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Spinal hyperintensity, hot flush, night sweats, headaches. CSF and protein tests done, MRi done. What could be the reason?

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Practicing since : 2001
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Getting worked up for MS with positive temoral and spinal hyperintensity. I don't see the neuro for several more weeks. No oligconal bands but HSV IGG in CSF is at the highest end of equivocal 1.08, csf pressure slightly high 28 and protein slightly high. I have had tingling lips and mouth lesion for about 2 months. Hot flashes and night sweats and headaches but no fever. Only positives were V-leiden hetero, HSV IGG, a few new small round temporal and periventricular lesions (from 2008 MRI), several spinal t2 hyperintensities, several spinal bulges and a cervical cyst and perirenal pelve on MRIs. March XXXXXXX was negative was 1:160 in February. Severe chills event and worsened symptoms (cogntive and tremor) were early February
Posted Sat, 2 Jun 2012 in Brain and Spine
Answered by Dr. Shiva Kumar R 46 hours later

Thank you for sending your question.

Your question is a good one and I will work on providing you with some information and recommendations regarding the symptoms you are experiencing.

Regarding the hperintensities seen on the MRI likely possibilities I can thin are CNS vasculitis and demyelination. In the back ground of high CSF pressure and positive HSV IGG one needs to consider the possibility of chronic herpes infection which can present with similar problems. In view of high XXXXXXX and absent oligoclonal bands I would like to consider the possibility of Vasculiitis followed by chronic herpes infection.

Regarding the feeling of hot flashes and night sweats I would like to consider the possibility of Hot flashes seen due to menopause — the time of life when a woman's menstrual periods stop. Hot flashes can also be caused by an overactive thyroid gland (hyperthyroidism). Fibromyalgia can cause variety of symptoms and this could be one of them.

Regarding the worsening of the tremors along with cognitive symptoms I feel it could be due to the either disease related ot due to anxiety neurosis. Infections and CNS vasculitis can present with on and off headaches.

My recommendation would be for you continue on the medications for your stiff leg and XXXXXXX your Neuro for a detailed evaluation and consultation. Based on the given details MS seems to be the least possibility in you. If hot flashes is the reason and these become bothersome and disrupt your daily routines you need to be on response to be both helpful and adequate.

If you have any additional concerns regarding your question I would be happy to address them.


Dr Shiva Kumar R
Consultant Neurologist & Epileptologist.
Above answer was peer-reviewed by
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