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Brain MRI, Fibromyalgia, Cataract Surgery, Dizzy, Headache, Neck Pain

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Posted on Mon, 21 May 2012
Question: I just had an MRI of my brain. I am 62 year old female with fibromyalgia. I have had cateracte surgery an then was told I had PVD of one eye several months after the surgery. I have been having dizzy spells and feel off balance a lot of the time,and it seems I walk off to right. The mri of the brain showed T2 hyperintensity in the white matter suggestive of small vessel ischemia or non specific demylination. I can't get into the doctor for awhile and can't figure out from the internet what this means. I also have been having about 4 headaches a week that go up the back of my neck to my temple area that are just a dull ache. I am 5'8 and 225. thankyou
doctor
Answered by Dr. Tulasi Raman.P (5 hours later)
Hi XXXXXXX

We have received you query at Healthcare Magic.

After going through your query, I am of the opinion that it would be helpful if you could share your previous reports (MRI, Hospital records, Lab reports etc).
Our specialist would be able understand your condition better and provide you with a better answer to your query.

Kindly send your reports to " YYYY@YYYY " with the subject as "ATTN : Dr. Tulasi - Specialist Query"

Once you send us the details, our specialist will reply to it shortly.

Thank You.

Regards
Dr.Tulasi Raman.P
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Tulasi Raman.P (10 hours later)
My labs have always came back normal except for chronic low potassium and several cbc showed a hgb of 16 but last one was 13.5. I have been to several arthritis doc. And had all the test done they do and all have come back normal. I have had a chronic cough for 10 years and have been worked up for copd and othere lung problems but everything was neg. except for bronchiectasis. The cough improved after I had a L-thyroidectomy for a 3 cm nodule removed in 2010 which was a colloid nodule consistent with uninodular goiter. This was done in6/2010 In 5/2010 I fell and hit my head and had a ct done which showed the spinal fusion I had done atC5 C6 was ok but I had degenerative changes in the cervical spine. The head CT was normal except for mild chronic sinusitis. My last test was done 5/10/2011, which is the one with the demyelination. At that ime they also did an MRI of the cervical spine showed no problem with the fusion hardware but T2 hyperintensity in pons which may related to nonspecific demyelination or small vessel ischemic changes. It also said I had mild to mod. Disc osteophyte in mulitiple levels most prominent at C4-C5. I also just had a EMG/NCS done on both arms for my hands going numb like I had novacan shot in them, mostly at night which wakes me up. It said on the Right hand there was prolong median sensory latency, with ever thing else normal. The left arm was normal. EMG was normal on both arms. My TSA was normal when checked05/05/2011 but vit d was 26.15. In my 1st note I said I had problems with my R leg dragging it is more like when I walk I don’t lift it high enough and trip all the time. I also have noticed when I talk I have a hard time thinking of the word I want to say and sometimes kind of sutter, which I did not do before as much. That is all I can think of except I have pain in most of my body. Thank you for your help
doctor
Answered by Dr. Tulasi Raman.P (12 hours later)
Hi XXXXXXX

Thanks for replying back.

Your query has been answered by our specialist Dr.A.S XXXXXXX XXXXXXX Consultant Neurologist.

You may wish to see his profile in the link below

WWW.WWWW.WW
Kindly find the specialist's answer below:

Hi XXXXXXX

You have narrated your symptoms quite nicely. But I have a few questions to ask.

1. Are the complaints of imbalance and difficulty in walking sudden in onset or gradually worsening?
2. What is the total duration of your symptoms? Did you have any weakness, numbness in limbs, visual disturbances or urinary retention/ urgency even in the past?
3.Do you suffer with hypertension or diabetes or increased cholesterol in blood?

Going by your description of your problems and investigation reports, you either have central demyelinating disease or cerebrovascular disease. I need answers for the above queries to point to a single entity. Also you may require further investigations like VEP, DOPPLER neck vessels, 2D ECHO.

Awaiting for your reply

Dr. XXXXXXX
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Tulasi Raman.P (7 hours later)
I have no weakness but hands go numb mostly at night, they are numb not asleep.Nio ua problems, mild hypertensionbut no cholesteral problemsvision problems since thePVD and my eye hurt sometimes at a 2 pain level. The off balance and dizziness has been gradual and started mostly in the last year. If this is central demyelintation what does this mean to my life?
doctor
Answered by Dr. Tulasi Raman.P (39 hours later)
You have set of degenerative changes like ischemic changes in the small vessels, Osteophyte growths, Demyelination etc.

Degenerative disease can be either primary ( without any known cause) or secondary to a specific cause eg., hypertension, your MRI findings could still be due to small vessel ischemia. Frequent headaches for the past couple of days can be significant. So you need further investigations like VEP, 2D ECHO, DOPPLER NECK VESSELS. Regarding the treatment, you can discuss with your doctor if antiplatelets therapy can benefit you ( for cerebral ischemia) or disease modifying agents (for demyelination).

Demyelinating diseases are not really life threatening, anything that is not lifethreatening can make you stronger to live with it. New MRI can reveal more findings as cerebrovascular accidents are more common at this age and amongst hypertensives.

Hope it helps.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
Answered by
Dr.
Dr. Tulasi Raman.P

General & Family Physician

Practicing since :2010

Answered : 126 Questions

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Brain MRI, Fibromyalgia, Cataract Surgery, Dizzy, Headache, Neck Pain

Hi XXXXXXX

We have received you query at Healthcare Magic.

After going through your query, I am of the opinion that it would be helpful if you could share your previous reports (MRI, Hospital records, Lab reports etc).
Our specialist would be able understand your condition better and provide you with a better answer to your query.

Kindly send your reports to " YYYY@YYYY " with the subject as "ATTN : Dr. Tulasi - Specialist Query"

Once you send us the details, our specialist will reply to it shortly.

Thank You.

Regards
Dr.Tulasi Raman.P