A lot of work has been done to determine the significance of white matter lesions. The thinking now is that they represent ischemia (lack of blood flow) in the small blood vessels of the brain. Hence they are also at times referred to as ischemic small vessel disease. Hence these lesions are more commonly seen in the MRI of patients who have cerebrovascular risk factors like hypertension, diabetes and high cholesterol as well those that smoke. Their incidence increases as we age (meaning you are more likely to see them on the MRI of someone who is 60 and above rather than someone who is in his 20′s).
Consequently, it is not wise to put MS in the differential diagnosis, if the clinician does not suspect the patient of having MS and on the MR incidental WMLs are found.
The odds are against the diagnosis of MS, because vascular WMLs are 50-500 times more likely than MS plaques.
On the other hand if a patient is clinically suspected of having MS and multiple WMLs are found, our major concern is the differential diagnosis MS versus vascular disease and we have to follow the McDonald criteria.
gunzgirl07 wrote:So I went to my go with fatigue, headaches memory issues, pins and needles in legs, fogginess. Sent me for a mri results came back with: best seen on FLAIR several areas of increased signal intensity biaterally in predominantly subcritical white matter. Impression: demyelinating disease or infectious etiology including Lyme's. Have no idea what any of this means I went for blood wrk n show no trace for Lymes. Not sure what this means
callmestitch wrote:My Neuro is pretty good, did all manner of blood tests including B12 which was in normal range. Also forgot to mention I was hyperthyroid and had the radioactive iodine treatment which sent me to hypothyroid, for some time but my levels are coming back to normal now, we found some of my symptoms correlated to this but not all. The lesions on brain were discovered routinely as they always do an MRI on people with facial palsy and slurred speech as a precaution as it might have been a small stroke (it wasn't)
I am not enjoying the dx process though, the limbo you tend to end up in (ie could be, might be, is possibly) can be a little frustrating, that MRI was taken a year ago, and my sx are off and on now, not as severe. A new sx was sudden onset of Migraines, had 3 in as many consecutive days, which had my Neuro a little concerned as I have no history of migraine let alone bad headaches. Would M.S cause Migraine also? I have not heard of it as a symptom, but have read some things online where majority of M.Sers have migraines, but you never can trust everything you read hey.. lol
Blood tests are commonly employed to check for vitamin deficiencies, toxic elements and evidence of an abnormal immune response.
Depending on your individual situation, your doctor may request certain laboratory tests to identify potentially treatable causes for neuropathy. These include tests for:
Vitamin B12 and folate levels
Thyroid, liver and kidney functions
Oral glucose tolerance test
Antibodies to nerve components (e.g., anti-MAG antibody)
Antibodies related to celiac disease
Hepatitis C and B
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