[tcl16]

Hey,
I am new here... I am 25f and have just received my results from my mri, but I dont understand what they mean. I was hoping someone could please clarify - or shed any light on them at all for that matter.

My last neuro appt I was told it was either ms or complex migraines and an mri would clear it up. When I spoke to the nurse today and she told me my results she said that they said 'query demyelination' I asked for a copy of the results and this is what they say:

Findings:

Brain:
A 9 mm focus of increased T2 and FLAIR signal is present in the posterior 50% of the right cerebral peduncle. There is no obvious mass-effect.
No other abnormal intra or extra-axial signal focus seen. The ventricles are normal shape and size. The major intracerebral vessels demonstrate normal signal void.

No areas of restricted diffusion seen

Cervical spine:
The cervical cord is of normal size and signal.
Cervical discs are satisfactor.
No disc herniation or nerve root entrapment identified.
Bone marrow signal is within normal limits.

Comment: 9 mm high T2 signal focus right cerebral peduncle. No other areas of signal abnormality can be seen.
Although it may represent a focus of demyelination other causes cannot be completely excluded.

Any insight at all would be much appreciated as my neuro appt is over a month away and I'm quite stressed!
Let me know if any more info is needed.
Thanks

[Dejibo]

first, breathe. Just breathe. it all sounds scary and its so frustrating and terrifying. It sound like you have ONE lesion on your MRI in your brain. that your spine is clear. MOST neurologists like to see at least 9 or 10 lesions before they start down the MS road, or that ONE lesion with other symptoms such as neuropathy, migraines, optic neuritis, a habit of falling into and out of neurologic symptoms.

As I tell alot of folks here there are more than 100 diseases that can mimic MS including the scary brain lesions. From lyme to lupus, and even drug abuse can cause lesions on the brain. What normally happens is the MD looks at the 100 things, and takes those that can be easily ruled out like B12 or Vit D def, and corrects that. Looks at your markers for lyme, lupus and other inflammatory conditions. Looks at your medication history. Looks at another MRI several months down the road to see if anything has changed. By the time the MD is left with a handful of say 10 items, he will be pegging the one that is "most likely" to fit YOUR MRI and YOUR Symptoms, and YOUR history. As many of us know MS is like fingerprints we are all different, and experience MS differently. Some of us get Optic issues. Some of us drag a leg. Some of us get numb burning feet or mouths. Its really rare for two of us to stand side by side and be a match. Even normal routine headaches can cause a lesion or two in our heads. a bump on the head, or even being exposed to certain toxins.

So, breathe deeply. Let your MD finish the study. One MRI does not a diagnosis make 99% of the time. You will need blood tests and neuro exams, and follow ups with your regular MD. So, hang in there, wait to hear from the neuro and hear his opinion on what he found.

Good luck and please let us know each step as you pass thru it. We are here to cheerlead you, comfort you or just be a willing ear to listen.

[SallyC]

Hi tcl, welcome to NeuroTalk. I'm so sorry for the pain that brought you here, but glad you found us.

It sounds like MS is suspected, but not concrete. Hopefully your Doc is trying to eliminate the other possible causes. It takes awhile for a deffinate DX, so hang in there and hang with us.

[tcl16]

Thanks so much for your replies! It means a lot!

That is kinda what I thought.... Do you think that one lesion combined with two 'episodes' would be enough for a diagnosis - cos the name implies MULTIPLE lesions....
symptoms (briefly): two 'episodes' of migranious headaches for a period of time then progressive numbness through one side of my body (esp hand/arm). As well as some visual symptoms - halo effect around black on white writing, eyesight deteriorating (that returned) and lack of clarity in thinking, as well as much more.

Thank you once again for your support,
Am going out to buy B12 today

[TXBatman]

Hi tcl16 and welcome to NT. As the others have said, don't panic. I am not a neuro or a radiologist, but I can help maybe work out a little bit of what can be taken from those results. We have all experienced what you are going through...looking at the results and trying to figure out what they mean. Just keep in mind that, as Dejibo said, an MS dx is often a process of elimination. So don't necessarily expect to go into your neuro appt. and have them give you any kind of a dx with absolute certainty based on these results alone. It may take quite some time to figure out exactly what ails you, and getting excitable or worried won't make it happen any quicker.

So you are doing the right thing in trying to educate yourself so you know what questions to ask the doctors, but don't go in with an opinion already formed. Listen to them...they are experts and you are paying them good money for their opinion. The rest of us are giving ours free of charge, and sometimes you do get what you pay for. With that said, here is my non-professional opinion of what you can get from those results.

The phrase "A 9 mm focus of increased T2 and FLAIR signal is present" simply means there is a bright spot on two of the different MRI scan types. Determining what that bright spot really represents is the million dollar question. Bright spots can represent areas where nerves have been stripped of their protective myelin sheath (Demylination) or they can represent other things like masses, blood flow abnormalities, etc. The type of scan it shows up on or whether it gets bright when they inject contrast into your veins can help the docs understand what the spot represents. I am not smart enough to walk you through that one.

The phrase "There is no obvious mass-effect." I believe is an indication that the radiologist doesn't see in the signal an indication of an abnormal mass of tissue such as a tumor. He doesn't say it isn't a mass...but if a mass is present to cause the signal, it isn't obvious on the MRI.

The discussion of the intracerebral vessels refers to blood vessels and just indicates no evidence of blockages or things like strokes. Finally, the conclusion "Although it may represent a focus of demyelination other causes cannot be completely excluded." gives a general direction for the neurologist to look. Demyelination is when some process is damaging the myelin that protects the bundles of nerves that make up most of our brain tissue. MS is just one of many diseases that can cause demyelination, and it is up to your neurologist to look at the rest of your blood work, symptoms, etc. and determine which of them is most likely. He may have already narrowed it down to a few things, but just because MS and migraines were the two he mentioned, don't jump to any conclusions until you actually see him.

As Dejibo said, they typically won't give an MS diagnosis with just one spot on an MRI, unless you also have a history of clinical symptoms and other test results such as spinal tap results that point towards MS. Do a search for "Multiple Sclerosis Diagnostic Criteria" and it will help you understand what the neuro will be looking for before giving any kind of dx. I wasn't aware of the diagnostic criteria when I first saw the neurologist after getting an abnormal MRI. I walked out of my first appt completely misunderstanding what she told me, and was quite shocked when she told me I did have MS two years later. Had I read the criteria first, I would have better understood what she was saying when she said I had too few lesions in the wrong places to get a dx that day.

Good luck and again, welcome to NT. Keep asking questions...we all have been where you are and understand the confusion and fear involved.

[tcl16]

Thank you all so much for your replies!
Will update when I've had neuro appt.

[Lady]

Hi tcl16,
Welcome! It's kind of scary having symptoms and not know what is causing them. We all want a name to our problem. But, that takes time, like most people have already mentioned that fact to you. "Wait and See" is the hardest part.

Some wait for weeks, others for years. You have to try to forget the worry until you have cause to worry. It might be just migraine headaches with aura. Or it might be one of the 150 or more neurological problems/disorders that it out there. Some are minor. I hope your problem turns out to be minor.

Let us know if you have any more tests, or questions, and then when you see you Neuro what he says about his findings. Nice to meet you.

[tcl16]

Hey everyone,
Thanks for all your replies. You're all incredibly supportive!
I just thought I'd let you know how the neuro appt went. Basically nothing came of it, I have to have another MRI in 3 months to check on what is there. She said that they can't rule out MS (Although she was hopeful it wasnt) but can't confirm it at this stage either.
I have had some blood tests done which may shed some light on the situation, will let you all know if anything comes of it.
Thanks again

[EddieF]

Welcome. My 1st mri after losing feeling in face one morning in 2006 was followed by a Spinal Tap which showed a very high (30x normal level) of MBP? I forget which pretty much confirmed MS. However - spinal tap could come back clean & still have MS.

Get your MRI on cd (free if you give a dr's name) and start studing. My avatar is me made by me. If cd comes with the cool/easy to use program for compiling slices into 3d model, I can teach how. Depends on facility cause I was catscanned in NY 3 weeks ago & the software is horrible compared to this little town in Florida go figure

[tcl16]

Hey all,
I just got off the phone with the nurse who said to me I have MS based on my ANA results:

ANA: Positive, Titre = 320
Pattern: Nucleolar
Comment: Associated with SLE and Progressive Systemic Sclerosis

I wasn't aware that ANA could be used in diagnosing MS, could anyone please shed some light on these results for me. I was under the impression my neuro was trying to rule out Lupus as I have a family history of it.

Kind Regards