MRI results/symptom paresthesia

[twalshioni]

I experienced left sided parethesia in arm/shoulder/jaw and part of the work-up included CT which showed some "hypodensity" and an MRI was recommended.  MRI results were as follows:
IMPRESSION:                                                                    
1.  Nonspecific punctate hyperintense signal within the external                
capsule/subcortical bifrontal white matter suggesting nonspecific              
microangiopathy.                                                                
2.  Small choroid fissure cyst on the right.                                    
3.  Otherwise no acute intracranial pathology.                          

I have my first appointment with nuerology coming up.  What should I expect?  My symptoms have waxed and waned and included the right side and my legs.  No pain, no wekaness.   Thank you.

[twalshioni]

No DM, no hypoglycemia.  He did mention that it might be "the beginnings of something" and did mention MS, but did not recommend testing at this point.  He just wants me to keep a journal of my symptoms and wait for the results of carotid US and EEG.  Thank you so much.  This forum is a Godsend!

[Abhijeet Deshmukh, MD]

Hello.

The MRI findings can be permanent if infarction has occurred at the site. Your Neurologist is suspecting a blood circulation cause. You should do follow up MRI, may be after a few months, as per his advice. The microangiopathy may resolve, but the damage done by it remains permanent.

The vomiting of bulimia nervosa is different from that if an increased ICP. The former is a self induced vomiting, whereas the later is caused by the raised ICP and you can not have a control on it. Raised ICP is not the case with you.

The microangiopathy can have a number of causes, from infections to auto-immune diseases. Your Neurologist is in the best position to diagnose. Diabetes is a cause. Do you have your sugars normal ? Did you ever have any blood sugar problems ?

Regards

[twalshioni]

I am 45.  I saw the neurologist today and he is ordering carotid ultrasound and EEG.  He wants me to keep a journal of my symptoms while we wait for the results of the tests.  I have had recurrence of symptoms primarily with numbness in my left arm.  I had one episode where I had a warm sensation and numbness across my back/shoulders and numbness down both arms and then my right leg.  
Are the findings on the MRI (Nonspecific punctate hyperintense signal within the external capsule/subcortical bifrontal white matter suggesting nonspecific microangiopathy.) permanent, or do they sometimes resolve?  What ares some of the causes of such a finding?  Micro-emboli?  Increased ICP (such as with vomiting?  I have a remote history of bulemia.)
Thank you.

[Abhijeet Deshmukh, MD]

Hello.

The neurologist will be asking you about any other symptoms apart from the ones you mentioned here. Your blood pressure will be checked for hypertension.

The choroid fissure cyst is an accidental finding. It is not responsible for any symptoms.

The MRI findings will have to be correlated with the clinical examination and history. These findings might also be normal according to your age. Can you mention your age ?

Regards