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What do my MRI scan test results indicate?

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Posted on Mon, 3 Oct 2016
Question: I am a 64 year old female. 5'4" , 115 lbs. I have very loud tinnitus in both ears which has slowly led to moderate hearing loss. 3 years ago, I suffered my first bout of vertigo when I sat up from a lying position on an exam table and the room spun sideways and I rolled off but was thankfully caught by a health aide. My next vertigo episode happened 2 years ago, was much more severed and lasted approx. 24 hours. I have been diagnosed with BPPV (horizontal canal), I have low or normal tension glaucoma and fairly significant visual issues which are being handled by a glaucoma specialist. I have difficulty walking in a straight line, aka, I tend to zig zag or put one foot over the other, I have moderate to severe dizziness and use a pole for walking around so as not to lose balance and fall. I've been to an ENT who performed numerous tests none of which showed anything. I have had at least 6 MRIs of my brain both with and without contrast which also turned up nothing. Also had one or two MRIs of my Cspine both with and without contrast. In 1991, I suffered a compression fracture of C-7 which causes pain a lot. Recently, I saw a neurologist who found "a long segment area of T2 hyper intensity in the spinal cord not related to compression or C-7. At first I thought he meant I had this condition in my second thoracic vertebrae but apparently that was not what he meant. He meant that the term T-2 can also be used to describe some coinciding symptom (such as water?) in the affected area. He didn't say it was water, just gave that as an example. I am due to see him Sept. 26. My biggest concern is that some of my doctors seem to think I have MS or perhaps Lupus (though I've never had the facial butterfly rash). I have since learned that MS is almost impossible to diagnose and that such a diagnosis would be more a process of elimination than anything else. Needless to say I am scared to put it mildly. This has been going on for about 3 years and I am now having panic attacks (which I had when I was much younger) but they've come back because, well, I guess I'm feeling more than a little panicky. i am not diabetic. I am on medication for high blood pressure, Xanax for panic attacks, Cymbalta for depression, Lisinopril for high cholesterol, Lumigan for glaucoma and low dose of Hydrocodone for pain along with a lot of Advil. About a month ago, I started to feel much stronger, muscle-wise, and balance-wise which I consider a blessing, God knows, but I am still in considerable pain (scale of 7 out of 10). I have no family history of any of these conditions. What I most fear is getting on some MS medical regime and then finding out that I don't have MS and have to go back to all sorts of testing. I can't begin to tell you how many blood samples I have submitted, all of which show nothing. I've been tested for Lyme which is widely rampant here in the Northeast but those tests came back negative as well. I heard someone talking about Cholesteatoma which involves a small hole in the inner ear which can induce sound or pressure induced vertigo and is very difficult to diagnose. But once it is treated, almost all vertigo, dizziness, and hearing distortion seems to go away. Have you heard of this? Some days are better than others. Other days, I'll get off the couch and practically pass out. It's altogether maddening, obviously. Do you have any ideas of what this might be or might NOT be based on what I've said? Are there any particular tests you would recommend?


I have a fairly thick packet of test results, blood results, MRI results, etc, and I think it would be quite unwieldy to download them. Some are handwritten and almost illegible. I did not receive any paperwork from the ENT which is irritating considering that my ears and perhaps inner ear are the problem but I supposed I can request a copy of his results if need be. The MRI/radiology results are practically Greek to me but maybe not to you. If you think a particular test result(s) might be helpful, I can try to dig them out and put them in a .pdf form. I also have a disc showing the actual MRI(s) or at least some of them but I am not allowed to send that considering it's worth something like $10,000 and only able to be read by specific type of machinery though I could probably find a simpler typed version of those results maybe.

I forgot to add one important symptom in my write-up. I have NYSTAGMUS in addition the rest of my symptoms.
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Answered by Dr. Olsi Taka (1 hour later)
Brief Answer:
Read below.

Detailed Answer:
I read your question carefully and I will try to ease some of your concerns.

First of all I do not see any reason to think of MS. I think you have got the wrong information regarding MS diagnosis, it is not impossible to diagnose. An MRI shows changes in the brain of MS patients in over 90% of the cases. Since you have had several MRIs with contrast over the years I would say that that percentage would be even higher. So the MRIs alone are enough to make it extremely unlikely to have MS.
The other factor making MS unlikely is your age. MS is typically diagnose in 15-45 years old patients, average age is 29 in women. There are cases in older individuals than 45, but rare. So to have MS manifest itself in your sixties while not impossible would be extremely rare.
So combining your age with the normal MRIs I really think MS is the last thing that should be on your mind.

As for cholesteatoma....again the MRIs should have detected that (though CT scan is the imaging modality of choice for that). However even without MRIs your presentation doesn't correspond to cholesteatoma, the main symptoms in all cases in hearing loss in the affected ear. Dizziness can happen but is less common. So don't think that is the case either.

Judging from your description the most likely cause to me seems to be an inner ear issue like BPPV really. The fact that you suffer from anxiety and depression issues may have contributed in worsening the symptoms. I am not sure why you haven't tried (at least you don't mention to) something like meclizine used to alleviate vertigo.

Regarding what the neurologist has said about that T2 hyperintensity I am not sure what to make of it, since you say two MRIs of the spine were considered normal someone seems to be wrong in the interpretation. I would be more inclined to side with the radiologist since it is not one but two MRIs of the spine, so hard to think they missed something twice. However a spinal lesion wouldn't explain the vertigo you describe.

As for the MRIs I am not sure why you think you are not allowed to send them and why they are worth that much. Where I live and in most European countries MRI images are put on a CD or DVD which can be easily opened on any computer with the appropriate software, there are plenty of free software on the net, just search for a Dicom viewer (dicom is the type of file used to store images in medicine). So not that complicated. You can simply upload a disk image on some file sharing site and provide the download link.

I remain at your disposal for other questions.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Dr. Olsi Taka

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Practicing since :2004

Answered : 3657 Questions

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What do my MRI scan test results indicate?

Brief Answer: Read below. Detailed Answer: I read your question carefully and I will try to ease some of your concerns. First of all I do not see any reason to think of MS. I think you have got the wrong information regarding MS diagnosis, it is not impossible to diagnose. An MRI shows changes in the brain of MS patients in over 90% of the cases. Since you have had several MRIs with contrast over the years I would say that that percentage would be even higher. So the MRIs alone are enough to make it extremely unlikely to have MS. The other factor making MS unlikely is your age. MS is typically diagnose in 15-45 years old patients, average age is 29 in women. There are cases in older individuals than 45, but rare. So to have MS manifest itself in your sixties while not impossible would be extremely rare. So combining your age with the normal MRIs I really think MS is the last thing that should be on your mind. As for cholesteatoma....again the MRIs should have detected that (though CT scan is the imaging modality of choice for that). However even without MRIs your presentation doesn't correspond to cholesteatoma, the main symptoms in all cases in hearing loss in the affected ear. Dizziness can happen but is less common. So don't think that is the case either. Judging from your description the most likely cause to me seems to be an inner ear issue like BPPV really. The fact that you suffer from anxiety and depression issues may have contributed in worsening the symptoms. I am not sure why you haven't tried (at least you don't mention to) something like meclizine used to alleviate vertigo. Regarding what the neurologist has said about that T2 hyperintensity I am not sure what to make of it, since you say two MRIs of the spine were considered normal someone seems to be wrong in the interpretation. I would be more inclined to side with the radiologist since it is not one but two MRIs of the spine, so hard to think they missed something twice. However a spinal lesion wouldn't explain the vertigo you describe. As for the MRIs I am not sure why you think you are not allowed to send them and why they are worth that much. Where I live and in most European countries MRI images are put on a CD or DVD which can be easily opened on any computer with the appropriate software, there are plenty of free software on the net, just search for a Dicom viewer (dicom is the type of file used to store images in medicine). So not that complicated. You can simply upload a disk image on some file sharing site and provide the download link. I remain at your disposal for other questions.