mri questions

[tambrown]

When I got this mri the nurse on the phone seemed to think I would get my dx so did I . Instead the Dr. said I was a conumdrum . It took 7 yrs to have a change on my mti . I also had dizziness off balance and uncontrollable eye movements (crossing an rolling back into my head )

It says compaired to mri from 2011 . An ill defined confluent FLAIR signal abnormality within the deep white matter at right postierior corona radiata is marginally increased in size . At comparable levels , this previously measured 6 mm and currently measures 8 mm. A subcortical FLAIR signal abnormality within right frontal lobe, previously measured 1 to 2 mm and currently measures 4 mm .

Bihemispheric puntuate FLAIR signal abnormality within the centrum semiovale and corona radiata regions are otherwise unchanged. No associated T1 signal change ,localized mass effect or enhancement is present .

there's other stuff talking about the dicks in my neck . The summary 1. Marginal increase in the FLAIR signal abnormality within the right parietal and right frontal lobes as described since feb. 2011 Demyelinating disease, vasculitides and post infectious syndromes remain within differential.

2. Otherwise no significante chage since feb. 2011

Having two changes on an mri I thought fit mcdonald criteria what am I not understanding ? I went from one lesion to numerous lesions in periventricular area and a couple other places Dr. said not in normal ms areas what are the normal ms areas ?


Sorry so long but I'm angry something is causing these lesions in my brain an I believe I have a right to be concerned. Thank you for any responses . I did forget I also had personality changes I was screaming at people I would normally never yell at .

[22cyclist]

There are many locations that MS lesions like to go. Some of the more common ones are: The corpus callosum, periventricular areas, and in the periventricular white matter distribution. There are also areas in the brainstem that MS likes to go.

http://emedicine.medscape.com/article/342254-overview

There are other places that MS lesions like to land, but these are the main areas.

There are other diseases that cause WML that are not MS. You should talk with your neurologist about this and what he/she thinks your white matter lesions are from.

Take care
Lisa

[MSer102]

I went from one lesion to numerous lesions in periventricular area and a couple other places Dr. said not in normal ms areas what are the normal ms areas ?

According to the 2010 McDonald criteria, dissemination in space can be demonstrated by 1 or more T2 lesions in at
least 2 of these 4 areas of the central nervous system:
Periventricular
Juxtacortical
Infratentorial
Spinal cord

Your radiology report notes lesions in only 1 of the 4 areas - periventricular. Subcortical is not the same thing as juxtacortical, so your subcortical lesion is not technically in the correct area to meet this criterion. This report doesn't say where the frontal and parietal lobe lesions are, but if your neurologist says your lesions aren't in the right places for MS lesions, they might be subcortical instead of juxtacortical as well. If that's true, then you don't meet the McDonald criterion for dissemination in space. It looks like that's not because you don't have spatially disseminated lesions, but because they aren't in the right locations to meet the 2 of 4 specific areas criterion. Two lesions being larger isn't enough by itself to meet the McDonald criteria.

If your neurologist can't figure out the conundrum, it might be a good idea to get another opinion.

[MSer102]

I also had dizziness off balance and uncontrollable eye movements (crossing an rolling back into my head )

Eye movements are controlled in areas of the brain where your current MRI and the one from 2011 don't show lesions. That's an indication that the eye movements - which you have said occurred only when you were tired or sleepy feeling - are not the primary condition.

If the eye movements were caused by lesions in one or more areas of the brain that control eye movements, the movements wouldn't happen only when you are sleepy or tired. They would happen at other times too, and you said that they don't or didn't.

Also, one or more lesions in the parts of the brain that control eye movements would not cause even one eye to "roll back" in your head, let alone both of them at the same time. The eye muscles aren't directly "wired" that way. That kind of movement has to have a different cause.

Since your eye movements aren't characteristic of what happens with brain lesions affecting eye muscles - and your MRIs don't show lesions in those regions anyway - it's more likely that something else is going on and the eye movements are just going along for the ride.

Your lesions apparently don't fit the McDonald criteria and you don't have lesions that would be associated with some of the symptoms you are having, particularly the eye movements. It's your neurologist's job to determine what's causing your lesions and to explain what's causing your symptoms when your MRI's don't directly support them.

That's another reason you might want to get a second opinion.