My follow up 2 yr MRI Brain and Spine

[Melb_83]

Hi guys,

Happy New Year!!!

All the best in 2015

I recently had a follow up MRI because some of my previous symptoms resurfaced. They were particularly the same symptoms i.e hands burning feet burning simultaneously on both sides.

I don't get to see my Neuro till the 19th but I managed to get a copy of the MRI report. I will copy and paste the findings to see if you guys can help me interpret what these findings mean.

FINDINGS:

Brain:
There are two areas of T2 increase signal in the posterior frontal
lobes bilaterally, each measuring approximately 3 mm in size.
Findings are non-specific. Another hyperintense focus seen on the
fluid sensitive sequence on external images in the posterior left
frontal lobe (image 15 series 3) is not seen on today's study.
There is no restricted diffusion or post contrast enhancement. The
remaining grey-white matter differentiation is preserved;
specifically there is no septo-callosal, subcortical U fibres or
brachium pontis areas of increase signal.

No cerebral oedema or midline shift. No ventriculo-sulcal
disproportion. The basal cisterns are patent. No hydrocephalus.

There is normal flow void within the intracranial vessels.

The midline structures and posterior fossa structures are normal.
The visualised orbits and optic nerve are normal.
The mastoid air cells and paranasal sinuses are normally
pneumatised.
Cervical and Thoracic spine:

Normal alignment of the cervical thoracic spine. There is no antero
or retrolisthesis. Vertebral body heights and intevertebral disk
space are relatively preserved.

The cervical and thoracic cord demonstrates normal signal
characteristics throughout. No evidence of focal cord lesion.

Multilevel disk bulge of the cervical and thoracic spine, please
refer to report below

CONCLUSION:
-Nonspecific T2 hyperintense foci in the posterior frontal lobe are
thought to be within normal limits.
-No demyelinating lesions in the supratentorial compartment,
posterior fossa or spinal cord.
- Multilevel disk bulge as described above, marked at right C4-5,
C5- 6 and left C6-7 with minor changes at the thoracic levels, all
are unchange compared to previous imaging from 14/06/2012.

[Melb_83]

thanks guys.

A friend that has MS that I just found out about went to Russia for HSCT. I will let you know how he went he has a review in 3 months with his neuro.

He has RRMS for 8 years before diagnosis.

[kwarendorf]

Great news re: Not having MS :-)

Kyle

[karryon55]

Hey Melb,

That all sounds like good news to me. I'm really glad it went well for you and to hear you sounding happier within yourself. It's always great news to hear that your brain is looking pretty good which I'm sure many here would be envious of lol.

Please remember you are not nuts as you have stated in one of your latter paragraphs. You have been very worried about what is causing your symptoms & I actually think you have shown great courage in writing what you have to help others. Sometimes stress and worry can just get away from us and we can lose perspective.

I really wish you good luck with your upcoming marriage, health and life in general.

Take Care,

Karry.

[Melb_83]

Update:

Just got back from the Neurologists whose specialty is MS.

We discussed in detail the report findings re: abnormal spots signals foci the works.

In my case he believes after comparison and analysis that these are benign spots and that they are related to past activities such as smoking, head trauma migraines.

We spoke numerous times about my symptoms to which and I quote "the scans do not indicate MS or any form of disease".

I have to admit, I now feel relieved about everything. The symptoms are still there but, they are not related to anything from my scans. So he cant see anything that is wrong.

Now, the peripheral neuropathy small fibre neuropathy part, again there was no evidence of anything pointing as to why i have this problem.

I asked what treatments are available, he didn't like the idea of going on Lyirca or any from of pills as he said sensory symptoms are not considered life changing and in your specific case they come and go.

Observation was the word he used.

So his advice was to monitor my disc herniations yearly by way of MRI scan.

Another possibility could be that the pins and needles would be coming from my cervical spine and Tarsal tunnel syndrome.

In regards to the feet (Tarsal Tunnel)he said surgery should be considered when the problem worsens and that's if it does.

Quite funny though he was very optimistic about my scan. He said "your scan looks very good".

Either way my situation is unique to me and I hope what I am writing here helps someone who like me suffers from anxiety, hyperchondria and stress.

I am not saying your nuts like me, but, chill out from time to time no matter what.

This is my 2015 resolution to chill out and smile again about what is good and not what can possibly go bad and yes I will seek professional help to do so.  This stress has been a conditioned thought process from young, so it will take me a while to address and take it on.

Good luck to everybody and good health to everybody, I will still be around.

Look forward to your feedback  : )

[Melb_83]

Thanks Karry,

I hope your right.

I will have news  after I meet with Neuro later this month.

Thank you for your responses,

Have a great week : )

[karryon55]

I believe your symptoms are real and there is something wrong but I also think you need to consider that you are overly worried about some spots on an MRI that you have been told by docs are not causing your symptoms. As I said before you have the abnormal NCS which would be suggesting some sort of peripheral neuropathy which in about 30% of cases they don't find the actual cause. That is something you should be sorting with your doctors and if you want to go on treatment then you must ask your GP as these drugs are available on general scripts.

I'm not sure if you realise how much anxiety can make underlying symptoms worse. It does with my sypmtoms & I have had such a stressful time with my parents being sick as well as many other things. I had to learn how to channel the stress in my life so it was not continuously making making my underlying RA & MS worse.

I think you started off with a symptom but with that came a health anxiety that has knocked the underlying problem out of the ballpark. If you could not be constantly worrying about your health which you have said you do a few times now, you would probably allow your body to settle enough to see what the original symptom was like.

I'm not sure that anyone can reassure you anymore about the spots in your frontal lobe as you have already been told by Neurologists that these are not to be concerned about already.

Good Luck & Take Care,
Karry.

[Melb_83]

I think your right but my gut tells me something is wrong.

I just hope that this doesn't turn out to be anything more than the spots on the MRI scan.

Either way we will find out very shortly as I will keep you guys poster.

I hope that it's all in mum head and those spots don't amount to anything.

[karryon55]

Hi Melb,

The radiologist can only speculate on an MRI and state what they see and where they see it. It all comes down to what your Neuro is picking up from their physical exam & as yours has said there are no abnormalities in your clinical exam he sees no concern for neuroloical causation.

I think sometimes excepting you have a problem with anxiety and depression is your first step to feeling better. What you need to do now is go to your GP and talk to them about the possibility of going on an antidepressant. I did this earlier last year and I am so glad that I did because things are so much easier to handle when you feel more like your old self.

It can take over your life and makes things that we could normally manage quite well seem like a mountain in front of us. I also see a counsellor which enables me to vent and to see things from a different perspective because sometimes something is staring me in the face but I just couldn't see it. I think the hardest thing with any sort of mental illness is the stigma attached to it (in this day and age I find this amazing) and getting past worrying what other people may think or say to you. :-(  Many people are quick to judge but many have been lucky enough to have not felt this way. It's not about being strong or any of that cr@p that people may say to you.

Please speak to someone like your GP about how you're feeling because there is so much out there to help you. When you start to feel better you will see things clearer and enjoy your life more like you should be. In the meantime try to not focus on what you're feeling in your arms and legs but divert your thoughts to something you really enjoy (ie Music) or try some meditation to stop things taking over.

If after you've saught treatment & couselling you are feeling no better then you must go back to your GP for further advice. Hang in there & with time will come change.

Take Care,

Karry.

[Melb_83]

Hi Karry,

You are right about my health anxiety. I have seen my neuro prior to this MRI and he has seen all the reports and had suggested the follow up MRI.

The burning sensations in hands feet knees etc he said was idiopathic. My Dr has done a complete bloodwork for ANA's and all relevant screens b12 etc all were normal. My b12 was elevated which he said not to worry about.

So unfortunately in my case they can't explain the cause for these symptoms.

I asked for meds and the Neuro said that they have side effects and did not want me start.

I think that I am borderline depressed from this health anxiety. I just don't know anymore.

You would think that from my MRI report if the spots were related to MS that the radiologist would mention it.

thanks again for your time.  

[karryon55]

I actually thought the radiologist has suggested that you had a lesion on previos MRI which is not found now from what you've written above. I honestly have to say that if you have abnormalities in a NCS which means it's your peripheral nervous system not your CNS like in MS.

After reading what you've written above about getting married etc I think you are jumping the gun a tad. I'm not sure why you would be thinking MS let alone PPMS. You have no diagnostic evidence on MRI to suggest that & I don't think your neurologist thinks MS either from what I've read. I am not sure who or what suggested MS to you originally.  It is not unusual to have some foci on an MRI in the frontal lobe moreso after your history of smoking & drugs.

This area of the brain would not be causing you to have sensations in all of your extremeties. You already have an abnormal NCS which points away from MS so I'm not sure how all this got you thinking what you are thinking. A person with PPMS will live their life to the fullest as well & just because they may have been given that label does not mean they commit themselves to a life of misery which seems to be your thinking.

Reading between the lines to a layperson who has not studied medicine I see a person who is very anxious with a possible health anxiety. You seem to be worrying about things that are probably never going to happen to you & whilst doing this probably causing your original symptoms to get out of hand. As I've said I'm not a doctor rather a person living with RA and MS so please speak to your Neuro or GP about all of this. You have an abnormal NCS so I would be more concerned about what is causing this in your PNS.

Just say you were dx tomorrow with PPMS what do you think is going to happen to you? Do you think your going to become disabled rapidly and be in a wheelchair within a few years? I get the feeling this is what you believe and you are becoming so caught up in this type of thinking that you are unable to get on with your life that is in front of you right now. I honestly would never have thought PPMS with your symptoms, MRI & NCS but I'm sure the Neuro will have a chat with you about this.

I just hope you can get some answers as to why you have an abnormal NCS & in the meantime to go on a drug that can help you manage this better. I hate to think of you spending so much time worrying about things that may never happen because life is just too short.

Take Care,
Karry.

[Melb_83]

Correction I mean to say could it possibly be primary progressive ms

[Melb_83]

Hi Karry,

My biggest concern is, it is possibly awkward be a primary progressive MS. I have had previous MRIs and one nerve conduction study that did find some damage in my legs in regards to sensory issues. Also I do have multiple disc protrusion is as stated in the report.

Is the fact that on this current study it shows  02 hyperintensities pose any significance whatsoever.

From a life perspective point of view I have just gotten engage to be married and having this over my head changes the course of my life decisions. I continually think about this all day at the moment and Worry.

Should the hyperintensity that he found in the previous study have become an ms plaque  to show traces of a MS considering that that MRI was done two years prior.

At the moment I just feel lost I really can't explain it any other way.
I really do appreciate your feedback.

[karryon55]

Have you had any NCS/Nerve Conduction Studies or similar done?

Do you suffer from anything like Migraine (even without a headache)?

The frontal lobe is not an area that is part of the criteria for MS but people with MS can have frontal lobe lesions as well. To be dx with MS they would be looking for Periventricular, Corpus Collasum, Juxtacortical, brain stem & spinal cord lesions so hopefully your Neurologist can advise you on these results.

If you have got symptoms coming from all of your limbs I would not have thought MS was the most unlikely cause of your symptoms. The Neuro will test for things like Celiacs, Vitamin deficiencies but also should check your peripheral nervous system if they haven't already. I am not a doctor rather a person living with MS but your MRI results and symptoms of both hands and feet burning do not make me think of MS.

See what your Neurologist has to say and let us know how you go.

Take Care,

Karry.

[Melb_83]

Hi Kyle,

Thank you for the response.

I guess my concern is that on my previous MRI there was a spot that was missed that this radiologist picked up.

So now to the obvious question, does the MRI scream out MS.

The only symptoms on and off have been burning forearms and feet no balance issues or vision changes.

I really don't know what else to think ?

[kwarendorf]

Hi Melb-

It doesn't sound like much has changed from 2 years ago. These reports are  notoriously convoluted. They can be pretty difficult for mere mortals to decipher.

The only hyper-intensities are the two in the posterior frontal lobes. The radiologist did not seem too concerned about them. Your neurologist should be able to help you maaake ense of the new MRI.

Kyle