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Thoughts on MRI?

New diagnosis and before diagnosis
#1

2 neurologists have told me that my history and current symptoms aren’t “typical” of MS. I am waiting for results of CSF test, and go for evoked potentials testing this Wednesday.

Symptoms started as muscle twitching in thenar area of left hand during pregnancy. I’ve had an EMG and nerve conduction test done. I am now having pain and occasional twitching in this area of both hands, twitching in left foot, fleeting tingling/numb feeling in baby finger of left hand and middle left toes, twitching in face and mouth area.

Here is my MRI report:

an MRI done with a demyelinating protocol demonstrated multiple subcortical and periventricular discrete T2 hyperintense foci with long axis perpendicular to the lateral ventricles along with lesions involving the corpus callosum, and, juxtacortically, left more so than right, frontal lobes. The posterior fossa was unremarkable. No areas demonstrated restricted diffusion. Imaging appearances were consistent with and, felt to be characteristic of, Multiple Sclerosis.

thoughts?

#2

Hi Sherwin,

I am no expert, but it does say that the imaging is consistent and characteristic of MS.

It really depends on how your neurologist reads it. My report said something similar, specifically it talked about ‘demyliating disease’ possibility etc.

I saw two neurologists- who both saw the same report and images. One said I was at medium risk of developing MS within the next few years possibly, but he felt that I should just take Vitamin D and see. He dismissed two episodes of numbness I had completely. The second neuro (who specialises in MS) looked at my report and my symptoms and said I have MS and need to go on treatment now.

The first neuro talked about the fact that the radiologists don’t really know about MS and are quick to use the term in their reports. But that only a neuro should really be diagnosing MS etc. So, I would say, prepare yourself- something has been found and the radiologist seems to think it’s consistent with MS. But only a neuro can tell you whether he agrees with it.

There are other reasons people have lesions in their brain on MRI (migraines, ageing etc).

When will you see the neuro next, for him/her to tell you what they think?

#3

Hi Sherwin

I agree with Emily. Once your had the VEP and see your neurologist for a follow up s/he will consider all the facts, your personal history, the neurological examination, the MRI, LP and VEP.

S/he will then come to a reasoned decision about whether you have MS, or whether you have CIS, another disorder, need to be referred elsewhere, don’t have the necessary evidence to make a diagnosis just yet, but may have later so gives you a further appointment, or in fact discharges you entirely.

Sue

#4

Thanks for your reply! Both neurologists have seen the MRI report. The first one said that the symptoms aren’t typical but, based on the MRI, he still suspects MS.

The second neurologist was sceptical, and immediately ordered the CSF test and evoked potentials. I had the CSF on Sept. 6 but it needed to be shipped somewhere so it can take 3 weeks for results. I have the evoked potentials tomorrow. The neurologist said she will call me as soon as the CSF test results are in.

So I am anxiously awaiting some results, but in the meantime I feel like my symptoms are getting worse.

#5

Thanks Sue. It’s the waiting that is hard, and in the meantime I feel all kinds of symptoms. It’s hard to know if it’s MS or medication or anxiety or something else. I guess I just have to wait and see!

#6

It’s a bugger waiting for test results. Especially when you are suffering a whole load of symptoms. I do feel for you. Hopefully it won’t be too long.

Sue