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What Does My MRI Scan Test Report Indicate?
Question: I had an MRI and it showed five or six tiny foci of high T2 Flair signal in the white matter of the frontal lobe's bilaterally - these white master foci are nonspecific likely age related or due to chronic microangiopathic isschema demylination or vasculitis. I've done a little bit of research online and one person suggested it could be related to exogenous toxins released by a virus. I was diagnosed with Ménière's disease a few years ago and doing research with that I found a paper suggesting the Ménière's can be aggravated by the herpes virus. I was diagnosed with Ménière's disease a few years ago and doing research with that I found a paper suggesting the Ménière's can be aggravated by the herpes virus. I have had Herpes Simplex for decades. I am interested in a neurologist opinion on this paper - preferably someone who is willing to look outside the normally accepted diagnosis and is somewhat progressive in their thinking. (No offence meant for all the hard working neurologists out there). Thank you.
Brief Answer:
A review of your condition and further evaluation needed.
Detailed Answer:
Hello and thanks for using HCM.
I have read your query and understand your concerns.
Meniere-like symptoms, or Labyrinthitis, (vertigo, dizziness, dysbalance) are well known to be related in some cases to Herpesvirus infection.
Not all the people that carry a herpesvirus infection suffer from these symptoms, as is true the opposite, not all Meniere-like syndromes are caused by herpesvirus infection.
MRI findings of your brain are not specific to herpesvirus infection, it affects predominantly temporal lobes and in case of Labyrinthitis, a thickening of vestibular nerves should be noted on MRI.
Those MRI findings are more consistent with microangiopathy related to high blood pressure, or Vasculitis.
Labyrinthitis is an " exclusive " diagnosis, it means there is need to exclude other possible conditions related to your symptoms.
In order to have a better understanding of your concerns, if they are related to herpesvirus infection or not, there is need for a review of your medical history ( when diagnosis of Ménière's was achieved did you experienced flu-like symptoms besides vertigo, dizziness, dysbalance, nausea?).
Labyrinthitis caused by herpesvirus has an acute phase ( flu-like with inner ear disfunction symptoms) and a chronic phase after fly-like symptoms subside.
There is need for a review of MRI images related to inner ear and vestibular nerves damage.
If there is high suspicion about herpesvirus infection of inner ear after this review, a lumbar puncture and cerebrospinal fluid examination is needed to confirm the diagnosis.
Hope I helped you. I remain at your disposal for further questions and clarifications.
Best regards.
A review of your condition and further evaluation needed.
Detailed Answer:
Hello and thanks for using HCM.
I have read your query and understand your concerns.
Meniere-like symptoms, or Labyrinthitis, (vertigo, dizziness, dysbalance) are well known to be related in some cases to Herpesvirus infection.
Not all the people that carry a herpesvirus infection suffer from these symptoms, as is true the opposite, not all Meniere-like syndromes are caused by herpesvirus infection.
MRI findings of your brain are not specific to herpesvirus infection, it affects predominantly temporal lobes and in case of Labyrinthitis, a thickening of vestibular nerves should be noted on MRI.
Those MRI findings are more consistent with microangiopathy related to high blood pressure, or Vasculitis.
Labyrinthitis is an " exclusive " diagnosis, it means there is need to exclude other possible conditions related to your symptoms.
In order to have a better understanding of your concerns, if they are related to herpesvirus infection or not, there is need for a review of your medical history ( when diagnosis of Ménière's was achieved did you experienced flu-like symptoms besides vertigo, dizziness, dysbalance, nausea?).
Labyrinthitis caused by herpesvirus has an acute phase ( flu-like with inner ear disfunction symptoms) and a chronic phase after fly-like symptoms subside.
There is need for a review of MRI images related to inner ear and vestibular nerves damage.
If there is high suspicion about herpesvirus infection of inner ear after this review, a lumbar puncture and cerebrospinal fluid examination is needed to confirm the diagnosis.
Hope I helped you. I remain at your disposal for further questions and clarifications.
Best regards.
Above answer was peer-reviewed by :
Dr. Vaishalee Punj
Hello and thank you for your response. I am otherwise healthy - no high blood pressure even when I was overweight (since last 5 months am at notmal weight). My diagnosis of menieres was about 3 years ago - I used to feel dizzy and attributed it to stress. Then one night leaving work i got dizzier and left work early with the feeling that I need to get home I reached home at which point I was extremely dizzy the room was spinning and I was throwing up. Laying in bed throwing up gave me no relief I continued to be dizzy. That prompted me to investigate with my medical Doctor Who then sent me to an ENT and that's where I got the diagnosis. I now experience dizziness when my eyes have too much to focus on for example in the movie theater when it's dark and I'm walking up the stairs and the little lights on the stairs are flashing I have to hold on. If I am in a certain yoga pose I am okay when I am upside down but I am not okay when I am attempting to balance. I'm attaching the wording of the MRI however I'm not allowed to have the actual MRI image until such time the neurologist requests it.I appreciate you being open to view the connection to the herpesvirus and would appreciate any links to further research that you might be able to offer. Of course I have tinnitus and I have loss of hearing on my right ear and I have hissing. I have been able to determine for myself by observation that stress levels do have an impact on the hissing and tinnitus. But I also have somewhat interesting reactions to certain tones and certain levels of sound for example I was sitting next to my granddaughter she squealed out and my sound in the ear went from the ringing to a very high-pitched but deep shift it's hard to explain it was really weird. Its as if my ear now resonates to tones that it can handle and tones that it can't. Although of course I wish I didn't have the hearing loss my main concern is the vertigo and the potential of it going bilateral.
Brief Answer:
Links you requested below.
Detailed Answer:
Welcome back.
Here are two important and serious links that treat the problem of inner ear infection by herpesvirus.
Hope this will help understand better your condition.
http://m.hopkinsmedicine.org/neurology_neurosurgery/centers_clinics/vestibular/conditions/labyrinthitis.html
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC0000/#!po=32.8283
Best regards.
Links you requested below.
Detailed Answer:
Welcome back.
Here are two important and serious links that treat the problem of inner ear infection by herpesvirus.
Hope this will help understand better your condition.
http://m.hopkinsmedicine.org/neurology_neurosurgery/centers_clinics/vestibular/conditions/labyrinthitis.html
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC0000/#!po=32.8283
Best regards.
Above answer was peer-reviewed by :
Dr. Raju A.T
Thank you. The link wasnt clickable so i had to copy it into the browser - painstakingly slowly. Lol lol.
I had another symtom that may be related. It has been going on before the diagnosis of menieres and still happens now. When i go to bed i am tired (obviously) and for the last few years i am able to sleep theough the night. (I used to have insomnia - diaagnosed from the sleep clinic - I used melatonin and one tbsp of Benadryl because of my preference bot to use prescroption drugs. After about 7 months i began to sleep theough the night. I havent used melatonin or Benadryl in the last 5 years or so). So i go to sleep tired but i wake up exhausted. I feel "heady" like my head is "full" and I feel groggy and exhausted. It takes me about one hour to "come to" and I feel most of me being able to "come to" is based on necessity of needing to get the day going. I dont have headaches but i do have what i call the feeling of "going to get a headache" and i also get this "somewhat innate sense" that i need to curl up into the fetal position, delete as much external stimuli as possible (i go under the covers, no music, no light,) and fall asleep. I'm assuming the "fetal position" is related to the need to heal? So given this infoemation, how, if at all, do you feel it may he associated to the diagnosis of menieres and aslo what would be best to ask the neurologist at my appointment. My concern is that he may assume the menieres and not "look" for something else? again, thabk you for your information so far. I feel i want to not only be more educated but also more proactive in helping myself.
I had another symtom that may be related. It has been going on before the diagnosis of menieres and still happens now. When i go to bed i am tired (obviously) and for the last few years i am able to sleep theough the night. (I used to have insomnia - diaagnosed from the sleep clinic - I used melatonin and one tbsp of Benadryl because of my preference bot to use prescroption drugs. After about 7 months i began to sleep theough the night. I havent used melatonin or Benadryl in the last 5 years or so). So i go to sleep tired but i wake up exhausted. I feel "heady" like my head is "full" and I feel groggy and exhausted. It takes me about one hour to "come to" and I feel most of me being able to "come to" is based on necessity of needing to get the day going. I dont have headaches but i do have what i call the feeling of "going to get a headache" and i also get this "somewhat innate sense" that i need to curl up into the fetal position, delete as much external stimuli as possible (i go under the covers, no music, no light,) and fall asleep. I'm assuming the "fetal position" is related to the need to heal? So given this infoemation, how, if at all, do you feel it may he associated to the diagnosis of menieres and aslo what would be best to ask the neurologist at my appointment. My concern is that he may assume the menieres and not "look" for something else? again, thabk you for your information so far. I feel i want to not only be more educated but also more proactive in helping myself.
Brief Answer:
Anxiety disorder and chronic fatigue syndrome should be discussed too.
Detailed Answer:
Hi again.
According to new information you provided, in my opinion, besides Meniere's disease and possible Labyrinthitis caused by herpes virus infection, you should discuss with your Neurologist about anxiety and stress disorder.
Fetal position during sleep is most adopted by highly emotional and sensitive people.
Another possible diagnosis, or coexistent with Meniere's that needs to be discussed with your Neurologist is chronic fatigue syndrome that may be related to unexplained fatigue and virus infection as well.
Hope I helped you to understand better your condition.
Take care.
Anxiety disorder and chronic fatigue syndrome should be discussed too.
Detailed Answer:
Hi again.
According to new information you provided, in my opinion, besides Meniere's disease and possible Labyrinthitis caused by herpes virus infection, you should discuss with your Neurologist about anxiety and stress disorder.
Fetal position during sleep is most adopted by highly emotional and sensitive people.
Another possible diagnosis, or coexistent with Meniere's that needs to be discussed with your Neurologist is chronic fatigue syndrome that may be related to unexplained fatigue and virus infection as well.
Hope I helped you to understand better your condition.
Take care.
Above answer was peer-reviewed by :
Dr. Raju A.T
Hello - last question - I am not saying thars my normal sleep pattern (fetal position) it is when I feel a possible onset of what I call an "attack" of Menieres and I instinctively want to shut down external stimuli - does that make a difference to your suggestion of anxiety disorder. Yes I am super sensitive. However I would look at anciety disorder as a psychological issue - is there a physical component that you're thinking (other than the obvious connection between mind and body)? I do appreciate youre patience in answerinf my quesrions -
Brief Answer:
Frontal lobe damage if extended could explain anxiety disorder.
Detailed Answer:
Hello again.
There is a possibility of physical component between anxiety and frontal lobe MRI findings, but this is related to extension and measures of areas damaged.
If milimetric foci, then the cause is not physical, and anxiety disorder should be assessed.
Hope I helped you. Best regards.
Frontal lobe damage if extended could explain anxiety disorder.
Detailed Answer:
Hello again.
There is a possibility of physical component between anxiety and frontal lobe MRI findings, but this is related to extension and measures of areas damaged.
If milimetric foci, then the cause is not physical, and anxiety disorder should be assessed.
Hope I helped you. Best regards.
Above answer was peer-reviewed by :
Dr. Neel Kudchadkar
Answered by
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