Mucous retention cyst or polyp. mild degenerative changes most pronounced at C5/C6 broad-based disc bulge and facet arthropathy causes mild bilateral neural foraminal narrowing left greater then right and moderate spinal stenosis.

Neuro says mild arthritis in neck. nothing to worry about. its normal.

MRO - MRI Brain W-WO Contrast.  1.5t

The ventricles and cortical sulci are enlarged from mild global volume loss. Multiple punctate hyperintensities are evident throughout the deep white matter bilaterally, predominately subcortical. no abnormal enhancement corresponding to these foci.

There are several periatrial foci bilaterally which are increased in number since the previous examination, however this may partially be due to the high-resolution on the current exam, on high field magnet. The findings are nonspecific and may represent chronic ischemic changes, migraine related changes as previously described.  

  ( I don't understand that as I don't have headaches - much less migraines )

Differential includes MS, however the findings are not pathognomonic. Corpus callosum is grossly unremarkable. No abnormal diffusion on restriction is noted, particularly corresponding to these foci. The degree of global volume loss is slightly greater then prior.

no acute infarct.  no intracranial mass. Basal cisterns are normal. no abnormal enhancement.

Neuro said nonspecific for MS. need LP to 'get MS off the table or to clear this up'.

I told him that was fine with me, but something is very wrong no matter if it is MS or not - it is something.
He only nodded. I told him my job ends thursday as well as my insurance. He wants to schedule a LP anyway and see if we can sneak it in. He said his nurse is off this week and he is off next week. but I am to call her with a contact number next week tuesday.

He had no problem of writing me a script for 3 months worth of flexeril in one script. he also gave it 3 refills. so hope to get that one last one through the insurance.

I haven't gotten my paper work from HR yet so I don't know how much cobra would be. can't think that i'll be able to afford it. so I don't know what he is thinking about the LP.  guess i'll just go along for right now. He was having a bad day with a poorly qualified temp.  she was scared to death of the computer. She wasn't to sure about weighting and BP either.

but with everything going on my BP was 122/80. lower then it has been but maybe because i haven't been eating much.

sorry that was long and boring i guess. I just don't understand how they don't find anything when I am having so much trouble.
Raz

[Sidesteps]

Hi Raz,

I'm a limbolander as well but my first MRI reflected no lesions --- but my clinical exams were showing signs of issues. I went on to get a second opinion (MSologist) that I think blew me off due to not being an obvious diagnosis. My new Neuro is walking with me and reviewed my MRI, she found some questionable areas on my optic track and has reordered an orbit MRI w/ brain. I have that Thursday.

I am not sure what they'll find but if it turns out to be similar to you (which wouldn't suprise me with my timeline of only having obvious symptoms for a year) then I'm okay with that. It's showing something is going on and I'll hope they can do something about my vision. I probably would do the Spinal under those recommendations as well because it doesn't really put you in a different place if it's negative but it could be the deciding factor to start DMD's sooner.

I'm sorry about your job. I was unemployed for awhile in the middle of my health issues as well. It's horrible. Can you go on state medical if you can't get cobra? Here in our state we can get financial assistance solely for medical and not food.

Hugs to you

[anon07072023]

I'm sorry that you're kind of still in limboland. I wonder if you had another doctor, if you would have a diagnosis by now. Does he seem to be a good doctor?  MS should also be based on clinical findings and once everything else has been ruled out.

I'm also sorry that you're losing your job and possibly your insurance. From what I've heard, COBRA is super expensive.  

I wish only the best for you.
I hope everything starts working out for the better.
-Kelly

[supermum_ms]

Sorry Raz! It would of been easier if the picture was clear though i'm wondering if you'd be better off with a second opinion. Just thinking your sx plus these results and still no other alternative dx still puts MS on the table, even a negative LP wouldn't get it off though it could add weight towards, if there are 0 bands.

"Differential includes MS, however the findings are not pathognomonic. Corpus callosum is grossly unremarkable." thats more about you not having a lesion showing up in the MS slam dunk location but still puts MS is the possibilities from my understanding of its meaning.

Not boring, they found lesions me thinks :-( or :-) not sure if thats good or bad it just depends on your perspective i guess!

Hugs.......JJ

[wiggles94]

Hi Raz, and sorry you are going through all of this.  

I am "possible" ms - gray area patient - so I understand the frustration of not knowing what's wrong.  But it sounds like they have found changes in your brain - that are nonspecific -

The hardest part of this is trying to figure it all out.  MS is a very hard disease to diagnose as you probably know if you have done research.  Sounds like the LP is a good next step - but understand that it may not give you what you are looking for either.

Sounds like your neuro is working with you to get to the bottom of this.  Hang in there and keep searching with the help of a good doc until you figure it all out.  

I was put on rebif by my neuro - they couldn't say I was clincially definitive MS - but felt there was enough evidence that I would convert - so to stall that - they put me on Rebif.  2nd opinion neuro (MS specialist) wasn't as convinced it's  MS - and then first neuro got wishy washy on me - so I went off Rebif (my choice)- So I understand the frustration - but you don't want an incorrect dx - want to make sure you're treating correctly.

Is your neuro MS specialist?

Good luck!  Wishing you answers soon - and feeling better.