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Having MS symptoms Done MRI. History of high BP. Taking adderall for fatigue. Advice?

Nov 2013
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Practicing since : 1994
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I have an MRI (suspicion of MS) with two reports that don't correlate completely and I would really appreciate an explanation that may shed some more light on my situation. I believe I see hyperintensities in the images that are not mentioned in the report. specifically a large number of small bright spots in the occipital and parietal lobes in the 4h and 5th images of the uploaded views. similar BO's can be seen in the second row images labelled 14/21-16/21 that I would really appreciate understanding. One more question if I may - Row 2, 2nd image (labelled 11/21) - is the arc-shaped enhancement in the corpus callosum?

I have had a very recent (the last few months) history of occasional high blood pressure. I have been taking adderall for fatigue and focus for a year and in the last few months it has started affecting my blood pressure, especially when in pain or anxious. As the reports indicate, there are not enhancements on the contrast enhanced images.

I would appreciate your opinion based on my history of MS-like symptoms and these images and NCV study-and any other information that I can provide?

I know that I'm asking a lot of detailed questions as a layman, but whatever the cause of the lesions, I expect that I may have more MRIs in my future and would really like to understand better than my doctor has been willing to discuss.
Posted Sun, 8 Sep 2013 in Multiple Sclerosis
Answered by Dr. Sudhir Kumar 3 hours later
Brief Answer:
MRI brain is suspicious of MS.

Detailed Answer:

Thank you for posting your queries.

I can understand your dilemma. I have seen the MRI images posted by you, as well as the nerve conduction studies reports.

I do see multiple white matter lesions, in the Periventricular and subcortical locations and at least one lesion in corpus callosum. I agree that these do not fulfil the criteria for a diagnosis of due to lack of blood flow to brain) in a person with high BP or sugars.

The lack of contrast enhancement on the MRI indicates that the disease is not active, and that is a good news.

In any case, you require repeat MRI after 3-6 months to study any progression of disease on the MRI.

Nerve conduction studies suggest an entrapment of median nerve at the level of wrist, and as of now, is not suggestive of a hereditary neuropathy. In addition, a few nerves at the neck region seems to be compressed (radiculopathy).

I hope it helps. Please get back if you have any more queries.

Best wishes,
Dr Sudhir Kumar MD DM (Neurology) XXXXXXX Consultant Neurologist
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