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What things can hyperintensities on the MRI indicate?

This was on my MRI report:

"Stable minimal nonenhancing periventricular white matter FLAIR hyperintensities in the right frontal periventricular region and adjacent centrum semiovale as well as in the bilateral posterior centrum semiovale."

I am in my thirties. I had an MRI at the ER because of one-sided muscle weakness. After I had it done I was only told that it was "fine" and sent home. I had and continue to have symptoms of one-sided muscle weakness/heaviness with tremor and lack of coordination along with buzzing/vibrating on the same side all of which worsen in heat. Interferes with my mobility when it gets bad. No explanation, going on for several weeks now. In the cold most of the symptoms get better and some go away. Symptoms seem to be getting better as time goes on but are still here.

Based on the MRI, could this be MS or do I need to keep looking for answers? I am seeing a neurologist but it will be weeks from now.
2 Responses
987762 tn?1331027953
COMMUNITY LEADER
Hi and welcome to our MS community,

Q: "Based on the MRI, could this be MS or do I need to keep looking for answers?"
A: the type of information from your brain MRI is not specifically suggestive or consistent towards anything, which basically means it's 'non specific' which wouldn't put a neurological condition like MS at the top of your causation list BUT nor does your 'brain' MRI completely rule out MS either!  

Unilateral muscle weakness is a neurological abnormal clinical sign that indicates a nervous system malfunction  but not which specific causation and the cause might be with the spine and not brain so IF you haven't as yet had a spinal MRI, as well as blood, peripheral nerve tests etc etc it is far to early in your diagnostic work up to point towards or away from anything yet.

In regards to symptoms worsening in the heat and remitting in the cold, which IF it is similar as the heat intolerance associated with MS, keep in mind MS is not the only cause and you still need to factor in the possibility of inadvertently overlooking the simple things eg like your hydration levels, sleep quality, how physically active you are/were etc if it's only during exposure to hot sunny weather or any type of heat ie, cooking, baths, showers, exercising, menstrual cycle, intercourse, drying your hair, electric blankets, partners body heat, infections and fevers etc etc etc  

Sometimes when symptoms seem to get worse in heat and remit in cold, heat gets focused on as what makes it worse but we totally miss all the other behavioural factors which could also be causing symptoms to get worse and then remit with cold temperatures....

eg it's a very hot summer, too many hot days and nights in a row and being out in the heat is taking it's toll on everyone but regardless of the weather you still have to work a full day getting the new stock sorted, pick up the kids from school and daycare, pick up the groceries and get everyone home in time for dinner before you can finally get off your feet and out of the heat. You've been sweating and running on empty all day focused on everyone else's needs but not your own and your body is playing up because of the heat and it won't stop until you cool down in the air-conditioning.....the muscle fatigue symptom's getting worse in this senario is less likely due to heat intolerance and more likely because of the amount of physical activity is too much, and the symptoms are remitting in the cold due to resting those fatigued muscles so in this case thinking the worsening in the heat and remitting in the cold would be overlooking all the other possible factors. (hope that wasn't too wishy washy an example and it made some sense)  

You've only got a few weeks before you'll see the neurologist and you'll likely need further tests before you get any idea what could be causing this, try to keep an open mind it just might not be a neurological condition at all and it will likely take a bit of time to work it out.

Hope that helps..........JJ
  

1 Comments
Thank you. That was very helpful. Sorry this is long but I need to vent. I am really frustrated.

I have actually done a few experiments on myself and it mostly happens when I am hot. Hot showers and heat from outside cause it as well. It can start to make it hard to use my arm and leg within a few minutes. I had it happen in a hot parking garage as I was walking around trying to find the exit. By the time I got out I had severe difficulty with walking. It also happened on a hot day in the parking lot as I was loading my vehicle. I had to be outside several minutes and I got very hot. If I exercise in the AC with ice water and breaks I am usually ok. I actually am in good physical condition otherwise as I work out a lot and take good care of myself.

I am a pretty analytical type of person and I have ruled out all of the simple things through experimentation. Vitamin deficiency, hydration, lack of food, medications etc.  When this started I just assumed it was benign and something simple, so I just tried different things to see if it would help.

I have had blood testing and I am not diabetic or prediabetic, I have no problems with thyroid or vitamin deficiencies nor problems with blood count. I was previously diagnosed with an autoimmune disease so I have had many tests that get repeated often. The disease I was diagnosed with cannot cause any of these symptoms.

The symptoms are from my leg to my lower face on one side. Some symptoms in the other arm and leg but they are minor. I also have a tremor that causes my head to move up and down when I sit, if I am hot. I think my neck must be spasming when this happens. I have had blood tests. I haven't had recent nerve tests but previously I was diagnosed with small fiber neuropathy causing autonomic dysfunction.

This all started maybe 8 weeks ago. I had had muscle stiffness without pain that caused me to limp sometimes and have trouble with stairs and my arm was often numb on one side for the past several months on and off. However I just ignored it and assumed it was caused by my other disease. I just want to know what is happening so I can move on with my life.

987762 tn?1331027953
COMMUNITY LEADER
Unfortunately it's not uncommon to be diagnosed with more than one autoimmune condition, symptoms often overlap which makes it harder to diagnose and treat accurately, there are a few MS mimics that i am aware of that are connected with Small Fiber Neuropathy Dysfunction (with autonomic) eg Celiac, Lupus, Sjögren and Sarcoidosis but i don't know much about them sorry and there are most likely more than i'm aware of.

Lupus is said to be the greatest mimic and it can be very hard to dx too because the blood work doesn't always pick it up so off the top of my head symptom wise that could be another direction to get looked into with a specialist.

I don't want to give you too much and send you down the garden path so to speak but structural and spinal cord related conditions would have to be included in your potential causes. I would suspect that if you've only been dx with Small Fiber Neuropathy Dysfunction (with autonomic) there is definitely more to it and it's only one component of what it is you're dealing with.

I know it's frustrating not knowing and not treating but if you can try not to let it get too ingrained, the answers typical do get discovered but sometime we just don't have a label that matches everything, so stay strong, stay positive and don't be a stranger!

Let us know how you get on.......JJ
1 Comments
Thank you for taking the time to respond. I have seen my rheumatologist who suspects either Sjogren's or lupus, but she is waiting for me to see the neurologist to see what they think. She has ordered more blood testing. Right now it seems that she believes there is something going on with my brain and possibly peripheral nervous system based on the MRI, and that it's probably autoimmune in nature. But a neurologist will have to see me, and I don't have that much faith in doctors anymore. I have already lined up an appointment with a second one just to have another opinion.

I believe my symptoms are beginning to subside, but it could also be the change in weather. It is much less hot than it was before. I still have tremor and stiffness in the heat, but not so much the limb heaviness/weakness and lack of coordination. I don't know if this is because I simply am just not getting as hot or if whatever disease I have is less active.
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