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Subependymal lesion and whit matter lesions. Had TIA. Was on evista. Suggest?

Nov 2013
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Would one subependymal lesion along with whit matter lesions I cerebral hemispheres bilaterally indicate ms in a 56 year old female? I had one TIA and was on Evista for 4 years
Posted Mon, 13 May 2013 in Brain and Spine
Answered by Dr. Sudhir Kumar 52 minutes later

Thank you for posting your query and providing great detailed description of your symptoms.

I would tend to disagree with your current doctor, and would make a diagnosis of small vessel disease (due to brain ischemia) in your case, based on clinical and MRI findings.

This is because the lesions you have on brain MRI are typically seen in patients with hypertension and cerebral ischemia. In addition, you have not had typical symptoms of MS such as optic neuritis, etc. Also, the typical MRI lesions such as corpus callosum, cerebellum, brainstem lesions, etc are not there in your case. The most strong point is your age. Though by definition, MS can start upto the age of 60, but of the 650 cases of MS that I have seen in the past 15 years, the oldest age for first symptom was 48 years.

So, I would not rush to start interferons in you, but would rather wait and watch and follow you up.

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

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