Please help me understand MRI!

[aegemm]

I have had intense and increasing tingling, numbness, predominantly throught the right side of my body for the last 10 days. (I think symptoms I have had for 8 years may be related...lightheadedness, supra ventricular tachycardia, they think (racing heart), headaches in the right sinus that feel like migraines.).  I just received MRI results and can't make heads or tails.  I am waiting for neurology eval in several weeks. Any helpo would be appreciated.

1. Mild, scattered non specifice foci T2/FLAIR signal hyperintensity.  These may reflect changes from chronic small vessel disease, or could be potentially be normal for patient's age.   Other white matter disease potentially in the differential including demyelinating disease, byt these lesions are not in the distributio typical for multiple sclerosis.
]2.  Material in the left frontal sinus, indicative of chronic or proteinaceous material given the increased T1 signal and heterogeneous T2 signal.  This could alternatively reflect small mococele.  Correlation with sinus CT recommended in the absence of prior studies.

I have hypothyroidism which is controlled with 50 mg fo Synthroid.  Latest labs showed low vitamin d (24) and I have just begun once weekly perscription dose ( I think 50,000).  I have perfect blood pressure and cholesterol.  I am a 51 year old mother of 6, otherwise very healthy.

Countless thank you's to anyone who will give me some insights.

[aegemm]

Thank you.  This was very helpful.  I have an appt. in 10 days I am seeing an endocrinologist tomorrow.  I also have polycystic ovarian disease, hypothyroidism, low vitamin d.  I am hoping they will test for low B12, as I have read this can cause similar symptoms. If you have any further suggestions of things to check out, I would welcoome them.Thank you so much for sharing your knowlege.

[Dr Sharma]

Hi there. Your doctor should investigate you for multiple sclerosis since you have multiple neurological symptoms. MS is a chronic demyelinating disorder 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. You also need to be checked for small vessel ischemic disease, cerebral ischemia etc for these MRI lesions. Therefore, it would be prudent to consult your neurologist with these concerns. Hope this helps. Take care.