I am not a neurologist or a radiologist, or a doctor of any kind, so my opinion is worth exactly what you are paying for it. But with that said, let me mention a few things that stick out to me in that brief description versus what your doctor said to you.

First is that the word hyperintensities in the report is plural, which is a fancy word, but being plural, it means to me that you have more than one spot visible on the scan. Your doctor may have just been referring to the one around the ventircle horn, or may have misread the report. Or the radiologist may have misspoke and there is only one spot. But reading what was written indicates more than one...which becomes more important when you go read the McDonald Diagnostic Criteria for MS. The number of spots (or lesions as they are called) and their locations is very important for diagnostic purposes, which is why a neurologist will typically want to see the actual scans and not just the radiologists report.

The second thought is that the periventricular white matter is a very common place for such spots to show up in people with MS. My neurologist specifically called out the location of one of mine around the horns of the ventricle as being "typical" for MS type lesions. That is not to say that you have MS. Just that given that location of lesion, your symptoms, and your age, MS is one of the front-runners as far as possible diagnoses.

Third, the "unusual for age" comment is just radiologist speak for "it isn't something I would expect to see in somebody in this age group". As we age, there are certain types of changes to our brains that are visible to radiologists on MRI scans. They will typicaly discount certain things by saying "blah blah is seen in this part of the brain, typical for this age group". So when they are calling out something as being unusual for the age, they are just pointing out that it isn't one of the things they would expect to see.

Lastly, regarding the LP. Some people have an easy flawless experience with them, some don't. I had one attempt that was tremedously painful and unsuccessful, and the second attempt the following morning was easy and nearly painless. My recovery was a whole other story. But long story short, mine was negative. I still have a dx of MS based on other things. I have heard it said that the bands may only show up in the spinal fluid if you have an active lesion at the time of the test. That kind of lesion will also show up on an MRI with contrast.

My advice would be to get a referral from your PCP to a good neurologist first, bring all your test results and a CD with your MRI scan on it to them, and let them decide what to do next. My guess is that the first thing they will want is an MRI with contrast, then may send you for the LP based on the result. The neurologist can also tell you what the narrowing at the base of the cervical space is about and whether it has any bearing on your symptoms.

Hi TXBatman,
Thank you for your help. I did notice the report said "hyperintensities"...as in plural and also questioned if that meant more than one lesion. My doctor specifically said "one spot" but she could have been referring to one "area" instead of one lesion. I have wondered all the same things as you mentioned. There wasn't any reference to the size of the "hyperintensities", is that common?

I have also thought about the location issue, since reading more about MS lesions, it does seem to be a very common location.

It's weird because yesterday I felt good and just couldn't imagine having MS, but today I feel like a bus hit me. I'm so fatigued, even after double the caffeine as normal day. My thigh is twitchy, my stupid eyelid is droopy, and my mood sucks. Sorry I shouldn't be whiny.

I really do appreciate all the information. I'll have to start looking closer for gluten free. I don't really eat much dairy. Maybe once or twice a week, do you eliminate it completely?

I was wondering about sx, do they last a long time in the same spot. I mean for me it like a few minutes my arms hurts then it stops, then a few minutes my thigh twitches then stops, then it my hand, then back to my thigh. The longest single issue lasted a few hours but then stops. Is that normal?

Thanks again

Great post TXTBatman!!!

Elle - The spondylosis and stenosis could definitely cause some numbness and tingling in your arms. You asked about common reasons for lesions. I don't know the statistics but I know that things like a virus or migraine could cause lesions. If you're looking for something mild as the cause. But, the only way you are going to know is by seeing a good neurologist. I agree that you may not need a LP. Like I mentioned, I was dx without an LP.

Hang in there!!! We are all here to help you through this.

My PCP set up the neuro appointment, it's next week on thursday, going to try to put it out of mind (lol) until then.

I'm a little nervous as I have to be outside most of the day today. I haven't spent much time outside since the last time that I had so much trouble walking. It's suppose to be in the mid 80's and humid. It's a work thing that will have me outside for at least 5-6 hours. I've gained weight since last summer so don't dare wear shorts, instead I'll be melting in my jeans. Hope! Hope all goes ok.

Ice water, ice packs, and wearing thin breathable clothing all help. Stay in the shade if you can. Enjoy your event.

It can take a lot to get diagnosed sometimes. Not everyone is lucky and gets dx with just an MRI. I had the MRI and it had all the bells and whistles for MS, but doc still sent me off for spinal. It came back negative. Fast forward 20yrs later, I did another spinal and it came back positive, nice little O-bands you have in your spinal fluid with MS. Thing Im getting at is sometimes you have to do what you have to do to get that dx. I had gone thru every test there is out there for my initial dx 20yrs prior, but because I hadn't kept up with any neurologist over the years, that new neuro put me thru all the tests again like I was new to it, just to make sure. I hated doing it, but I did it. Better to know than not. Good luck to you, and we're all here for you!

It turn out fine. We had rain at first that kept us indoors for a while and although I did get warm later into the night, I was never super hot or in direct sun. I felt ok. I was careful going up & down wet stairs after the rain, but no problems. Maybe I was just busy and distracted, but didn't seem to have any trouble. I was so happy!! and it was a very long night.