mri diagnosis

[sooty]

my father aged 77 has had detiorating ill health for 7 years. Initially suffered skin lesions on backs of hands and ear lobes and rash across face.  Increasing attacks of comlete exhaustion, pain on either side of chest,rash thought to be vasculitis on legs. Has had numerous tests. No blood test has proved positive for lupus. Heart fairly okay. On medication for low blood pressure. Suffers night sweats and will sometimes throw himself out of bed. Now experiemcing attacks of pins and needles and numbness on either side of the body, unable to walk straight, balance poor, attacks come and go.Brain CT normal as was scan of neck artery,  MRI shows extensive patchy high signal in the periventricular deep white matter bilaterally consistent with small vessel ischaemia, marked atrophy of the hippocampi, widening of gyral spaces in relation to sylvian fissure and dilatation of the ventricles.  Consultant states caused by mini strokes,but as CT was clear could this damage be caused by lupus. My father had TB in youth but otherwise health was good until these problems began 7 years ago. X ray of hands show changes the same as in R.A. but again bloods negative.  We are desperate for some help and to know what questions we should ask.  Currently awaiting an EEG

[yeyekari]

Have your father been checked for shingles, after many year's shingle is the result from chicken pox.

[CCF-Neuro-M.D.-CS]

Based on what you reported on the MRI it is shows a shrinkage of the brain tissue and abnormal signal deep within the brain. Chronic small vessel ischemia means that the small arteries of the brain have slowed become closed, and damaged the brain. This would not be typical findings for lupus. These changes can be seen in patients with diabetes and hypertension. Things to ask your doctor about include could these be normal pressure hydrocephalus. It typically involves loss of cognitive function, balance problems, and urine incontinence. Other disorders include dementia, CNS vasculitis,  structural problems in the cervical spine, and abnormalities within the basilar artery (artery which travels up the back of the brain). I think the EEG is reasonable. Without having the opportunity to examine him, I can not be more specific.