MS or adinoma?

[vickiw]

Thank you Dr. for taking the time to answer my question.  I have been having waxing and waning symptoms since last December.  My symptoms include: extreme fatigue, weakness and tremors in legs, weakness in arms, some numbness in both arms and legs, urinary frequency, blurred vision, and a sensation of heat in one of my feet radiating up to my leg.  The episodes lasted a month in December, primarily in my legs, then went away.  In March I had about 3 weeks of weakness and numbness in my arms.  I still occasionally have some tremors in my legs if very tired, and my coordination is still off.  My Dr. mentioned MS and sent me to a neuro, who thought it was a demylinating disease.  He ordered a round of testing.  Had an MRI w/wo contrast last Friday.  The results came back as a small signal interruption typical of spider venous adenomia in the brain, and a small signal interupption typical of a hemanoma in T-2 and an osteocye formation that is causing a minimal indention into the thecal sac.  My question is could these be causing my symptoms?  All are small.  Does this MRI rule out MS?  I am scheduled for an SSEP and EMG in a couple of weeks.  Will this help determine the problem?  Thank you again for taking the time to help out.

[Metz]

From what I have read and have been told, the absence of lesions on the MRI still does not exclude MS.  In fact, there are several cases of debilitating MS where definitive lesions still have not been identified.

I just had another MRI w/ and w/o contrast of both the head and spinal cord due to progressive worsing of symptoms - weakness, numbness, extreme fatique, loss of balance, foggy memory (and the list goes on).  My neurologist and I decided that, even in the absence of plaques/lesions, we are going to start the ABC drugs.

What are your thoughts on this?

[CCF-Neuro-M.D.-RPS]

Dear Vickiw:

Sorry that your experiencing symptoms.  The MRI is certainly not the usual finding in MS, especially if the symptoms have been going on for awhile.  But no, a normal MRI does not rule out MS completely, although a normal MRI of the brain and spinal cord makes it pretty unlikely.   This is a good thing because brain tissue that is lost is gone forever.  Whether the venous angioma and hemangioma at Tt are causing your symptoms is not possible to tell you without actually viewing the MRI and doing the neurological exam.  Yes, depending on the location of the angioma and how compromized the thecal sac.  I think I would stil procede with the SSEP and EMG.  That  way you wil hve more assurance that things are not caused bysomething worrisome.  Let us know how it turns out.

Sincerely,

CCF Neuro MDl