MRI results

[pnw0611]

Hi everyone. I have not been diagnosed with MS but due to scary memory problems, developing double vision, and getting bad results on a visual evoked potential test (slow signal latencies, worse on left), I was sent for a brain MRI.

Today I received the radiologist's report that says "unremarkable" for most everything, but says this:
"Brain parenchyma: A few, less than 3 mm diameter bilateral frontal and right parietal deep white matter T2 hyperintensities, likely represent normal aging process and/or minimal small vessel ischemic process. Migraine associated white matter disease is difficult to exclude."

While trying to figure out what that means, I gather that "hyperintensities" are lesions that showed up with contrast, is that correct?

Regarding the normal aging process possibility, I'm only 48. Don't these kinds of things normally show up after age 60?

Regarding the vessel ischemic process possibility, I have no risk factors for that. I don't have high blood pressure, diabetes, high cholesterol, or smoke, plus again, just 48 years old.

Regarding migraine disease, I don't have migraines. I've never been diagnosed or treated for migraines. In my 20s I had headaches I thought could be migraines, but that was ages ago and not ongoing.

So...does anyone have some insight as to what my results could mean? There was no mention of MS on the report, but my doctor and optometrist both mentioned it before the MRI. Could those lesions be MS (do they sound like in the normal area or type)?

I don't see my doctor for another week, and frankly, I have no faith in her based on things she's said in the past (I'm poor and on Medicaid, so basically am lucky I get to see anyone, can't be choosy). I know nobody can diagnose me, and I'm not asking for that, I'm just asking for knowledge and experience and probabilities.

Thanks in advance

[SNOOPY]

Hi pnw0611 and welcome to MSWorld.

I gather that "hyperintensities" are lesions

Yes, however lesions can have different causes.

There was no mention of MS on the report, but my doctor and optometrist both mentioned it before the MRI. Could those lesions be MS

What a Dr. may suspect can change based on test results.

A few, less than 3 mm diameter bilateral frontal and right parietal deep white matter T2 hyperintensities, likely represent normal aging process and/or minimal small vessel ischemic process. Migraine associated white matter disease is difficult to exclude."

Multiple Sclerosis is a demyelinating disease. In your report there is no mention of "demyelination" or "demyelinating disease" as a possible cause for findings on your MRI.

It is possible you are not dealing with MS as a cause for your symptoms. However, only more testing, time and your Dr. could give you an answer.

Best wishes

[AnneShirley]

I would have another neurologist look at the MRI for a second opinion. One who deals with MS consistently. A spinal tap sounds like the next step to me. I don't know where you are from but I go to the MS Center in Worcester, MA. My doctor is Carolina Ionete. Hope this helps!

Lauren
Disabled Nurse
MS since 2010

[btrfly2541]

Same Boat, slightly different paddle

Hi-
I am in a very similar situation. I started this year with numbness and tingling on my left side, weakness, eye problems, headaches, etc. I went to several docs including neuro and had MRI of head, spine and neck. Spine and neck looked ok, head had several small <3 mm hyperintensities in the parietal lobe and somewhere else (can't remember where); not likely due to age (ironic because I am 42- not that far off from 48), possible due to migraine changes but demyelinating disease could not be ruled out. Recommended follow up scan in 6 months.

I have had increasing symptoms with weakness and fatigue and my dr just had labs drawn to rule out MG since it was just a blood panel and because my weakness causes my muscles to literally shake when I've used them too much.

So, for me- still a wait and see. Sorry I don't have any new information to share- just support from someone trying to paddle upstream in the same polluted river

Barb

[22cyclist]

I agree with SNOOPY here. You may be dealing with something other than MS. MS looks a certain way and is in certain places in the brain. Since your neuro-radiologist mentioned things other than demyelination, you may be looking at mimics. However, your neurologist will go over the results with you and talk with you about where to go from here.

Good luck and let us know how it goes, OK?

Lisa

[pnw0611]

Thanks for the responses, everyone.

I haven't seen a neurologist and I called my doctor's office today to see if they have put through a referral and they have not. Both my doctor and optometrist said they would do that a couple weeks ago, but neither has. I also asked for my doctor to call me to go over the radiology report but no, no call.

I'm especially confused about how I could show signal delays on the VEP test WITHOUT having some nerve issue going on. Isn't that exactly what that test is for? Does an MRI show nerves or demyelation?

[SNOOPY]

Does an MRI show nerves or demyelation?

Multiple = Many, Sclerosis = Scaring

The scaring seen in MS is due to damage done to the Myelin Sheath which is the protective coating surrounding the nerves. This process is demyelination.

Multiple Sclerosis is a disease of the Central Nervous System (CNS) which include the brain, spinal cord and optic nerves. Lesions (scaring) can show up in any or all of those locations.

There is no single test, by it's self, which can give a diagnosis of MS.

There are numerous other conditions, diseases, some medications, and vitamin/mineral deficiencies that cause similar symptoms as MS.

The VEP, if positive, can indicate the possibility of MS. However, this test is not used exclusively for MS and other causes need to be ruled out. A Neurologist will do other testing which could point to MS or some other condition/cause.

Some basic information about diagnosing MS:
http://www.nationalmssociety.org/Sym.../Diagnosing-MS

[pnw0611]

I got a referral to a neurologist, so I called them today to make an appointment. My appointment is in MAY, as in 6 months from now! So surprised and discouraged.

I'm grateful I was able to get my MRI via my doctor instead of waiting to see a neuro first or I'd be crazy anxious about my vision issues (which I am anxious about, but the MRI did rule out many things, which eased my anxiety some).

[pnw0611]

I got a referral to a neurologist, so I called them today to make an appointment. My appointment is in MAY, as in 6 months from now! So surprised and discouraged.

I'm grateful I was able to get my MRI via my doctor instead of waiting to see a neuro first or I'd be crazy anxious about my vision issues (which I am anxious about, but the MRI did rule out many things, which eased my anxiety some).

[SNOOPY]

Hi pnw0611,

Sometime it can take awhile for a new patient to get into see a Neurologist.

I know you said you have seen an Optometrist but you might consider seeing an Ophthalmologist for a 2nd opinion about your double vision.