Hi,
I posted on here previously. I had had one episode of ON and an MRI scan and was being referred to a neurologist but am still waiting for an appointment.
Went to see my GP today who gave me a copy of the letter from the opthalmologist.
About the MRI it says,
“The MRI scan shows demyelinating lesions in the optic nerve, supra and infra-tentorial as well as in the brain stem and this makes the diagnosis of MS likely”.
I had no other symptoms until I saw the opthalmologist but now have a heavy leg and arm on the left that varies depending on how distracted I am.
I would be so greatful if anyone could help with the MRI .
Sallyxxxx
Demyelinating lesions means areas of damage due to demyelination (the process by which the myelin coating around nerves is damaged and one of the key processes in MS).
Lesions of the optic nerve cause optic neuritis, so they are to be expected from your symptoms.
The tentorium cerebelli is a sort of membrane that separates the cerebellum from the cerebrum. The cerebrum is the biggest part of the brain, on the top. The cerebellum is the smaller, roundish part that lies underneath the back of the cerebrum. Supratentorial means above the tentorium cerebelli and basically means the cerebrum. Infratentorial means below the tentorium cerebelli and usually means the brain stem and the cerebellum. The brain stem is the part of the brain that lies at the top of the spinal cord, joining the spinal cord with the rest of the brain.
I’m not sure why the ophthalmologist has said infratentorial and then separated out the brain stem, but I would guess it means that you have lesions in both the cerebellum and the brain stem, as well as in the cerebrum.
The diagnostic criteria for MS include details on what needs to be shown on MRI. These are (for RRMS) having at least one lesion in at least two areas that are typical of MS, namely periventricular (next to the “lakes” of CSF in the middle of the cerebrum), juxtacortical (next to the outer layers of the cerebrum), infratentorial and spinal cord. The fact that the ophthalmologist has said that your MRI is consistent with MS makes me suspect that the lesions in your cerebrum are periventricular and/or juxtacortical. Together with the infratentorial lesions, this would satisfy the McDonald criteria.
It’s important to know that there are several different causes of demyelinating lesions, including some one off things, however the fact that you have developed symptoms since your MRI suggests that a one off thing is unlikely. MS is the obvious conclusion given the ON and the MRI results, however, an ophthalmologist is not qualified to diagnose MS with good reason: they are not neuros, so there may be another explanation and for now, if I were you, I would try and accept the likelihood of MS, but keep an open mind.
I hope the neuro appointment comes through soon so you can get some proper answers about what’s going on.
Karen x
Hi Karen,
Thankyou so much for translating that for me. Although it’s not what I want to hear, it is what it is.
I’m not sure whether anxiety is bringing the symtoms on or whether they are really there.
This forum is truly blessed to have you on it for when we are blinded with long words!
I’m not sure if the opthalmologist has just copied it all from the MRI herself.
I will chase up neuro appt tomorrow.Was initially referred to neuro surgeon, so it’s all been a bit delayed.
Thankyou again.
Take care,
Sallyx