This Is MS Multiple Sclerosis Community: Knowledge & Support

Hi,

I'm not Dx as yet. My MRI scan result following first bout of Optic Neuritis is below. The neuro only got the result by phone and gave me a very fast overview which was basically - its not clear but not much we can do. Just wait and see etc etc .

Here it is

Conclusion Three small areas of T2 hyperintensity are noted on the brain study. The two supratentorial foci in isolation would be considered a non-specific finding. However, the presence of an area of abnormality in the deep right cerebellar hemisphere would indicate that inflammatory demyelination is a more likely possibility. This alone however would not be a considered diagnostic of this.

Detail
There are two tiny areas of T2 hyperintensity involving a subcortical white matter of the posterior right frontal lobe and the periventricular deep white matter adjacent to the posterior aspect of the left lateral ventricle respectively. The remainder of the cerebral hemisphere white matter appears normal. The corpus callosum is normal.

Coincidental note is made of a developmental venous anomaly ( DVA) in the left temporo-occipital region. This is a coincidental finding.

There is a tiny nodular area of T2 hyperintensity in the deep right cerebellar white matter. The remainder of the cerebellum is normal. The brain stem structures appear normal.

Intracranial vascular flow voids, both arterial and venous are normal. Cerebrospinal fluid spaces are normal. Patchy mucosal thickening is seen in the paranasal sinuses consistent with inflammatory change.


Can you help me to understand what might happen in the future?

Hey Coastal

Gosh this is tough, I will give my 2c worth, but I am by no means an expert!

Did they do an MRI of your c-spine/neck too? Did they use gladolinium as enhancement? Hyperintense seems as if the lesions are enhancing with contrast, but you don't mention it specifically. What about an LP?

So you have 3 lesions in various areas in your brain. Peri-ventricular is one typical area for an ms lesion, but in terms of diagnostic criteria, you need more lesions, or some enhancing ones on the c-spine too, and/or more relapses.
Apparently, there are lots of folks walking around with some small 'spots' in their brains, but with no symptoms of any disease - this has been found coincidentally at autopsy. ON can have other causes too.
So the ON, and 'suggestion' of de-mylenation could indicate that you might end up with ms, or this could be a clinically isolated incident and won't recurr....
Horrible to be in limbo-land. Maybe you can spend a little time eucating yourself on ms symptoms so that you are aware of them. That way, if you experience anyof them, you can go straight back to the neuro, and if these new symptoms can be established clinically or on repeat MRI, you will fulfil the 'dissemination in time' criteria for diagnosis...
Hopefully, you won't experience any further relapses or new symptoms, and this is just a worrying glitch and you will continue with good health.

There is some good info here on diagnostic criteria - just do a search in the Forums - hope it helps.
So right now, they can't diagnose ms, and you may never have another problem, or you may end up developing ms - frustrating!
I do know that the trend now is to start using the CRABS early to treat clinically isolated syndromes, but they are horrible drugs and I don't know if I would want to be on them if I didn't have a definite diagnosis...

What kind of venous anomally are they talking about - I know it is a non-symptomatic and coincidental finding - just interested.

All the best for the future - hope the ON has resolved.

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Al

Hi Ally!

Thanks for your kind, encouraging message. I did have a CSpine which was OK ( just a bit of wear and tear evident but no lesions etc.) The dVA thing is quite common I think( Deep Venous Anomoly.)

I think I might have more eye touble before too long -the one I had ON in is "quivering" and I suspect the other has a touch of the pre-ON pain I had with the other one.

Thanks again!

Hey Coastal

If the ON comes back, especially in the other eye, I would suggest that it could be a second relapse and you may need IV steroids and further investigation. If it turns out to be ms, you should get started on some treatment quickly - go back to your doc asap if you think the ON is back.

Hope it all turns out well for you.

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Al

I'm afraid I can't give you much advice about the MRI but it is worth continuing to hound your neuro if the ON recurs. They won't give you steroids in the NHS (maybe if you're private) but they will take you more seriously with a 2nd relapse.

Hope it turns out to be ok though.

Thanks Mrs George. Everyone seems to go throught the same kinds of turmoil as time goes by!

Hope you're doin OK too!