multiple brain lesions unconcerning in young person?

[fritzou88]

Hi everyone! I am new here, and not diagnosed with MS.

I was referred to neurology for myasthenia gravis. The resident noted asymmetrical reflexes, for which I received a brain MRI to rule out MS.

The result is reportedly unconcerning because "unidentified bright objects" are common. I am 27, so I am a bit surprised that this is considered normal:

IMPRESSION:
1. There is a 7mm FLAIR hyperintensity of the left parieto-occipital junction white matter adjacent to the cortex.
2. There are nonspecific mild punctate FLAIR hyperintensities of the left frontal, left occipital, and right occipital lobe white matter.
3. The above findings are nonspecific with a differential which would include demyelination, vasculitis, and sequelae of prior inflammation or injury.

A little bit of background: I have thyroid disease, positive ANA, a prolactin-secreting pituitary microadenoma, and mild myasthenia. My fatigue and heat sensitivity could be due to these conditions alone. I also have very mild muscle wasting and weakness on one side of my body (which I failed to mention to the docs).

The attending physician is a widely known MS expert, which makes me think I should drop the subject. The resident is the one who informed me, but I imagine that the attending must have known. Should I still be worried?

thanks so much for any of your thoughts!

[Marco]

I am not qualified to review your MRI or MRI reports, but I can tell you this.

Lesions can be caused by a wide-range of conditions including blood pressure, migraines, trauma, infection, etc. So having a lesion or bright object isn't necessarily suggestive of MS. When reviewing the MRI, radiologists and MS specialist look at the location, size, shape, etc of the lesion to determine if they are consistent with MS or not.

MS specialists are not all created equal. If you want to take this to the next level, you can have the MRI reviewed by another MS specialist. There's also a pretty good chance the resident was overzealous and raised unnecessary fears. I hope you do not have MS, sounds like you have enough things going on without it. More than anything, I wish you well.

[fritzou88]

thanks so much for your input, marco. i may be tired of pursuing diagnoses, so perhaps i will just sit back and hope that my "hyperintensities" don't render themselves obtrusive.

i follow up in a few months, and just started provigil for fatigue so i haven't been completely dismissed either.

best of luck to you, too!