Get your Health question answered in 3 easy steps
A Doctor will be with you shortly
Ask a Doctor Now
179 Doctors are Online

I ve been under investigation for dysphagia, lasting approximately one

User rating for this question
Very Good
Answered by

Neurologist
Practicing since : 2006
Answered : 2047 Questions
Question
I've been under investigation for dysphagia, lasting approximately one year. I had an MRI done, which noted a 3mm lesion in the pons. Another MRI was ordered, with contrast, and I got the results from my general practitioner. I haven't heard from my neurologist yet. This one says: "There are a few scattered nonspecific foci of increased T2 FLAIR signal within the supratentorial periventricular white matter. These may reflect mild chronic microangiopathic ischemic white matter changes. The previously documented 4mm focus of increased T2 FLAIR signal within the left side of the pons is not dramatically changed. On post gadolinium imaging, there is no enhancement in this region. In fact there is no abnormal intra or extra axial enhancement. Impressions: There are a few nonspecific foci of increased T2 FLAIR signal within the supratentorial periventricular white matter, and solitary focus within the pons. While the findings could reflect mild chronic microangiopathic ischemic white matter changes, other causes for demyelination are not reliably distinguished on imaging." The report recommends Clinical follow up and repeat MRI in six months. Could you please help me understand these findings, and tell me if they are at all likely to have anything to do with my dysphagia. Thank you.
Fri, 2 Feb 2018 in Headache and Migraines
 
 
Answered by Dr. Neeraj Kumar 58 minutes later
Brief Answer:
Get examined and evaluated by a neurologist

Detailed Answer:
Hello,
I have gone through your question and understand your concern.
The mri changes are due to small blood vessels block due to aging or other risk factirs like hypertension or diabetes.
The lesion in pons region is atypical but non uptake of contrast rules out any malignancy at present.
Follow up imaging is required to monitor the pons lesion.
There ia less likely chance of dysphagia due to this pons lesion.
Other possibilities may be achalsia or bulbar onset motor neuron disease.
Examination by a neurologist will be helpful.
EMG may Be required too.
Is there any wasting if tongue musculature?
Any muscle rippling or twitching movements?
Any muscle wasting in limb?
Any speech changes?
Hope you found the answer helpful.
Do get back to me for further information.
Regards
Dr N Kumar
Neurologist
Above answer was peer-reviewed by
 
Follow-up: I ve been under investigation for dysphagia, lasting approximately one 15 hours later
Nothing unusual with the tongue. No muscular weakness.
Yes, some muscle twitching and vocal changes (vocal fry, loss of range in singing voice.)

Esophageal Manometry was done - I have not seen the report, but the technician said she saw strong evidence of the XXXXXXX failing to relax. Achalasia?
 
 
Answered by Dr. Neeraj Kumar 23 hours later
Brief Answer:
please visit and consult a gastro medicine doctor

Detailed Answer:
Hello,

If investigations are suggesting achalasia, then you should consult a gastroenterologist doctor for further management.

Regards
Dr. N Kumar

Above answer was peer-reviewed by
 
Share on Facebook
Share on Twitter
Share on Google+

The user accepted the expert's answer

Ask a Neurologist

© Ebix, Inc. All Rights Reserved.
All the information, content and live chat provided on the site is intended to be for informational purposes only, and not a substitute for professional or medical advice. You should always speak with your doctor before you follow anything that you read on this website. Any health question asked on this site will be visible to the people who browse this site. Hence, the user assumes the responsibility not to divulge any personally identifiable information in the question. Use of this site is subject to our Terms & Conditions
Already Rated.
Your rating:

Ask a Doctor