Chronic Headache?

[scmommato3]

I am not diagnosed with ms. I recently had an MRI which showed 4 tiny lesions in the juxtacortical and periventricular regions of my brain. The radiologist said on the report that the lesions didn't meet MS criteria, but the neurologist called me and said she wanted to do further testing and when I asked what she thought about the lesions she said possibly MS. I had a lumbar puncture and it revealed absolutely nothing. No white blood cells either so no sign of infection. My only symptom is a chronic headache that I have had daily for 6 months and also slight fullness/pulling in the muscles of my neck (front). I can't stand this headache any longer I'm so desperate for help. I am on nortriptilyn for it and it helped at first but now does nothing for me.
My questions are: does it sound like I have MS? Has anyone experienced headaches like this with MS? If not MS, what else could be causing these tiny lesions?

[scmommato3]

Hello, I just wanted to update that I had my appointment this morning (I had written the date wrong thank goodness for the reminder call). My lesions are so faint that the neurologist almost couldn't find them. She had to read the radiologist's report as to where they are. She said you almost have to "make believe" they are there to see them. She showed me on the screen and it just looked like tiny grey areas. And still she insisted there are only 3 tiny lesions opposed to 4. She also said they look more consistent to hypertension than MS and since my blood pressure is never high (it usually runs low actually) she is certain that they are from my chronic migraines. She wants to rescan in one year and in the meantime we are trying different medications to deal with the migraines. Thank you so much for your feedback while I waited for my appointment.

[aspen2]

That sounds like a great outcome!  Rescanning in a year is also very smart -- she'll keep an eye on you to make absolutely sure. Hopefully you can now get some help with the migraine.

[scmommato3]

I'm just wondering if your friend ever got control of her migraines? Thanks for your time.

[aspen2]

She was put on a migraine med and yes, it has worked well.  Perhaps your doctor could look for another option for you?

[scmommato3]

Thanks so much for the response. I'll update after my appointment Friday. Sure wish I could kick this headache!

[aspen2]

I've heard neurologists say repeatedly that headaches/migraine are not caused by ms.

I have a friend diagnosed with ms whose main symptom was headache, although she also had weakness.  Her neurologist says that the headache is separate from the ms.  Either way, the mri she had for headache ended up showing presence of lesions suggestive of ms.  Much more commonly, patients with headache show lesions that end up being caused by the headache/migraine history and not by something like ms.

Tiny lesions can be caused by other things such as vascular issues, smoking, migraine, lupus, Lyme and many other conditions; however your neurologist is being prudent in your case because of the presence of juxtacortical lesions (which CAN be caused by other things but are more common in ms).

It sounds like you are in great hands with this neurologist.  With tiny lesions and a negative LP it is unlikely you meet criteria for ms, and you very likely don't have it.  I hope this is the case!  If it does end up ms, how wonderful that it was caught accidentally, and so early, prior to you having severe disability. (I realize the headaches are quite disabling, but they should be manageable.)

Did the neurologist suggest you have an mri of your cspine as well as brain?  That way she could check for cord lesions, but as well spinal (vertebral) trouble that could be contributing to headaches.  As well, if ms is ruled out, a referral to a neurologist who specializes in headache and migraine would be helpful.

Keep us posted!