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What does "white matter changes confluent in frontal parietal" mean? - Online Doctor Chats

Date : 02-Mar-2014
User rating for this question
Very Good Posted in: X-ray, Lab tests and Scans
Answered by

General & Family Physician
Practicing since : 2005
Answered : 2407 Questions
User:Hi. My name is XXXXXXX Had MRI done that showed diffuse white matter changes confluent in frontal parietal areas bilaterally. Leukoencephelopathy was mentioned. Bloodwork only revealed high antithyroid antibodies. MRI done 1 year later showed no changes. I am greatly concerned about the word leukoencephelopathy being mentioned. Currently suffer anxiety and depression. I am 35 years old.
Doctor:I am here to help you today
Doctor:Let me read your query for two minutes
Doctor:Ok Gone through it
Doctor:Now you should be happy that the repeat MRI had no changes
Doctor:Why was it concerning you
User:The word diffuse and the word leukoencephelopathy
Doctor:Ok but anti thyroid antibodies indicate some kind of autoimmune process in your body
User:Could hashimotos cause such white matter changes. It was high about 1000
Doctor:since they have probability of involving other systems the word diffuse
Doctor:What is 1000? Anti peroxide antiboides??
User:Antithyroid antibodies were
Doctor:So did they perform both Anti thyroglobulin antibodies and Antithyroid peroxidase?
Doctor:If both are high Hashimotos Encephalopathy should be considered
User:Just an antithyroid antibody screen
User:But I didn't have major symptoms for hashimotos encephelopathy
Doctor:Yeah that is important, do you have memory loss or sleepiness or
Doctor:Depression has to be immediately treated
Doctor:Depression is known to show certain changes in the MRI brain
Doctor:Ok what have the doctors done now
User:Even diffuse? To me diffuse means scattered and a lot
Doctor:it is scattered but may not be lot
Doctor:If it is a lot the radiologist shall mention extensive
User:Left it up to me to get an opinion somewg
User:Somewhere else
Doctor:I am positive because the follow up MRI is clear and was it done at the same centre with previous MRI in place
User:What about ms in those lobes?
Doctor:Did the previous radiologist attempt to see the previous one before opinion
User:Yes done at same place
User:Yes he did
Doctor:MS also cause white matter changes put the description would be (plaques)
Doctor:Please remember MS is still a clinical diagnosis
Doctor:and MRI is just to see the extent
User:I read something about that genetic diffuse leucoencephelopathy and that scared me! Would it present like that?
Doctor:Ok I am not up to date on that
Doctor:As far as I know granuloma, infections, ischemic changes and any degeneration will be reported like this
Doctor:You should speak to a Neurologist cum Neuroradiologist
User:I thought they were mot
Doctor:What is mot
Doctor:I am sorry I did not understand
User:I thought they were more focal less ions rather than diffuse
Doctor:yeah in your report it is confined to only fronto parietal part
User:Yes so focal is worse or better than diffuse findings.
Doctor:I think there is still a good prognosis
Doctor:because the MRI changes did not progress or disappeaared
User:So in your opinion what can this possibly represent
Doctor:The prognosis did not depend on focal or diffuse
User:Could I have been born with this since there is no comparision
Doctor:In my opinion it is an immune mediated process
Doctor:with evidence of antithyroid antibody
Doctor:and the process flares sometimes
Doctor:and sometimes it does not
User:No comparison to a previous MRI from while back
Doctor:so the first MRI was taken when there was a flare or attack
Doctor:of the antibodies against the white matter
User:Yes and a year later it showed the same thing with no changes noted
Doctor:and the next time there was no action of antibodies
Doctor:and so no changes
Doctor:Get a autoimmune profiling done
User:No the mris presented the same. They both looked the same
User:I think I did
Doctor:pANCA, RF factor, ANA, AntidsDNA
Doctor:Anti SSA
Doctor:Anti ACE
Doctor:Was a Lumbar puncture done to check for infections and granulomas
User:He checked for lupus did something called alpha beta gamma, Ana, cmv,
User:No not yet
Doctor:Hey did you lose weight
Doctor:No memory loss?
Doctor:yea you do not sound
Doctor:Any other medicines?
Doctor:Were some steroids tried like Predinosone
Doctor:Are you with me?
Doctor:I am Dr. XXXXXXX here
User:Hi. What kind of doctor?
Doctor:I am a Physician. I see you been chatting with another doctor. I shall transfer to him.
User:Ok thank you
Doctor:Hi, I am Dr. Mazumdar here.
User:It's still me regarding the MRI of brain
Doctor:So I was asking about your medications and if you were put on steroids?
User:Why do the neurologists check antithyroid antibodies regarding brain mri
User:No wasn't on any
Doctor:It is the simple way to test if you have an autoimmune disease.
User:Would there have been changes on my MRI after a year if it was something serious like leukoencephelopathy
User:But what really does it have to do with the brain MRI? Could hashimotos diseas really have caused that? By the way my tsp was normal
Doctor:Most leukoencephalopathy are slowly progressing
Doctor:there may only be negligible difference
User:I meant tsh was normal
User:So it may be leukoencephelopathy then. Aren't they deadly with no cure??? That's why I'm freaking out!!
Doctor:I understand that completely
Doctor:Not all of them are deadly
Doctor:Most of them have cure
Doctor:when the cause is found
Doctor:If nothing is found a simple steroid is in practice
User:Which kind are not? What can cause them other than drugs
Doctor:to stop the changes
User:Steroids will stop the demylenation?
Doctor:I am unsure how much percentage is deadly but very low
User:Have you ever seen people with that
Doctor:only once during my initial training years
Doctor:though i could not follow the person
Doctor:But your problem is still not a mystery
User:Oh so u don't know how he made out?
User:I hope your u think I should do any more testing if I'm asymptomatic?
Doctor:If I were your treating doctor, I would not
Doctor:I keep a close watch on even simple symptoms
User:Do u know if the drug accutane can damage the brain.
User:Was on it twice in past
Doctor:I mean was it oral or application
Doctor:It is commonly used drug and if damages it would be banned by now
Doctor:However amongst the rare side effects stoke was mentioned
User:So how r most leukoencephelopathys treated
User:Yes I know about stroke
Doctor:plus the cause of the leukoencephalopathy
User:What are some causes
Doctor:I already mentioned those
Doctor:Infections, granuloma, autoimmune that's why he checks antithyroid antibodies
User:What's a granuloma
Doctor:a reaction to agents like TB, Sarcoidosis
User:Oh ok.
Doctor:Was HIV, Hepatitis and other STD
Doctor:ruled out
Doctor:Metal toxicity?
Doctor:Blood pressure?
User:I dont think so
User:Bp is great
User:So is cholesterol
Doctor:ok I have used up my ideas to find out the cause then
Doctor:Try to see if you can get some messages from here
User:Would u think hashimotos disease can do this.
Doctor:Yes but no other symptoms
Doctor:puts me on back foot with TSH normal
Doctor:Get the other tests done
User:Not really other than depression and anxiety
Doctor:Depression has the potential
Doctor:Thank you for being with me
Doctor:It seems we are short of time
User:Ok. All in all do u think it is something curable if it is somthing
Doctor:why not
Doctor:keep researching
Doctor:Bye for now
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