Any other "disease" ideas ?

[Lulu54]

I have had an MRI, brain and spine series  - results are below - just wondering what other demyenlinating diseases besides MS fit these MRI findings?

I have some fairly common MS symptoms as well - dizziness, numb leg that tires in heat, incontinence issues....

All blood tests come back clean - I've been checked for everything!  An LP is scheduled for this Tuesday and I want to have other options in mind to discuss with the neuro.  Thanks.

Brain MRI with and without contrast:
There is moderate white matter disease. Periventricular and to a lesser extent subcortical, and also a lesion involving the posterior limb of the left internal capsule.  No brachium pontis lesions are seen. No medial temporal lobe or definite corpus callosal lesions are see. One slightly ovoid lesion is seen in the right frontal white matter posteriorly. A number of these lesions show a vague rim of increased T1 signal due to lipid leaching , and this occurs commonly with demyelinating disease such as MS. Additionally, one of the lesions in the right frontal white matter is active and enhances … There is also an active enhancing lesion shown in the left parietal white matter ….  Punctuate lesion, which is enhancing, in the left frontal white matter…. There is also some blackhole formation bilaterally, greater on the right, which indicated severe axonal desctruction.
Impression: Moderate white matter disease in keeping with a demyelinating process such as MS with at least three active enhancing lesions shown.  There also is some blackhole formation bilaterally, greater on the right, which indicates severe axonal destruction.

MRI Spine Thoracic w/o Contrast
Impression: No abnormal signal is seen within the thoracic cord. No compression deformity is seen.

MRI Spine Lumbar w/o Contrast
Impression: Multilevel discogenic changes are seen throughout the lumbar spine.  There is a disc protrusion seen at L5-S1 which effaces the ventral thecal sac and abuts the descending S1 nerve roots as well as the exiting L5 nerve roots.  (there’s more in the details but this is the summary paragraph)

MRI Spine Cervical w/o Contrast
Impression: Multi-level discogenic changes, most notable at C4-C5 and C5-C6.  At C5-C6 there is a circumferential disc osteophyte complex with left parasagittal disc protrusion which effaces the ventral CSF and cord.  There is a focal area of abnormal signal seen within the left lateral and peripheral aspect of the cord which may represent a focal area of demyelination or edema.  (there’s  more in the details but this is the summary paragraph)

[Lulu54]

Lori,
Thanks for the reply.  I believe it is MS too and have had that conversation on the MS board - I was just covering my bases and checking if anyone on the neurology board could pick up something we may have missed.

This is so new - first saw the neuro in early August so it is just one month.  I don't have two separate attacks documented, but obviously from my mri this has been going on for a long time.

Thanks again,
Laura

[Lauri8967]

Hey there -
It definately sounds like you have MS...The location and enhancement of the brain lesions, the opiod shape, the enhancing rim around lesion, etc.  Also, there is no other disease process that causes lesions in the spine area (there can be different reasons for lesions in brain, but not in spine).  
I would expect that your LP will show O bands.  As a amtter of fact, Im surprised your doc is even doing an LP, as its not essential for Dx.  You have enough evidence on MRIs for Dx.  Im assuming you have Sx that correlates with MS and have had two seperate attacks?  If so, you have satisfied the McDonald Criteria for MS DX.
Good luck, and I hope you get treatment soon...
Lauri