First MRI/ need help on reading

[th1]

I have dealt with all of the symptoms of MS for over 20 years but no doctor ever sent me to a Neurologist or for a MRI Scan. The doctors would only tell me it was a mystery to them or they did not believe me ...until a urologist told me my urinary incontinence could be because of MS.

She scheduled me an appointment with a MS specialist Neurologist. My new MS doctor examined me and went through my symptoms and medical history.

She ordered a MRI and also started me on Gabapentin and she wanted me to start taking it right away.

The results came in and she only told me the Brain MRI was abnormal but non specific.

But the MRI of my spine had a few places that may be small rupture disc. She said I may want to see a surgeon for that. And also it may explain some of my symptoms but not all of them. She said she was scheduling me a lumbar puncture to give her a clear picture.


I went on the hospital website to pull my reports. I would like to understand more of what this report is saying on the MRI of the brain.

To me it looks like MS. And the doctor needs to be 100% sure with the lumbar puncture.


Hey may sound strange, but this is what I want to hear. I want a name to what has made my life hell. I will take MS I just do not want to hear I have a mystery disease or not believed.

let me know what you think. Does anything on this report might look like MS? I know after the LP my doctor will let me know more.

Thanks


MR BRAIN (MS PROTOCOL) WWO CONTRAST*

Impression
Multiple scattered small T2/FLAIR hyperintense lesions within the subcortical and periventricular white matter. This finding is abnormal but nonspecific and may reflect the sequela of chronic microvascular disease or prior demyelinating process. Other etiologies include remote trauma, inflammation or chronic ischemia due to migraine or other vasculopathies.

Findings discussed with Dr. xxx by Dr. xxx at 4:45 p.m. on 7/17/2013.





MR SPINE CERVICAL WWO CONTRAST

Impression
1. Central posterior disc herniation at C5-C6 slightly eccentric to the left, which abuts and slightly deforms the ventral aspect of the spinal cord. There is no intrinsic cord signal abnormality.

2. Mild right neural foraminal stenosis at C4-C5.

Findings discussed with Dr. xxx by Dr. xxx at 4:45 p.m. on 7/17/2013.

Component Results
There is no component information for this result.

General Information
Collected:
7/17/2013 4:25 PM

[22cyclist]

Your findings include several possible findings. Those include: small vascular disease; prior demyelinating process, migraines, or other vasculopathies. Your lesions are apparently small, and do not fit an MS like pattern off the bat or they would say consistent with MS. MS lesions are big and ovoid in appearance. Your neurologist will look at your MRI and decide if yours meet these requirements.

Your spinal results are mostly about your herniation and stenosis. No lesions found.

At this point it doesn't scream MS. You will surely need an LP. Good luck with that and I hope that will solidify things for you.

Lisa
Moderation Team

[JerryD]

I read your post with some interest. I games withthat you don't have MS, but it sure sounds like it to me. I suggest you stop playing games with the doctors that do not have answers and get into a neurologist at a 'teaching hospital'. Find out who the top docs are in your area, and get an appointment for a consult. Good luck

[th1]

Your findings include several possible findings. Those include: small vascular disease; prior demyelinating process, migraines, or other vasculopathies. Your lesions are apparently small, and do not fit an MS like pattern off the bat or they would say consistent with MS. MS lesions are big and ovoid in appearance. Your neurologist will look at your MRI and decide if yours meet these requirements.

Your spinal results are mostly about your herniation and stenosis. No lesions found.

At this point it doesn't scream MS. You will surely need an LP. Good luck with that and I hope that will solidify things for you.

Lisa
Moderation Team

" small vascular disease; prior demyelinating process, migraines, or other vasculopathies"

Lisa minus the migraines ( never had one in my life) very few headaches what could be some of the others things since you do not think MS ? Will the LP this Thursday tell me one way or the other?

Jerry I am seeing a MS Specialist Neurologist at a teaching school. She will share more information with me after the LP this Thursday.

She told me ( by phone) that my MRI brain came back abnormal but non specific and that she wanted to do a LP to know more.

I went to the hospital web site and pulled down the report and printed it here ( and another MS forum site) trying to find out more information. My MS doctor has not giving me much to go on. This report is written by the radiologist and shared with the MS doctor.

20 years of having" whatever" I have will drive you a little crazy....waiting is the hardest part

Thanks to all for the help..

[onlyairfare]

I feel for you, as it is so hard waiting and waiting - especially if you've been dealing with mystery stuff for 20 years!

It sounds like you are getting close to a diagnosis, with a good MS specialist at a teaching hospital. Planning on the spinal tap to check the CSF for "oligoclonal bands" commonly used to diagnose MS, then maybe evoked potentials if more information needed.

Those MRI "non-specific changes" are often seen as a normal part of the aging process in adults; "microvascular changes" are like "hardening of the arteries" in the really small blood vessels in the brain, just as can occur elsewhere in the body circulation. Other auto-immune diseases can cause those changes through "vasculitis" or inflammation of the blood vessels. Migraine headaches too, but you've mentioned you don't have migraines.

Your neurologist will put together all your test results (including what the urologist found when examining you for incontinence) to see if you fit the McDonald criteria for diagnosis of MS. And that's presuming you had all the other routine lab testing done to rule out other causes and mimics, which sounds like what your other doctors have been doing over the years.

I don't think it is "strange" for you to want a diagnosis. Not only is it good to have a name for your illness, but also there are treatments available.

Good luck with your diagnostic process.

[th1]

Your neurologist will put together all your test results (including what the urologist found when examining you for incontinence) to see if you fit the McDonald criteria for diagnosis of MS. And that's presuming you had all the other routine lab testing done to rule out other causes and mimics, which sounds like what your other doctors have been doing over the years.

I don't think it is "strange" for you to want a diagnosis. Not only is it good to have a name for your illness, but also there are treatments available.

Good luck with your diagnostic process.

(including what the urologist found when examining you for incontinence)

That is the main one my neurologist wants is from my urologist. My urologist is the one that suggested that my other (fecal) incontinence could also be linked to MS. She said it would make sense to her that my bladder and rectum spasm I have could be MS related. My neurologist should have my medical report from her by now.

Blood work oh yea. Thousands of dollars over 20 years and a recent one of the ones the neurologist would want. Clean nothing there.

She said she did not need my blood work or my medical records at this time. She only wants the one from my urologist for now.

My doctors and Rheumatologists have checked for everything ( fibromyalgia too) over 20 years except to order a MRI and send me to a neurologist.

[22cyclist]

th1: Your LP will for sure help with your search for a diagnosis. Since your neurologist wants one, and has pegged your MRI as abnormal or questionable, the LP will be very meaningful. Like onlyairfair said, they will look for things like oligoclonal bands, myelin basic protein levels, etc. Some of the fluid taken from the CSF will rule out things like Lyme, CNS cancer, etc.

Good luck with the LP. Drink caffeine and lie down flat.

Take care
Lisa
Moderation Team

[th1]

I just had my LP ( yesterday) and yes, I now think I might know what a migraine feels like. lol I will survive though

I did get some of the results back. All reports look normal except for the protein is slightly elevated over the normal range. Report below.. Anything I can take from this?


The main (report) one will take 2 weeks to come in because it was sent to California....that is the one I know my doctor is looking for.


I also found out that the hospital I got my MRI is supposed to update their MRI scanners. The scanners are 25 years old.

I do not know which scanner (age & power) was used on me.

Tom


Component Results

Component Your Value Standard Range Units
PROTEIN CSF 46 15 - 45 MG/DL

[MSer102]

One unit above the reference range isn't significant. My neurologist would say that your protein number is a normal result.

[SNOOPY]

Component Results

Component Your Value Standard Range Units
PROTEIN CSF 46 15 - 45 MG/DL

It appears to be within normal but I am not an expert

This link will give you information about LP results and what is considered normal or abnormal:
http://www.nlm.nih.gov/medlineplus/e...cle/003428.htm

[HelpMyReadMRI]

HELP READ MY MRI PLEASE!

Hello,

I am 30y/o male I used to be athletic and worked out regularly. I went through a major breakup that left me semi depressed. That is just a little about me and what I was going through when my back started hurting. My back now, is an ever day pain. Non stop lower back pain witch hurts more to the right and radiates down my leg (Sciatica Im assuming) I started using an inversion table for 2 weeks now but no change. I am frustrated and sad that I can not find a way to fix this!

I went and had an MRI done and it reads as follows:
(I will skip to Impression)
Impression:

1. The L4-L5 disc space level demonstrates a bulging disc touching the focal herniated disc or spinal stenosis. The neural foramina are normal.

2. The L5-S1 disc space level demonstrates desiccation of the disc.there is paracentral herniated disc protrusion measuring 10mm x 15mm in size displacing posteriorly the right S1 nerve root. There is mild arthropathy.

Some one PLEASE help me read and understand this!

[22cyclist]

You have a bulging disk between L4 and L5.
You have a herniated disk between L5 and S1 that is a paracentral herniated disk protrusion measuring 10mm - 15mm in size. This displaces the S1 nerve root.

SYMPTOMS
Pain in the back or radicular to the buttock, into the leg and extending down behind the knee, to the foot depending on the nerve involved and the severity of the encroachment.
Impairment of normal reflexes in the lower extremity.
Numbness or paraesthesia (tingling) may be experienced from the low back to the foot depending on the distribution of the affected nerve.
Muscle weakness may occur on any muscle that is innervated by the pinched nerve. Long-term pressure on the nerve can produce atrophy or wasting of that particular muscle.
Pain and tenderness localized at the level of the involved nerve.
Muscle spasm and changes in posture in response to the injury.
Pain with excess activity and relief with rest.
Pain and tenderness localized at the level of the involved nerve.
Loss of motion like the inability to bend backward, move sideways to the effected side, or stand erect for extended periods of time.
Sitting, standing and walking can be difficult if the irritation is severe.
Loss of the normal lumbar curvature or lordosis.
Development of stenotic like symptoms.
Stiffness in the joints following a period of rest.

COMMON PAIN PROBLEMS
L4- Back and anterior surface of the thigh, to the inner surface of the lower leg, to the foot and great toe.
L5- Back to the lateral thigh, anterior lower leg, the top and bottom of the foot to the middle toes.
S1 S2- Buttock, back of the thigh and the lower leg.

Good luck with treatment
Lisa
Moderation Team