MRI question

[Treeboa21]

Hi,

I had an MRI on 4/18/16 and it said:

FINDINGS: The cerebral volume is age appropriate. There are periventricular
white matter lesions adjacent to the margins of the lateral ventricles. This is
particularly notable adjacent to the posterior horn of the left lateral ventricle with a lesion measuring about 1 cm in length and showing subtle T1
cavitation (image 28, series 2, 3.) There are a few other periventricular
lesions and a few scattered deep white matter hyperintensities. There is a
subtle lesion within the body of the corpus callosum measuring about 1 mm (image 39, series 3.) There is the suggestion of a juxtacortical lesions within the right frontal lobe near the vertex. On the postcontrast images, there is no
abnormal enhancement within the parenchyma or leptomeninges.

Then I just had one on 4/7/17 and it said:
Perivascular spaces are noted at the level of the anterior commissure.  Mild increased T2-weighted White matter signal changes are noted in the periventricular distribution.  Some are oriented perpendicular to the ventricles.  Involvement of the callosal septal region is also seen.

My neuro just called yesterday and said it is now looking more like MS (as opposed to before) and wants me to have a VER within the week.  Can someone please tell me what would make it look more like it now compared to before? I have had a chronic headache in the back of my head everyday for 5 1/2 years, have floaters in my eyes and polyneuropathy in my legs. My lumbar puncture came back negative so he basically just said before there was no reason why I had the headaches or polyneuropathy. Now with these changes he thinks its looking more like MS.  I am just beyond frustrated as I have been dealing with this for 5 1/2 years now.  Can anyone please provide some insight?

Thanks!

[supermum_ms]

Hi and welcome to our little MS community,

Unfortunately your brain MRI's show diagnostic signs that are more typically associated with conditions like MS; T1 lesions (black holes), lesion in the corpus callosum (CC), perpendicular to the ventricles (Dawsons fingers), as well as additionally having 2 out of the 4 specific lesion locations needed to meet the MS Mcdonald diagnostic criteria, periventricular and juxtacortical, neurological conditions like MS would be very high on your list of potential causes.

LP's are not diagnostically exclusive for MS, 10-15% of pwMS don't actually have the 2+ Obands that is suggestive/consistent with MS, some pwMS can have elevated proteins as well as or without Obands....LP results are basically added to all your other diagnostic suggestive/consistent evidence but a negative LP is not suppose to exclude MS though we still hear of it happening...

Peripheral nerve conductor tests are usually negative with conditions like MS because MS is a condition of the central nervous system, though it can also effect the peripheral nervous system just not as commonly. IF your neurological clinical signs are abnormal and or symptoms are suggestive/consistent with nervous system damage like polyneuropathy but there isn't the typical evidence or medical condition to explain it, MS could be a potential explanation.

Floaters are not very specific to MS, MS definitely has a high percentage of visual issues eg Optic Neuritis, Nystagmus, Dyplopia or double vision etc but things like blotches, rings, floaters are not outside the norm for pwMS....the VER will be able to determine if there is any abnormality in your optic nerves, visual motor function etc

I would suggest you seriously consider getting an appointment with an MS specialising neurologist for a second opinion, MS specific neuro's are usually more up to date with all things related to MS and typically in an MSers best interest.

I hope that helps, and if you need any question answered please just ask, no question has ever been off limits here.....JJ  

[mineandours]

I have a suggestion, although I can't say for sure. I'm currently in the same boat as you are right now. Diagnosed with MS and on MS meds BUT rethinking my diagnosis because it just doesn't seem to fit, even tho I have an abnormal MRI. Do some Googling on Lyme disease (neurological) and its co-infections. Visit lymenet.org and see if anything fits other than MS. Good Luck.