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Suggest Treatment For Anxiety And Depression

Posted on Tue, 2 Sep 2014

Question: Had mri of brain done at 31 years of age. am currently 35. showed t2 hypersignall abnormality noticeably confluent in frontalparietal region. abnormal for this age group. no pathological contrast at any location. I'm scared. could I have dementia? ms? Ms doesn't scare me I can handl en that but not the dementia. The only thing blood work showed was very high antithyroid antibodies. Mri done bc of general feeling unwell...unexplained sleepiness increased anxiety and depression

Answered by Dr. Indu Kumar (30 minutes later)

Brief Answer:
It may be due to many reasons.

Detailed Answer:
Hello XXXX

I have thoroughly gone through your reports in detail.

In MRI(Brain),FLAIR or T2 weighted tiny hyper intensities less than five in number in deep white matter of brain or periventricular region can be ignored.
Mostly it is due to ischemic changes(decreased blood supply) that involves small blood vessels.However demyelination,post traumatic and post infective sequel should also be ruled out with follow up scans.Diabetes mellitus and vitamin B12 deficiency also aggravates the situation.
Hyper intensities more than five in number should be the cause of concern and it need investigations.

You need monitoring of conditions that leads to ischemic changes like hypertension,altered lipid profile,diabetes mellitus.
You need investigations like routine hemogram,RBS,LFT,RFT,Lipid profile,vitamin B12 estimation,ultrasound of abdomen.
If there is any more physical problems then it should be treated also.

You need follow up MRI (Brain)scan to see the progression of lesions.Demyelinating disorders are associated with many other neurological findings.You need clinical correlation.

Get well soon.
Hope i have answered your query.
Further queries are most welcome.

Take Care
Dr.Indu XXXXXXX

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Indu Kumar (6 minutes later)

I had all those tests and we're normal other than the thyroid antibodies. I'm so nervous. I feel physically fine but I have had increased anxiety. What else can this be?? Could I have dementia?? That scares me. It's nowhere in my family but I'm concerned.

Answered by Dr. Indu Kumar (5 minutes later)

Brief Answer:
Please find detail answer below.

Detailed Answer:
Hello XXXX

If all investigations are fine and number of lesions are less than five then you shouldn't worry at all.
This will not progress to dementia at all.Don't take tension.You are fine.

Get well soon.
Hope i have answered your query.
Further queries are most welcome.

Take Care
Dr.Indu XXXXXXX

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Indu Kumar (4 minutes later)

I think there were more than 5. but there was no change after repeating one year later.

Answered by Dr. Indu Kumar (4 minutes later)

Brief Answer:
Please find detail answer below.

Detailed Answer:
Hello xxxx

It is good that lesions are not progressed.Blood investigations and clinical findings are normal,so you don't worry at all.

Get well soon.
Hope i have answered your query.
Further queries are most welcome.

Take Care
Dr.Indu XXXXXXX

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Indu Kumar (8 minutes later)

Could this be ms or anything to do with the very high antithyroid antibodies?? I have great bp am very healthy other than the hashimotos disease. does ms present like this? I did get the mri in the first place for feeling very unwell and extremely sleeping following periods of what felt like hot flashes

Answered by Dr. Indu Kumar (6 minutes later)

Brief Answer:
Please find detail answer below.

Detailed Answer:
HelloXXXX

It is unlikely to present MS like this.Non progression of lesions in follow up scan is also against MS.
MS has typical distribution in MRI Brain findings.
MS should be clinically correlated.There are many neurological findings associated with MS.All things are against MS.

Get well soon.
Hope i have answered your query.
Further queries are most welcome.

Take Care
Dr.Indu XXXXXXX

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Indu Kumar (6 minutes later)

Hashimotos encephelopathy??? Could it just have been somthing I was born with?? Did grow up w a little bit of a learning disablity. Struggling to process info and attention to detail. Although I did make it successfully through college and am a practicing occupational therapist
Hashimotos encephelopathy or somthing I was born with??

Answered by Dr. Indu Kumar (19 hours later)

Brief Answer:
Please find detail answer below.

Detailed Answer:
Hello XXXX

Hashimoto's encephelopathy can show variety of findings in MRI imaging.It may show similar lesions that you have,can have normal findings and in some patients there may be mild cerebral atrophy.
These lesions are not definitely related,you need proper assessment by endocrinologist.

Get well soon.
Hope i have answered your query.
Further queries are most welcome.

Take Care
Dr.Indu XXXXXXX

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Indu Kumar (22 hours later)

What are the other kinds of demylenation disorders other than ms that this could be for my age??

Answered by Dr. Indu Kumar (19 hours later)

Brief Answer:
Please find detail answer below.

Detailed Answer:
Hello XXXX

Demyelinating disorders may be due to (1)primary (2)ischemic (3)infectious and (4)toxic and metabolic causes.

MS is classical of primary cause.
Ischemia may be also be one of the reasons in some patients who develop early ischemic changes.
It may also develop after some infections.
Metabolic reasons and certain toxic materials may also cause demyelination.

Get well soon.
Hope i have answered your query.
Further queries are most welcome.

Take Care
Dr.Indu XXXXXXX

Above answer was peer-reviewed by : Dr. Yogesh D