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Child has tremors in head, neck, leg and hand. Delayed speech. Done Ayurvedic treatment, brain MRI. Meaning? - Online Doctor Chats

Date : 12-Jun-2013
User rating for this question
Very Good Posted in: Child Health
Answered by

General & Family Physician
Practicing since : 2002
Answered : 106 Questions
Doctor:Good Evening
User:Good Evening
Doctor:I am Dr. XXXXXXX
Doctor:How can I help you?
User:I am XXXXXXX .I need medical advice on a family member
Doctor:Sure. Please proceed with your query.
User:I have a 14 year old cousin who has had tremors in the head, neck, hand and legs since Age 2 years
User:She also has slow and delayed speech as compared to her peers along with balance issues
User:Periodic treatment by Shirodhara (an ayurvedic oiling treatment) over the last 4 years has helped considerably
User:However now that she is in the ninth grade, we thought she needs more specific help
User:The neurologist to whom we showed her last week asked for a MRI brain scan
Doctor:Please proceed.
User:The reports are out and the findings are as follows- MRI study of brain shows focal area of increased signal intensity on DWI involving the cortico spinal tracts. Bilateral symmetries, White Matter Hyperintensity in the forceps major region. In view of the imaging findings, the possibilities of metabolic disorder needs to be considered in differentials. Suggested possibility is mitochondrial leuko dystrophy. Suggested CSF evaluation/MRI spectrascopy for further evaluation
User:This is the gist/conclusion of the report.
User:The neurologist has also asked for a battery of other tests to be conducted simultaneously- like blood tests, vitamin level checks, sonography
User:What does this largely mean?
User:A broad view would also help
Doctor:Ok. I have gone through the details.
Doctor:I would be able to give a general idea on this. But, I can't be much specific because it is a little above my level.
User:The neurologist is extremely busy this week and we have managed to get an appointment only next week...hence i would appreciate even if you can give a general idea about this
Doctor:In general words, it says that there were areas of increased activity in brain.
Doctor:It could be due to metabolic errors, which has to be ruled out by investigations.
User:what are metabolic errors?
Doctor:Metabolism: It is the chemical reactions which takes place in the body.
Doctor:Due to that only, we have enrgy produced in the body.
User:This is also reponsible for digestion in the body right?
Doctor:In her case, , they have mentioned leukodystrophy.
User:what is leukodystrophy?
Doctor:Certain parts of brain were showing a decreased activity.
Doctor:In a condition called leukodystophy, this can be seen.
Doctor:So according to the MRI, the possibility of leukodystrophy is there.
User:Should the report be very concerning?
User:I mean- Does this need immediate medical attention?
Doctor:No. It does not need immediate care, as it is not an emergency.
Doctor:But, it is a progressive disease.
User:progressive as in- it can increase with age?
Doctor:Not with age. But, there can be a gradual slow down in the movements, gait, speech, vision etc.
User:Ayurvedic Treatment (Shirodhara) which have been doing regularly (i.e periodically) has helped a lot...A few years back she was unable to pronounce certain words with clarity ..Now she can
Doctor:Ok. That is an improvement.
User:Yes definite improvement
Doctor:So, this is what I would be able to guide you regarding the condition.
User:I googled leukodystrophy and it gave me the picture that in this condition, symptoms usually worsen
User:however in her case, it has improved considerably over time
Doctor:That shows her treatment is going in the right direction.
User:In your reading of the report, could you make out medical jargon for any sort of tumour, cancer,lesion ?
Doctor:because, according to my knowledge, no much advancement has occurred in the treatment of leukodystrophies.
Doctor:I could not find anything related to any tumours or growths.
Doctor:You need not worry about that.
User:what do increased/decreased activity in brain signals mean?
Doctor:The MRI is more looking at the activity of the brain tissue.
Doctor:The activity of MRI is based on magnetic resonance.
Doctor:So, if there is any higher /lower activity, it picks up. it bad to have 'increased signal intensity'?
Doctor:It can be bad. In the sense, it shows an abnormality.
User:So a normal report would not read 'increased/decreased' signal intensity
Doctor:have you followed everything explained till now?
User:what is 'white matter hyperintensity' in forceps major reason- Last question
User:Sorry to bother you.. This is my last question
User:Yes, you have explained it well. Thanks so much
Doctor:In brain, there are major parts called as white matter and grey matter.
Doctor:white matter contains nerve bodies.
Doctor:So, if white matter shows an hyperintensity,
Doctor:it may indicate that, the covering of nerve bodies are deficient.
User:ok...any sort of treatment..alternative or otherwise?
Doctor:At present, within my knowledge, I do not know of any particular treatment for the same. But, you can try for treatment with nutritional supplements.
User:Does her report show any life threatening indications ?
Doctor:No. Report does not indicate anything life threatening.
User:I just got a call from home to say that all other reports have come out absolutely normal
Doctor:That is nice to hear.
User:So does that indicate anything further?
User:That this is probably only brain related?
Doctor:I wouldn't be able to decipher much from that, as I don't know why the investigations were prescribed.
Doctor:To me, it looks more like a metabolic error.
User:You have been of great help
Doctor:But, then it can be confirmed only after going through all the history , investigations and examinations.
Doctor:So, relax. And wait for the appointment with the neurologist.
User:If I have any more questions for you in the next week, can i chat with you?
Doctor:Don't be anxious.
Doctor:There is nothing much to worry.
Doctor:It is just the continuation from childhood.
Doctor:There is no emergency.
User:One more thing- Her parents are first cousins (the consanguinity factor)
Doctor:But let the neurologist go through all the details.
User:So the neurologist had somewhere indicated that it could be genetic
Doctor:That can be a factor.
Doctor:leukodystrophies are mainly genetic origin.
User:sure..I will chat with the neurologist next week
User:oh ok
Doctor:Hope things are much more clear to you now.
User:yes, thanks for your help
User:really appreciate
Doctor:You are welcome.
User:Have a good day ahead
Doctor:And thanks for consulting me.
User:Thanks :-0
Doctor:You too have a Nice Evening!!
User:Take Care...Bye
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