Kamavi,

I am not a neurologist or a radiologist, so please take what I (or anybody else on the internet) have to say as being worth exactly what you paid me for it. With that said, here is one way to look at your MRI results. Yes, random spots can appear on MRIs with age. Just because they can appear and may be normal, does not mean they ARE normal in your case. In your case, you have some very non-specific symptoms that could be MS or could be something else entirely. Any doctor looking for the possibility of MS is going to use the McDonald diagnostic criteria. That criteria has specifics both in number and location of lesions appearing on an MRI as well as clinical symptoms and their distribution over time to consider before a doctor can give a diagnosis of MS.

In my case, I had total hearing loss in one ear that occurred one day while I was sitting at my desk and it lasted approximately 8 weeks. As part of looking for a cause for that, an MRI showed 2 lesions in the periventricular white matter. The periventricular white matter is a very common location for MS symptoms to show up, but it is not considered "diagnostic" by itself under the McDonald criteria, and the number of lesions I had also were not diagnostic alone, or with my one clinical episode of symptoms (hearing loss). So my neurologist explained to me that I didn't have enough lesions in the right places or enough symptoms for her to give me a diagnosis of MS.

I walked away from that appointment thinking that she thought I didn't have MS. I walked away thinking she had told me that the lesions I had were not in the right place or didn't look right to be MS. She also brought up the possibility of them simply being age related. So I went home thinking I didn't have MS and that we still had no idea why my hearing loss occurred. HOWEVER, she did ask me to keep track of any new or recurring symptoms that were out of the ordinary, and asked me to come back once a year for followup MRIs. Two years later, my 2nd followup MRI showed 5 more lesions, and she immediately said I now met the criteria (because of the number of lesions, including new ones separated by more than 6 months time) and she could give me a diagnosis of MS and start me on disease modifying meds.

So think carefully about the way the docs worded what they said to you. I mistakenly thought mine was telling me that she didn't think I had MS. But what she was really saying was that the number of lesions and my history of clinical symptoms didn't meet the McDonald Criteria. Your neuro may have meant the same thing in what they said to you. If you google the McDonald Diagnostic criteria for MS before your 2nd neuro opinion, and look into some of the websites showing "typical" locations for MRI lesions, you will have more information to use to ask better questions about what the doctor is telling you. If possible, get a copy of your MRI results on CD or DVD, and take them with you to the neuro appointment. Ask the neuro to show you the "hyperintensities" on the scan and discuss whether those locations are typical or atypical for MS.

Most of all, don't let whether you do or don't get a diagnosis right now discourage you. Spots on an MRI may be something or they may be nothing, and they are certainly not diagnostic of anything by themselves. So any diagnosis of what is causing your issues will be a process of elimination where they slowly rule out other causes over time. That is why the symptom log is important, and why additional followups (including possibly new MRIs) can be very important if you have new symptoms that could indicate different areas being affected by new lesions.

Keep checking in and letting us know how things are going and I hope you get some relief and some clarity about what is going on.