White spots on brian but not ms

[shorty671]

Hi I have been suffering with migraine for the last 4 years, in the last year i have been getting blurred vision pins and needles in my arms and legs and weakness, this can come and go for months at a time. I went for an mri and mra scan which showed white spots but the nero doc says its just migraine not ms. Everytime I go through the phase of this i always get strange symptoms i.e saw jaw, vertigo.

If this is not ms what else can it be? its taking over my life and I even lost my job 3 months ago, pls help I dont want to loose my new job and im sick of feeling like a freak.

[Neuro Forum]

Thanks for using the forum. I am happy to address your questions, and my answer will be based on the information you provided here. Please make sure you recognize that this forum is for educational purposes only, and it does not substitute for a formal office visit with your doctor.

Without the ability to examine you and obtain a history, I can not provide with an explanation for your particular MRI findings, however I will try to provide you with some information.

There are multiple causes for so called white matter lesions in the brain. Most often, these are due to what is called "chronic small vessel disease", literally meaning diseased small vessels that supply blood flow to the brain. This is not an uncommon process in the brain and increases with age. This is not a disease in and of itself but rather is a reflection of unhealthy blood vessels, damaged by years of plaque build-up. This is most often due to a combination of several factors including the following: high blood pressure, diabetes, smoking, and high cholesterol. If these factors are well controlled, the damage to the brain can be stabilized and further damage prevented.

Other causes of white matter lesions in the brain can be migraine. People with migraine often have white matter lesions on their MRI that are of unclear cause or significance.

Other causes of white matter lesions on MRI can usually be distinguished based on history and symptoms, such as symptoms of neurologic deficit (for example arm weakness or difficulty walking etc). These can also be distinguished based on the MRI appearance. These include, but are not limited to, multiple sclerosis, other demyelinating disease, cancer metastesis, infection, and inflammatory processes such as vasculitis.

In your case, if the white matter lesions are due to either the migraines, they are likely inconsequential. If they are due to chronic small vessel disease, it is imperative that you stop smoking if you do, take medication to control your blood pressure, cholesterol, and diabetes, eat a healthy diet, and exercise. If other causes are diagnosed, there are treatments for some of them depending on the process occurring.

The different causes can be determined to some extent by interpretation of various sequences of the MRI. It sounds like your neurologist does not think the pattern of white spots in your brain are typical of multiple sclerosis. Other investigations are sometimes necessary to distinguish the various causes of white matter lesions. A lumbar puncture is sometimes necessary, in which fluid from around the spine and brain is taken out and analyzed with various tests.

It is possible that your MRI findings are entirely unrelated to your symptoms of blurred vision and pins and needles in the arms and legs with weakness. Pins and needles can be a sign of neuropathy, a problem with the peripheral nerves that supply sensation to our arms and legs and provide innervation to the muscles. However, a neuropathy does not cause symptoms that come and go, such as in your case; the symptoms are usually constant and sometimes progressive. Other causes of pins and needles that are usually constant (rather than fluctuating such as in your case) can include diabetes, vitamin B12 deficiency and other vitamin and mineral deficiencies (copper), and protein abnormalities (a particular condition called monoclonal gammopathy).

If your vertigo is associated with your headache, it may be a variant of migraine called basilar migraine. In this case, your vertigo could possibly respond to migraine medications.

While it is imperative to rule out neurologic causes to your symptoms, it is also important to consider psychiatric problems as well. Depression and anxiety can sometimes cause physical symptoms and treating the depression and anxiety can help the physical symptoms resolve.

It is important for you to further address your questions and concerns with your neurologist.

Thank you for using the forum, I hope you find this information useful, good luck

[Riki69]

five years ago the docs at CCF told me that my white spots were not MS, but was scarring due to some sort of trauma, and that my CSF that showed "MS bands" were caused by a genetic problem, not MS. Well, five years later I have had a change in my MRI and more symptoms and finally have been given a diagnosis of MS. Unfortunately, MS is very difficult to diagnose and Docs don't like to hand it out too readily. They like to wait. Now my Doc wants me to start treatment right away. If you are not comfortable with diagnosis, then go elsewhere, but make sure you have a lumbar puncture as that is very telling. If you do not have the "bands" that are associated with MS, then you are probably not looking at it. But if you do and if the Docs still tell you that you don't have MS, go somewhere else.  Good luck friend.

[Hope75]

I just read your post and wanted to let you know you are not alone in your symptoms.  I, too, have migraines and a spot on my MRI that docs think is not significant.  I also have tingling, burning extremities etc.  2 years in August with no answers.  I am happy to report that my symptoms were worse in the beginning and have slowly improved.  I am still having burning feet and it migrates to other parts of my body, but I am not disabled by it.  It can bring me down mentally, but I try to think positively and keep moving forward.  So far, so good:)