NEED HELP UNDERSTANDING THIS

[sunflower1965]

How many lesions are supposedly supposed to show on an mri before they tell you its ms? There were 25 showing on the front part of my brain and a few in other areas.

[sunflower1965]

I do not see the doctor till jan2..they changed my appointment which was first on dec 2nd...i have had the nerve test done and during which i had an episode...could not breath..left leg and arm doing spasms and i could not speak for a good 3mins so his response was i have never had that happen to me while doing this test maybe we should not finish it....from there i was off the the neurologist....this all started because i had numbness in my left arm and leg for mths...then my speech was affected i could not get everyday words out without stuttering. I have had dizziness ,my balance is affected,,memory and i find that i am getting more and more episodes where my left hand and leg go into what i would assume are spasms ...twitching on their own...the leg one happened while i was driving so i had to pull over. My vision is also becoming worse alot of double vision going on . I have also found that my normal everyday baking or cooking is getting hard...i fidn myself reading the instructions numerous times before i actually start so things are taking me alot longer now. I am just in limbo right now waiting to see what the doc says.....and thanks for the welcome

[sllowe]

Hi Sunflower,

Adding on a welcome to you. A dx of MS should not have anything to do with the number of lesions though unfortunately some docs are lesion counters.

It's moreso what Bob alludes to when he writes about clinical diagnosis. The radiologist was quite clear about your imaging being consistent with clinical diagnosis of MS, however, there is no way for the Rad to know what your clinical history is. Imaging alone will not support an MS diagnosis.

Have you a chance to peek at our health pages? If not, they are excellent and explain the dx process in more detail.

How long until your follow up appt? And, has the doctor ordered labs and other testing?

Thanks for joining us!
-Shell

[COBOB]

Not sure what symptoms you have had that triggered and MRI of your brain.  The radiologist's report says it as plainly as I have ever seen an radiologist say it: "The distribution and number of lesions would be consistent with a clinical diagnosis of multiple sclerosis."  If you have had two attacks (episodes, exacerbations)  separated by a month and these MRI results, that should be enough for your Neurologist to make a diagnosis.  If you only had one attack, they could diagnosis CIS (Clinically Isolated Syndrome) and if there have been no attacks, some Neurologists will diagnosis RIS or Radiologic Isolated Syndrome.

There are not that many diseases that would cause this many T2 hyperintense lesions in this type of distribution for someone your age.  Your Neurologist should still rule out the common mimics like Lyme's, neurosyphilis, etc

Bob

[sunflower1965]

This is all new to me and this is my first mri of my brain the first was of my spine and there were things showing on the one to.I did not get a copy of it so i cannot remember medically what it said. This is what my mri results stated>There are several predominantly subcortical high T2signal foci noted in the fronto-parietal white matter,most prominent in the frontal white matter and best seen on the flair images. There are approximately 25 small foci of subcortical increased T2signal in the supra-tentorial fronto-parietal white matter. Small focus of increased T2 signal in the posterior medial left cerebellum noted on the flair images only. Mild prominence of the peri-vascular spaces in the parietal white matter is also noted. The ventricular system is within normal limits. Questionable focus of increased T2 signal in the mid anterior medulla is also suggested.The distribution and number of lesions would be consistent with a clinical diagnosis of multiple sclerosis. Can u make any sense of these findings?

[COBOB]

It has more to do with size and the area of the brain that the lesions are in.  It really depends on the Neuro.  Was this your first MRI or Second or more?  Neuros seem to discount "frontal lesions."  They are really looking for the classic "larger periventricular oval lesions perpendicular to the ventricular wall."  Too bad the lesions never read the instructions for how they are supposed to look and where they should reside in our brains,

I just got the report on my 2nd MRI, and it shows a "few new lesions."  I think the fact that I have had new clinical symptoms and signs and the locations of the new lesions might catch the Neuro's interest.  No telling.

Bob