Multiple Sclerosis Community
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1169520 tn?1263430421

White Spots on MRI with a lot of symptoms

I started feeling symptoms about a year ago and never put 2 and 2 together untill now! My symptoms started out with just a small hand tremmor but has escalated into full body tremmors, Numbness in my legs and left hand, night sweats, headaches, dizzyness, lightheadedness, the more I use my hands the more they shake. I'm a healthy 33yr old male that just donated my kidney to my mother 5 yrs ago. I'm physicaly fit but injured my back some time ago so I take 20mg oxycontins for that. I just had an MRI without contrast of my brain. There were 3 white spots. The Neurologist walked into the room and before he even introduced himself he imediatly said "You Don't Have MS" Then he proceeded to do an exam and then told me that it was my medication that was causing all these symptoms and that I don't fit the profile of someone with MS! He ordered a Full Body MRI with contrast and several blood tests including Thyroyd, Arthritis, and B12! He told me it was all in my head and if it all came out clean he would be pisst! Now ok the Dr was Arogant I'm sure we can all agree! My back injury was 7yrs sgo and I've been taking these forms of medication including spinal injections for this entire time! What I'm looking for is someone who may have had some or all of these symptoms and give me some advice or thie opinion! I intend on getting the MRI's done and definantly consaulting another Dr of course, a second opinion is always better then 1....
10 Responses
941625 tn?1263585382

I think this one is pretty clear -- see another doctor! I'm not saying that you have MS, that doc is right that other things can cause those symptoms but there are several things most docs do to rule out MS before making that statement.

Also, I gotta say -- and I'm not a doctor for sure -- but when I went through this process, my primary doctor did a bunch of blood tests to rule out other diseases BEFORE the MRI. After I had clean blood tests, I was referred to neuro and then a  "hands on" exam in the office, then the MRI.  While waiting for the MRI results, I had my VEP.

Like you, I had white spots but was initially told I didn't have MS. It was just a tremor. Turns out when I saw another neuro it was MS. I don't know if your meds could start messing with you like this after seven years, but I think you really need a second opinion.

I think you will find a wealth of support on this forum, and you will also find almost all of us have had some bumpy roads toward diagnosis. This is because of so many factors like varying symptoms, timing of your MRI and lesions, etc. but also because some neuros have trouble interpreting, listening or whatever to their patients. Sometimes, they take one piece of info and hang onto it and make a decision without looking at all the rest. MS diagnosis can require a real investigative approach and not all the docs seem to be willing to take that on. Unfortunately, the patients are the ones who suffer. Hahaha ... I'm sure I didn't say all that the way it was organized in my head ... and I hope no one gets offended or confused by what I was trying to say.

No matter what, seek a second opinion. Find a doc who's willing to listen to and care for you with respect and understanding. You deserve that. And definitely stay with us and we will offer you all the support we can!

1169520 tn?1263430421
Thank you for your response! The MRI was done first because they were afraid I had a TIA (Mini Stroke)! The symptoms I went in complaining about that day was dizzyness and numbness in my left hand! After the MRI then my primary care Dr called me with the resaults and set up an appointment with the neurologist. I am the type of person that prepairs for the worst but hopes and preys for the best. So once something is said that it could be I fully educate myself on the subject. I will keep this up to daate as this progresses! My next brain MRI with contrast is on friday January 15th in the evening so I will have the resaults by saturday or monday and I will post what is found! once again thank you ;-)
1080243 tn?1262978963
Hi Ray,

I too have just had MRI done have left hand weakness,numb,vertigo,balance ect and they wanted to rule out stroke.

Have had MRI 2 yrs ago 3 spots/leisions in frontal lobe so Neuro wants to see if any changes have occured but he is thinking now MS due to pattern of symtoms.

I will look out for your results and like wise will put my results up when I receive them.

Good luck for the 15th tarter
147426 tn?1317269232
Hi, and welcome to the Forum!  This really is a good place to educate yourself on the disease and to meet people who have been through what you are going through.

You saw a dodo of a neurologist.  Any physician that announces from the onset what your diagnosis is or isn't is a loser to run fast and far from.  This type of doctor is one we rage against and find too often.  There really are better ones out there.

Your symptoms are certainly among the kinds of symptoms we see in MS.  However, the proper approach to diagnosis goes like this:

The doctor first LISTENS to your story, your symptoms, your history, your meds and such.  When he hears that you have had a serious back injury and use a narcotic med are only pieces of a puzzle.  Wondering if the back is at fault for all symptoms is noted as a part of the puzzle to be investigated.  Use of pain meds is noted and the question is asked (to himself) if the pain is adequately controlled, and perhaps a mental note to consult with prescribing physician about your use pattern.

During this LISTENING part, the neuro will try to put the symptoms into some kind of pattern - are the symptoms constant?  Do they come in attacks or episodes.  What do these attacks imply with regard to their possible cause?

The next phase is to do a complete, uber-thorough, neuro exam from head to foot.  This takes a goodly amount of time, such that the initial visit often lasts an hour or two.  I call this the LOOKING at you phase where the good doc will attempt to obtain as much info as he possibly can from testing your body.  Are the reflexes too brisk, does the person have good coordination and balance.  Is the muscle strength normal side to side.  Is the eye exam normal?  And so on.  The neuro exam can show the doctor long before any MRI is done, that there is a lesion in the central nervous system.

The next step is usually an MRI to look for any lesions - any at all.  If MS even figures into the paossible cause of the patient's problems the MRI is ordered using the MRI Protocol for MS.  Lesions are examined for their size, appearance, location.

Often along withorder the MRI, blood tests for the mimics of MS, or for things that came to mind during the history and physical, are also ordered.  MS cannot be diagnosed until all the more reasonable mimics ("other reasonable explanations") have been ruled out.

The results of the MRI are reviewed and the good neurologist will read them himself - often before looking at the official report.  No lesions are discounted.

Now, you have already noticed that your neuro failed in his duties somewhat about four paragraphs ago.  Yes, indeedy!

Now, Can daily narcotics cause all those symptoms?  Conceivably yes, if you are in a phase of use that requires you to use more and more med and if you are pretty constantly in a mild state of withdrawal.  Trembling, lightheadedness, sweats etc are classic for withdrawal.  That is something you might want to explore with a pain management doc (which you probably have already done), but merely the use of a narcotic for pain relief does not answer why a person is having widespread neurologic symptoms.

Have the people following you for back pain re-evaluated your spine for evidence that is the source of some of your pain?

"You are not in the typical patient profile of a person with MS."  Say what!!?  Uh, you are exactly at the typical age of diagnosis.  BUT, you are a male....Hmmm...this doctor has not noticed that AT LEAST ONE FOURTH of his MS patients are men!??  If they aren't, he is leaving a lot of men out there undiagnosed.

Yes, I am saying that by best recent estimates out of every 10,000 people diagnosed between the ages of 20 and 40 now, 2,500 are men.  This guy is an imbecile.  He is also D.U.M.B. (a Doctor with Unfounded Medical Beliefs).  While 60 years ago the ration of women to men with MS (in the US) was 2:1, it has been growing over the last 6 decades
and is felt to be about 3.5:1.  That ration does not rule out ANY amn from having MS.
So, he chuck him to the curb knowing that he knows zip about MS and we worry that he can find his behind with both hands.

Now, you are right about the timing of these symptoms occurring now when the injury was 7 years ago.   Unless there has been a destabilization in your back, we can't say the back injury is responsible for your symptoms.  If nerves are being impinged (pinched) then they could account for many of your leg symptoms, but not for full body tremors.

At 33 no one can blame 3 lesions on age, though some young people have white matter lesions WHICH DO NOT CAUSE SYMPTOMS.  Any assessments of the meaning of the lesions MUST take into consideration the person's symptoms.  Can you get a copy of your MRI report?  Do you know where the lesions are and how big they are?

Also, could you tell us how your symptoms have behaved?  Did they all just start and continue?  Have they come, improved, and shown up again?  When did they first start?

So there is a whole lot more to having MS than just having the right symptoms and the lesions.  However, that "neuro" didn't give you the time of day when it comes to a real assessment.  How dare he subtley threaten you by saying if everything was normal "he'd" be p!ssed!  I would go back to your regular doctor and say that this guy dismissed you without ever really assessing you.  Would he obtain the results of the blood tests and refer you to a different neurologist.  No way would I give this neuro another chance at belittling me.

My first neuro dismissed me by telling me that I was too old at 52 to have MS (wrong) and that my brain lesion (one) - was insignificant - wrong, again.  He delayed my proper diagnosis for two years.

Well, I talked my fingers off as usual.  We'll be looking for the answers to your questions.  I hope this helps, and that we can help you through all this.

Quix, MD
1169520 tn?1263430421
My symptoms come in what I want to call "Attacks" except the tremmors they come and go through out the day! But the other symptoms don't happen every day! It all starts with a headach. The headache lasts for an hour or 2 but during that time I will start feeling dizzy and lightheaded! Then comes the numbness! The other Day I was driving my companies 30foot Dump truck and after the headach and lightheaded feelings hit I went numb in both legs and feet for about 7hrs! That makes it pretty hard to drive a truck! Then for a couple days I was fine. Then it hit again, again began with the headach! Only this time just my left index finger and right thumb went numb! They go so numb it borderline hurts! When my legs went numb I had issues walking cause I couldn't feel wear my legs were! No matter what my hands always shake, some time worse then other times and at some point in the day I always get the full body tremmors but they come and go through out the day! As for my meds I take them as perscribed so I never run out so I don't ever go through a detox! I have indeed spoke with my pain Dr about this matter but he reallt feels that the meds are not to b lame for this! These attacks come on so sperstic and sudden that it worries me because in my job I may be hauling construction debri in my dump truck 1 day and ontop of a high rise in down town Seattle the next and in my profesion 1 wrong move could be the differance between life or death but at the same time I can't aford not to work! Is their anyway I can minamize these attacks so that they don't happen as often or as sevear?
1169520 tn?1263430421
I pick up the MRI today
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