New--32 y/o female diagnosed with TIA--possible MS

[dkdean]

Hello :-)  I've been doing lots of research this last week and this site seems to be a wealth of knowledge.  My story--An overall healthy 32 y/o female.  Last Monday as I was responding to an email, I started with bright halos/aura in my eyes, very bright--I then realized I could not read what I had just typed and could not figure out what words I wanted to type next.  My right hand then went numb and the numbness travelled up my right arm and into my face/cheek/teeth/tongue.  I continued to get more confused with my speech and struggled to communicate.  From visual disturbances to numbness being essentially gone, it was about 45min.  I was driven to the ER and went through a variety of tests--CT, echo,  u/s of neck/carotid, MRI.  Was told that the MRI was fine and that they felt I had suffered a TIA (mini-stroke).  I have continued to have some vision issues this past week and numbness in my pinkie and right forearm.  When I called on Wednesday to get the bloodwork results, I was told that in subsequent reads of the MRI, 'non-specific lesions' in the left frontal and temporal lobes were noted on the MRI and 'demyelination could not be ruled out'.  I have an appt with a Neuro-Optha  in 3 weeks and the reg neuro in 8 weeks (although I'd like to get it moved sooner since I still have symptoms).  The radiologists are suggesting another MRI with and without contrast to take a better look at the lesions.

So, I am wondering:
1-Was the TIA really a stronger stroke that did cause damage (hence the lesions and continued symptoms)?
2-Am I in the early stages of MS and are these symptoms that sound familiar?

I'm trying to get as much info as I can to keep myself prepared...I realize there isn't much I can do to change whether it's a TIA, stroke, MS, something else, but I feel better getting all the research done that I can!

Thanks,
K

[dkdean]

Stephanie--Yes, it was called low-lying cerebellar tonsils.  Off to do more reading on that!

[steph74]

"And, apparently my cerebellum is measuring at 6mm (5mm or more is considered abnormal).  This shouldn't cause the problems I am having, but it did show up on the MRI."

Have you looked into Chiari Malformation?  I'm not sure if this is what you're referring to when you say your cerebellum measured at 6 mm.  It could be called "low lying cerebellar tonsils" and yes, I believe >5 mm is classified as CM.  It can be a big MS mimic.  It often (though not always) comes with a bad headache near the base of the skull.

Stephanie

[dkdean]

Ahhh....yes, female :)  And my husband 'rescued' me from that state up north too :)  I got my master's from OSU just to stop the ribbing from our Buckeye friends!!!;)

[PastorDan]

Yes, welcome to another Central Ohioan.  I am married to a lovely lady who originated in that state up north, but she got here as fast as she could!

Oh, this crazy system keeps telling me you're male.  You might want to check your profile settings.

[dkdean]

The neuro is through OSU's Neurology Dept.  I saw her (a resident) and her attending today.  They were fine, but I'd still like a 2nd opinion--esp if the meds for migraine don't seem to do much.  2 weeks of continual visual disturbances don't seem to fall in line with many of the things I am hearing...we shall see.  Neuro-Optha appt is in 2 weeks.  

[Lulu54]

HI dk,
I don't really have anything to add to this post right now - I just want to stop and add my welcome and tell you there are quite a few of us Buckeyes on the forum.  We seem to be in a hotspot for MS.  

Where are you going to see the MS Neuro?  I travel to Columbus to OSU and many of our community go to Cleveland Clinic.  U. of Cincinnati has an excellent MS clinic as well - we are fortunate to have so many good choices.

welcome again,
Lulu

[dkdean]

Added a few questions in the last 2 posts....any insight??  Thanks :)

[dkdean]

Adding....the vision stuff seems to be constant.  Some of it is halos, sometimes it seems like the grass/floor/steering wheel is moving (when it's not), sometimes a fogginess, sometimes just 'shifting' in my vision...I'm getting headaches behind my eyes now too...not sure if it's because I feel like I am squinting?  or ??  It's not really pain...just achy (and annoying!).


Is there a certain part of the brain (lobe-wise) where MS lesions tend to show up?  Or is it an equal-lobe disease?  I know it shows up in certain types of brain matter, I just haven't been able to find out if it's typically located in the same lobes.

And, apparently my cerebellum is measuring at 6mm (5mm or more is considered abnormal).  This shouldn't cause the problems I am having, but it did show up on the MRI.

[dkdean]

Thanks for the feedback.  I have the results for a plethora of blood work (all normal except a slightly low phosphrous level)--Neg for clotting issues,  neg lupus, normal rbc/wbc/hemoglobin/hematocrit/platelets....I have the rest written at home...those are off the top of my head.

Thanks for the MRI info--I will ask those questions.  The Neuro appt has been moved to this Thursday (funny how appts open up when you have residual symptoms!!).

I had looked into silent migraine and had some of those symptoms...the neuro didn't feel that was what I was experiencing, but who knows??  No history of migraines or high blood pressure--there is a paternal history of stroke/diabetes.  

Risk factors for MS--Yes on northern US upbringing (Michigan for my first 21yrs, central Ohio for the last 11); have had mono (at age 19)

I found the board after doing some searches for "MS early symptoms" and "TIA MS".  Seems like a good group of people :)

Thanks for your help :)
K

[Nancy T]

Boy, that sounds CLASSIC for a big old migraine attack, except for (as Quix mentioned) the lasting symptoms.

The visual aura and the "marching" numbness up the arm, the 45-minute duration, the confusion with speaking and understanding... all classic migraine stuff. Migraine does NOT require a headache.

Even if you've never had (or thought you had) migraines before, you could still be a migraineur, especially if you have a family history of it. I never knew I was a migraineur until I had a visual aura (no headache) at age 42. My son would get the numbness/tingling marching up his arm.

Migraines can certainly cause nonspecific brain lesions. But given the lasting symptoms, maybe a TIA makes more sense? I don't know.

So... don't worry much about MS yet. It really seems unlikely, especially since the symptoms mostly resolved in such a short time. See what the neurologist says.

[ozjohn]

hi from all of us

! more thing until anything is confirmed please relax and do not worry

As Quix said have some ice cream
i am having some chocolate easter egg

take care

john

[Quixotic1]

Oh, and we have a lot of articles written by our members on some of the most common topics.  they are called Health Pages.  You'll find them in the upper right.

q

[Quixotic1]

Hi, and welcome to our forum.  Wow, you're world has turned upsidedown in the last week, hasn't it.  As you were describing your progression of symptoms, my first thought was migraine aura without headache.  The timing seemed about right.  But, the lingering symptoms and lesions on MRI made something more degenerative a definite possibility.  Do you have a history of migraine disease or high blood pressure?  Is there such a history in the family?

If this was a TIA the lesions wouldn't have the same look as the lesions of demyelination, I wouldn't think.  New ischemic tissue death looks different.

The symptoms you have are certainly quite characteristic of MS, and of some of the MS Mimics.  Before anyone starts talking seriously about MS you need a thorough neuro exam and a full process (mostly blood tests) to rule out mimics of MS.

My big question is whether the MRI they did emergently was done using the MS Protocol for MRI.  I suspect it was not as they were looking for life-threatening things like a tumor or stroke.  The protocol specifies certain techniques that are best at showing up MS lesions.  It also specifies that the "slices" of the MRI be very small, no wider than 3mm, and that the slices be contiguous with no large skipped areas.  That is certainly something you could call and ask the department that did the imaging.  It could be that this protocol is something they have in mind for the repeat MRI.

So, MS has certainly crept onto the the radar, but it is far to early to say probably yes or no.  You are exactly the right age and gender.  Other risk factors are a genetic susceptibility, first 15 years of life spent in the more northern lattitudes, like northern US, Canada.  Another is Northern European heritage.  Another is a history of mononucleosis and still another is low Vitamin D.  So, it really appears that there are many risk factors and/or triggers for MS.

The big mimics of MS are several of the autoimune diseases, certain infections like Lyme Disease, syphillis, HIV, Vitamin B12 deficiency, Neurosarcoidosis and a dozen or so others.

I think you have found yourself in the right place.  We do pride ourselves on having good, evidence-based information.  Besides that, this is the most caring and supportive group you'll ever find.  I am Quix, a physician in a former life - here because of MS - and medical mentor here - mostly to clarify some of the mysteries of medical stuff.

Pull up a chair and ask more questions.  Have some ice cream.  I always have some available.  I'm curious, how did you find us?

Oh, make sure you call the offices of the neuro-ophtho and the neuro and ask to be place on their cancellation list.  And make sure you stop in with your primary so that (s)he is in the loop.

You are going to need some basic blood work, if they didn't do it in the ER.  You'll need a

CBC
Thyroid panel
ANA
ESR
Vit B12 level
Vit D level
Antiphospholipid antibodies (panel)

The neuro will likely want more, but these are some of the basics and will give the neuro more info before you see him.

Welcome again.  Others will be along to say hi, by and by.  The weekends and holidays are often slow.

Quix, MD