Hi there. It is important to make note that white matter lesions on a brain mri does not necessarily mean Multiple sclerosis. White matter lesions can be seen in various conditions. These represent micro vascular ischemic changes in the brain hence these white matter abnormalities on mri are common in patients who have microvascular and macro vascular risk factors like history of hypertension, diabetes and high cholesterol. White matter signal changes on MRI are seen in infectious and other inflammatory conditions and migraine headaches. These white matter signal changes on brain mri need to be correlated to the history, clinical examination and other ancillary investigations. Your doctor will need to investigate your daughter in law for multiple sclerosis where the disease phase is characterized by active phase and remissions. It has multiple symptoms and signs and is a diagnosis of exclusion. The symptoms of multiple sclerosis are loss of balance, muscle spasms, numbness in any area, problems with walking and coordination, tremors in one or more arms and legs. Bowel and bladder symptoms include frequency of micturition, urine leakage, eye symptoms like double vision uncontrollable rapid eye movements, facial pain, painful muscle spasms, tingling, burning in arms or legs, depression, dizziness, hearing loss, fatigue etc. The treatment is essentially limited to symptomatic therapy so the course of action would not change much whether MS has been diagnosed or not. Apart from clinical neurological examination, MRI shows MS as paler areas of demyelination, two different episodes of demyelination separated by one month in at least two different brain locations. Spinal tap is done and CSF electrophoresis reveals oligoclonal bands suggestive of immune activity, which is suggestive but not diagnostic of MS. Demyelinating neurons, transmit nerve signals slower than non-demyelinated ones and can be detected with EP tests. These are visual evoked potentials, brain stem auditory evoked response, and somatosensory evoked potential. Slower nerve responses in any one of these is not confirmatory of MS but can be used to complement diagnosis along with a neurological examination, medical history and an MRI in addition, a spinal tap. Therefore, it would be prudent to consult your neurologist with these concerns. Hope this helps. Take care.
Thats a good question. I would like to know when you find out. They said they may have seen one on my daughter.