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What does my MRI scan report indicate?

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Posted on Fri, 4 Dec 2015
Question: Hello,
I'm having a recurrence of symptoms that include burning/numbness in left side of my face, the palms of my hands, tops of my legs and bottom of my feet (particularly the left). Have spasms in my left eye and tremors in my right hand. Happens when I'm resting and worsens when I reach for something. My MRI has shown "multiple lesions in the periventricular white matter". My doc is taking a slow approach of exclusion and is considering MS, but I'm wondering if there are other possibilities. Would appreciate your thoughts.
doctor
Answered by Dr. Ajay Panwar (1 hour later)
Brief Answer:
Hypertension/Vasculitis/Autoimmune/Infections/Alcohol

Detailed Answer:
Hi xxxxxxxxx,
Thanks for being on healthcaremagic.com.
I am Dr.Ajay Panwar,a neurologist,here to answer your query.

Though,there can be several causes of periventricular white matter lesions in addition to MS,like-
2)Vasculitis
3)Connective tissue/Autoimmune disorders
4)CNS infections
5)Alcoholism and toxins
6)Leukodystrophies

However,one can limit the possible causes based on clinical history and physical examination.

I would suggest you to upload a scanned image of the periventricular lesions in your brain MRI.That may be of help to better answer this query.

Also,see if any of the above causes applies to you.

I shall be glad answer your follow-up questions.

Regards
Dr.Ajay Panwar,
MD,DM(Neurology)
Above answer was peer-reviewed by : Dr. Raju A.T
doctor
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Follow up: Dr. Ajay Panwar (1 hour later)
Thanks for your reply. While I don't have the images, I can respond to your thoughts.

Blood pressure is normal, don't drink alcohol. Father diagnosed with polymyositis at 54, died at 54. Several immediate family members have autoimmune conditions.

What would you suggest as best course of action? The bouts of symptoms are severe, then eventually resolve, usually after a round of steroids or neurontin.

The cycle is maddening and I'd like to rule in or out all the options, to move toward a definitive diagnosis.
doctor
Answered by Dr. Ajay Panwar (12 hours later)
Brief Answer:
CSF/work up for connective tissue disorders/infections

Detailed Answer:
Hi xxxxxxxxxxx,
Thanks for being in follow-up.

Broadly,the following investigations should be done-
1)CSF for cells,sugar and proteins.
2)Oligoclonal bands and IgG index in CSF.
3)Visual evoked potential
4)MRI Spine
5)Autoimmune/vasculitis/connective tissue disorder work up.
6)CNS infections-viral markers
7)Thyroid function tests.

Please feel free to ask further questions.

Regards
Dr.Ajay Panwar,
MD,DM(Neurology)
Above answer was peer-reviewed by : Dr. Raju A.T
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Answered by
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Dr. Ajay Panwar

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Practicing since :2007

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What does my MRI scan report indicate?

Brief Answer: Hypertension/Vasculitis/Autoimmune/Infections/Alcohol Detailed Answer: Hi xxxxxxxxx, Thanks for being on healthcaremagic.com. I am Dr.Ajay Panwar,a neurologist,here to answer your query. Though,there can be several causes of periventricular white matter lesions in addition to MS,like- 2)Vasculitis 3)Connective tissue/Autoimmune disorders 4)CNS infections 5)Alcoholism and toxins 6)Leukodystrophies However,one can limit the possible causes based on clinical history and physical examination. I would suggest you to upload a scanned image of the periventricular lesions in your brain MRI.That may be of help to better answer this query. Also,see if any of the above causes applies to you. I shall be glad answer your follow-up questions. Regards Dr.Ajay Panwar, MD,DM(Neurology)