MRI Results

[Skye76]

Hello - I am a 31 year old female who just had an MRI. The results came back as follows:

Scattered subcortical punctate foci of T2 signal hyperintensity are seen within the cerebral hemispheres bilaterally, greater on the right, best seen on the sagittal FLAIR sequence. No abnormal enhancement is seen. The corpus callusum, brainstem and cerebellar peduncles appear unremarkable. No abnormal enhancement is seen. No extra-axial signal abnormality is seen.

Impression - A few scattered nonspecific white matter changes filling none of the McDonald criteria for multiple sclerosis.

When my GP read the first part, she immediately said "MS." She then said my symptoms do not really seem like MS. Do these findings point to MS? Why would the radiologist say it fits none of the criteria? I'm confused and concerned. Thanks for any advice you can give.

[art104]

My 60 year old husband began seeing white dots peripherally  two days ago.  Although
originally located outside left in his line of vision, the circles or dots have now shifted to
outside right.   He had a thorough eye exam a month ago and aside from a change is prescription,all seemed fine.  Back in the mid 70's, he had a flu shot that resulted in 6
months of partial paralysis in both legs.  He  self diagnosed it as Gillian Barre  Syndrome but it was never professionally resolved.  He also has episodes of heavy coughing followed by what he describes as throat closure and an inability to catch his breath.  I also notice that he has body tremors while sleeping.  His breathing is irregular while sleeping.
We have made an appointment with a neurologist through our family physician but  must wait an additional 2 weeks to see him. Meantime, the symptoms are not subsiding.

What could this ailment be?  Thank you for your assistance.    

[art104]

My 60 year old husband began seeing white dots peripherally  two days ago.  Although
originally located outside left in his line of vision, the circles or dots have now shifted to
outside right.   He had a thorough eye exam a month ago and aside from a change is prescription,all seemed fine.  Back in the mid 70's, he had a flu shot that resulted in 6
months of partial paralysis in both legs.  He  self diagnosed it as Gillian Barre  Syndrome but it was never professionally resolved.  He also has episodes of heavy coughing followed by what he describes as throat closure and an inability to catch his breath.  I also notice that he has body tremors while sleeping.  His breathing is irregular while sleeping.
We have made an appointment with a neurologist through our family physician but  must wait an additional 2 weeks to see him. Meantime, the symptoms are not subsiding.

What could this ailment be?  Thank you for your assistance.    

[Skye76]

Thanks so much for the response. This is such a wonderful service you provide! I was initially experiencing pressure in the back of my head and hand tingling after a very stressful event. The pressure went away after about a week and I was left with tingling in the hands and feet. After a couple weeks, this went away and I now have acute pain in my back, hands, forearm and feet. A cervical spine MRI revealed a herniated disk and foraminal neural stenosis. However, my neurosurgeon wanted to rule out MS and also look into Chiari. Thanks again for the time you took in generating a response!

[CCFNeuroMD JT, MD]

Dear Skye76-

Thank you very much for your question. I am happy to address the issues that you pose, although it is important that you recognize that my impression is based entirely on the information you have provided in your posting and is by no means a replacement for an office visit with a neurologist.  Diagnosis is contingent on detailed history and physical exam and as such, the following information should be considered solely for educational purposes.

Obviously, it will be difficult for me to comment with certainty on your MRI as I have not had the chance to review them for myself.  However, given the distribution of the white matter lesions you describe in your posting and your apparent lack of symptoms, it seems less likely that these lesions represent multiple sclerosis.  I would need more details regarding your symptoms as well as a physical exam to be able to interpret these findings in context.

Unfortunately, I am not clear on the reason the MRI was done in the first place.  Do you experience migraines/headaches?  Sometimes, patients with migraine headaches can develop white matter abnormalities as you described above.

At any rate, if you feel as though your GP has not adequately addressed your concerns, you might consider consulting with a neurologist who may be able to sort out your history and provide you with more information.  If you do choose to do so, I recommend you bring the actual films (not just the MRI report) with you to the appointment for the neurologist to review.

I wish you the best of luck!

Sincerely,
JBT, MD