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Just had 4th or 5th MRI done

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    Just had 4th or 5th MRI done

    Hi, I have been in limbo for five years now. I started getting symptoms around March of 2010 (tingling, electrical sensations, pain everywhere). I had my first MRI (positive for 4-5 T2 white matter lesions) in July of 2010, and was referred to a local neurologist who ordered a C-spine MRI (negative for lesions) and did not suspect MS, but couldn't rule it out. I also had a LP in July of 2010, which caused issues with my vision and chronic dizziness. My vision has been off ever since (blurriness with panning while watching TV and fast moving objects intensifying dizziness).

    I waited about 6 months to finally schedule an appointment with an MS specialist, because I was having symptoms again, along with a new strange sensation in the middle of my chest and extreme dizziness. He ordered another MRI of my brain (January 2011), which showed no changes. He ordered another MRI of my brain and C-spine in August 2011, and that showed no changes. I had another MRI of my brain and C-spine in January of 2012 which showed no changes. The MS specialist was doubtful that it was MS at that point, instead pointing towards my migraines as the probable cause of my white matter lesions and neck muscle tightness/spine straightening as the cause of my pain/numbness/tingling/other symptoms.

    I was supposed to get another MRI of just my brain in January of 2013, in which the MS specialist said he would rule out MS if there were no new lesions, I kept pushing off scheduling it until recently and had my latest MRI yesterday. (I denied the contrast dye, which I know is important, but I am weary about it, due to the new studies demonstrating that gadolinium is not completely eliminated, even in patients with healthy kidneys. I'll wait for the FDA to investigate it further before getting another MRI with contrast). I do not see my MS specialist for 3 weeks, but the diagnostic radiologist wrote this:

    MRI BRAIN WO CONTRAST

    HISTORY: Multiple sclerosis. Routine follow-up

    TECHNIQUE: Brain MRI with demyelinating disease protocol without
    contrast. The patient declined gadolinium contrast.


    COMPARISON: 1/30/12


    BRAIN RESULT:

    Findings: There are multiple foci of hyperintensity on spin density, T2
    and FLAIR within the white matter, compatible with the clinical diagnosis
    of multiple sclerosis.

    New T2 Lesions: None

    Interval Improvement: None.

    New Enhancing Lesions: Not applicable.

    T2 Burden of Disease: Mild.

    Parenchymal Volume Loss: Mild.

    Other Significant Findings: None.


    Impression

    IMPRESSION:

    Multiple intracranial white matter lesions compatible with multiple
    sclerosis. No new T2 lesions. Mild parenchymal volume loss.

    Other significant findings: None.





    It seems as if she is diagnosing/assuming MS, while there are no new lesions? Any comments/suggestions would be appreciated. I tried to get into see my MS specialist sooner, but he is booked.

    #2
    I am new and don't know enough to advise anything but want to show my support to you sounds like you have been through a lot x

    Comment


      #3
      Hi,

      My recommendation would be to see a 2nd neurologist specializing in MS in addition to the one who you have been seeing. (Basically get a 2nd opinion). At the 'very' least when you do see your current MS specialist neurologist, I would directly question the impression stated on the results.

      Multiple intracranial white matter lesions compatible with multiple

      sclerosis. No new T2 lesions. Mild parenchymal volume loss.

      If it is/was/has been MS, the good news would seem to be that you are not progressing in it.

      I would also inquire about the brain loss statement. Brain volume decreases naturally with aging. However, it decreases more rapidly in people with MS. That statement 'could' be an indicator along with the lesions that might point toward evidence of MS opposed to the lesions being only from migraines. You would want to find out how much brain volume loss you have had as compared to a "normal" person of your age/sex.
      RRMS Dx: 3/23/15
      (Optic Neuritis Dx 2/27/15; Feb/2014 right leg numbness--at the time diagnosed as Sciatica, but probably first episode)
      Started Tysabri 5/22/15: (Infusions: 5/22/15, 6/18/15, 7/16/15)

      Comment


        #4
        Originally posted by steve19 View Post

        IMPRESSION:
        Multiple intracranial white matter lesions compatible with multiple
        sclerosis. No new T2 lesions. Mild parenchymal volume loss.

        It seems as if she is diagnosing/assuming MS, while there are no new lesions? Any comments/suggestions would be appreciated.
        Hi steve:

        The radiologist isn't diagnosing you with anything or making any assumptions. Radiologists don't diagnose. They only report their findings.

        The radiology report states that the radiologist's impression is that your MRI is consistent with multiple sclerosis.

        New lesions aren't necessary for a diagnosis of MS. Plus, MS lesions can come and go, so there's no way to know what was going on between your MRIs.

        But MS isn't diagnosed based on MRIs alone. There is no single test that can diagnose MS. Your history and presentation of symptoms are also important, as are other test results. It can be possible that your MRI is consistent with MS but your symptoms and their presentation aren't. All other possible causes for your symptoms have to be ruled out also.

        There's nothing urgent on your MRI that indicates you need to see your neurologist sooner than scheduled. Your neuro should be able to answer all of your questions about your MRI at your appointment. Be sure to have your questions prepared in advance.

        Comment

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