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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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Borderline Diabetic, Cholesterol, Dizziness, Insomnia, Fibromyalgia, Eye Spasms. MRI Shows Change On Ventricular Rt Frontal Lobe. MS?

I had an MRI done. It shows single new punctate focus change on t2 post ventricular Rt frontal lobe . I have a hd of dizziness, insomnia , fibromyalgia, muscle weakness , eye spasms and headaches. High family risk of aneurysms . I m borderline diabetic, and have cholesterol @ 210. Is this possibly a sign of ms? Or could this be artifact. Please explain the t2 white matter in more detail. My medical background is in pathology.. but not so much in neuro or radiology. I have an appointment Monday... I d like to be prepared. Thanks. Tanya
Tue, 10 Sep 2013
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General & Family Physician 's  Response
Hi and thanks for the query,

It might be possible to think of multiple sclerosis from the clinical signs that you just presented. Doing a spinal tap and searching for characteristic bands after analysis could be most helpful. However, other causes of similar symptoms should be checked for. From a rheumatologic point of view, systemic diseases, vasculitis must be excluded. Lupus, Small and medium blood vessel vasculitis must be carefully evaluated and excluded. Rheumatoid factor, HLA27, Complement system analysis, C3 and C4, Anti Ds DNa anti bodies and Anti histone antibody anti bodies including a simple complete blood count are sufficient and very informative to move on. PANCA and CANCA for vascu;itis are as well very necessary.
I suggest to get a second opinion from a rheumatologist before moving on. Thanks and kind regards.

Bain LE, MD.
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Borderline Diabetic, Cholesterol, Dizziness, Insomnia, Fibromyalgia, Eye Spasms. MRI Shows Change On Ventricular Rt Frontal Lobe. MS?

Hi and thanks for the query, It might be possible to think of multiple sclerosis from the clinical signs that you just presented. Doing a spinal tap and searching for characteristic bands after analysis could be most helpful. However, other causes of similar symptoms should be checked for. From a rheumatologic point of view, systemic diseases, vasculitis must be excluded. Lupus, Small and medium blood vessel vasculitis must be carefully evaluated and excluded. Rheumatoid factor, HLA27, Complement system analysis, C3 and C4, Anti Ds DNa anti bodies and Anti histone antibody anti bodies including a simple complete blood count are sufficient and very informative to move on. PANCA and CANCA for vascu;itis are as well very necessary. I suggest to get a second opinion from a rheumatologist before moving on. Thanks and kind regards. Bain LE, MD.