Help needed!!

New diagnosis and before diagnosis
1

Hi All,

I got my MRI results letter from my consultant and really need some help with deciphering it…i am notsure what it means.

Can someone message me…private or on forum, i not bothered which and i will post the results below and see what you all make of it.

It goes…

Youy patient has had an episode of myelitis. The radiologist that reported on her scans missed the lesion. There is a clear cut area of altered signal in her cervical spine at C1/2 on the rigth side afffecting the spinothalmic tract and readily accounts for all her symptoms. She has to some extent bilateral symptoms and she now has Lhermitte’s symptom. Her brain scan look pretty normal and does not have T2 hyperintensity affecting the cerebral white matter. The are however two areas of subtle alteration of signal affecting the pons bilaterally and they may be of significance. (what the hell does this mean???)

She also suffered an episode of bilateral deafness and has some impairment in her right ear still.

She knows that widespread lesion mean we would be thinking of MS, she knows also that this may mean that this might be the first episode of something which is going to occur again. She also knows that i have emphasised that her scans only show one lesion and the cause of her myelitis is unknown, therefore it may be something which may not give rise to reoccurances. Basically time will tell.

I feel we do not need to look at cerebrospinal fluid and there is no treatment which is going to get this episode better. The best thing for her at the moment is to be on no treatment. I have suggested we should review her in 6 months when we can consider whether to arrange further imaging.

Ok, so any help would be gratefully received, Karen/Rizzo…please?

Hope you can shed light on this for me.

Laters

xx

2

I wish i this kind of feedback from my consultant i’ve never had anything, sounds like your in good hands

mel x

3

Myelitis is inflammation of the spinal cord. The letter is saying that you have a lesion high up in your neck that the radiologist missed(!) and that explains your symptoms: C1 & C2 are the top two vertebrae in the neck and your lesion is in line with these. It is on the right, but it is affecting both sides of your body (“bilateral”) and giving you L’Hermitte’s.

Your brain scan is normal except for two brighter spots on your pons which is one of the main structures of the brain stem and which controls various fundamental functions. These brighter areas are not obvious lesions, but given that the pons is important for hearing, you have a brighter area on both sides and you have suffered loss of hearing in both ears, it’s likely that these are the areas of damage causing the problems.

The rest of the letter is saying that you are aware that these multiple lesions may indicate a first episode of MS, but that there is also a possibility that it is a one off and you won’t have further problems. Time will tell.

They don’t think you need an LP because it won’t tell them anything they don’t already know and that there is no treatment available at the moment anyway.

New scans in 6 months will probably depend on how you’re doing.

It sounds like you have a very sensible and thorough neuro there. Hth.

Karen x

4

Hi Karen,

Thanks again for you wealth of knowledge.

Grateful that you can explain this for me, oh and yes i think he is a pretty good neuro !

Thanks again xx