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Brain demyelination and migraine headaches - Online Doctor Chats

Date : 21-Feb-2012
User rating for this question
Very Good Posted in: X-ray, Lab tests and Scans
Answered by

General & Family Physician
Practicing since : 2005
Answered : 2408 Questions
Doctor :   Hi
Doctor :   How can I help you?
User :   Hi
User :   I have SLE and had a brain MRI done without contrast and I received the results yesterday and I was wondering if you could help me to interpret them.
User :   Findings: The cerebral cortical sulci and ventricles are within normal limits in size. There are mild scattered nonspecific punctate T2 hyperintensities in frontal white matter. These are nonspecific but are most consistent small foci of ischemic white matter change or possibly demyelination of other etiology. These can be found secondary to migraine headaches related to microvascular ischemia. The diffusion-weighted images are unremarkable. There are expected flow-voids in the carotid and basilar arteries. No signal abnormality seen in the brainstem or cerebellum. There is no mass effect or extra-axial collection. Impression: There are mild nonspecific scattered punctate T2 hyperintensities in frontal white matter. These may be small foci of ischemic white matter change or possibly demyelination. Otherwise unremarkable MR of the brain.
Doctor :   Can I ask why this MRI brain scan was done?
Doctor :   Can you describe the symptoms for which the doctor suggested you to get the scan?
User :   I had been having daily severe headaches along with confusion, memory loss, "brain fog", tremors in my hands, black spots in my visions
Doctor :   Ok
Doctor :   Let me explain.
Doctor :   The scan finding that you have mentioned are revealing areas in the brain which could be due secondary to migraine headaches(recurrent headaches)
User :   So all of this could be related to the headaches and nothing major
Doctor :   The other possible conclusion is that these areas are due to damage of the insulation covering around the nerves.
User :   what does that mean?
Doctor :   Demyelination is a term used when there is damage to the covering around the nerves.
Doctor :   This can happen due to multiple reasons,
Doctor :   autoimmune disorders being one.
Doctor :   They are a reversible condition
Doctor :   and can be reversed with medications - steroids and vitamins.
User :   that is good to know..I am already on steroids of 35 mg/day
Doctor :   However it is necessary to know the cause for such demyelination inorder to prevent them.
Doctor :   Yes, steroids will reverse the present condition.
User :   how can you figure out what causes the demyelination?
Doctor :   This however is possible by evaluation alone.
Doctor :   You will need few blood tests, immunological studies, and if needed analysis of CSF,
Doctor :   if your neurologist considers these areas of demyelination significant and responsible for your symptoms.
Doctor :   Have you followed what I have suggested?
User :   yes, I have, thank you very much
User :   I will followup with my neurologist this week
Doctor :   Do you have any other query?
User :   no, that is it...thank you
Doctor :   Thanks for consulting me.
Doctor :   wish you the best of health.
Doctor :   Bye for now.
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