Some Help Please!!!

[OSS55]

Can someone explaine to me what Deep Whhite Matter Lesions are with demyelinating and axonal features mean?  I was diagnosed with predominent (primary) sensory polyneuropathy.
Thanks.

[OSS55]

Thank you for your response.  I was dx'd with probable MS in 1994.  I do have all the clinical symptomology for MS.  When my Nerve Conduction Test showed snesory neuropathy, my Neurologist only went with a dx of Sensory Neuropathy.  Yet my repeated MRI's and now a CT all report MS.  What am I to believe???  Can I have both?

Blessings

[Abhijeet Deshmukh, MD]

Hi.

The CT scan suggests that you have some lesions in the white matter. This itself is not to be considered as suggestive of MS. Even though the report mentions MS, please discuss this with your Neurologist. The clinical symptoms and the CT picture should correlate. And more importantly, an MRI would clarify things.

Do not worry about the details of the report.

Regards

[OSS55]

My CT Report reads as follows:  (I hope you can sort it out for me):
CT HEAD W/OUT CM   Comparison: 05/04/06  MRI  with and w/out CM

Scattered low densities are seen within the centrum semiovale and deep white matter tracts, consistent with patient's history of MS.  There does appear to be interval progression involving the left deep parietal white matter along the anterior limb of the internal capsule and the subinsular region.  No acute hemorrhage identified.  The visualized sinuses are clear.

SUMMARY
10  Scattered foci of abnormal attenuation in the centrum semiovale and deep white matter tracts, progressive in deep left parietal region.  Given the extensive changes, an MRI would be helpful for further characterization.
2)  No acute hemorrhage identified.

What does all this mean?  Your assistance is greatly appreciated!!!

Blessings

[Abhijeet Deshmukh, MD]

Hello.

The progressive worsening symptoms may not be necessarily of MS. The neuropathy can also worsen, if not treated adequately.

Please keep me posted about your CT scan report.

regards

[OSS55]

Thank you for your response regarding my lesions.  I was initially diagnosed with MS in 1994.  MRI then did not show any lesions, so dx was "probable" MS. In 2004 MRI showed 5 deep white matter lesions; they did not enhance.  Dr. Rifaat Bashir at Creighton University Medical Center said he did not think I had MS, asked if I had had TIA's possibly.  My symptoms do mimic MS, and have got progressively worse over the years.  I just had a CT of my head, but do not know the results of this yet.  I also have moderate lumbar spondylositis.

[Abhijeet Deshmukh, MD]

Hello.

Do you want to say polyneuropathy with demyelinating and axonal features ?

White matter is the name give to the collection of axons (tail like long projections of nerve cells). The axons are covered with a protective "myelin" sheath. If this myelin is destroyed, we call it demyelination.

Demyelination can be found in MS, infections, autoimmune diseases, etc.

I can not comment upon the deep white matter lesions. Some lesions are normal at the age of 50. They may not be clinically significant in your case.

Regards