Two MRIs showing different things

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LillyBloom
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Two MRIs showing different things

Post by LillyBloom » 2 weeks ago

We have run into a hiccup with diagnosis. I had a pretty rough episode in 2015. Double vision, couldn't walk properly, pain, burning, tingling in legs that felt heavy and uncoordinated. After 17 days it stopped and I could walk but my legs were weak. So I got an MRI and had Evoked Potential.
MRI showed several small peri ventricular white matter lesions. Report said MS was possible and would need to be ruled out.

I was good for a few years up until last September. I started to have very serious attacks of vertigo and numbness and tingling mostly in the left side of my body. Then I got tightness in my chest all around the thoracic area, front and back. Had my heart check and it's all good.
December 9th I had an attack of vertigo in the shower, blacked out and fell. My husband insisted it looked like a seizure. I could not walk talk or see properly. The ER staff insisted I was drunk or on drugs even doing a full panel for alcohol and numerous street drugs. The next day I had another attack of vertigo in my doctors office. He gave me a quick shot of steroids. After a few days I kinda snap out of what I called almost dream like state. I had been very confused, short term memory was messed up. But now I'm feeling normal. That lasted about a week. Then came the spells of vertigo and tingling "sometimes painful stinging" sensations down my left leg and arm, or feeling of a wet foot and squeezing in my chest and sharp pokes in my chest. I also have not been able to drive because the vertigo comes on so fast.
So doc orders an MRI and this one shows "Singular punctate hyperintensity
in the subcortical white matter of the right parietal lobe. Nonspecific, not demyelinization."

So now I have two MRIs over a period of 4 yeas and feel like we have more questions than answers.

Have any of you had this happen? Should I opt for a third MRI?

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jimmylegs
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Re: Two MRIs showing different things

Post by jimmylegs » 2 weeks ago

hi lili, welcome to the forum. sorry to hear you've been having a rough time and a confusing dx process.
others may be able to comment more knowledgeably than i on your specific xp. i don't know much about mris or diagnostics. i do know that lesions come and go, and from personal xp my own behaviour dictates how well or poorly i do over time.

i generally encourage all to examine any degree to which day to day status quo diverges from specific public health recommendations re diet and exercise.
look to improve those and worst case scenario you are in better condition to face whatever it is. also, at least going forward (and recognizing that it can take some time to 'dig out' of any long term figurative 'holes' dug prior), you get to exclude any potential muddying influence of poor day to day lifestyle on your diagnostic scenario.

a glance at google scholar, using search terms deficiency vertigo:
https://scholar.google.ca/scholar?as_yl ... as_sdt=0,5
d3 is commonly low among ms patients, not to mention a bunch of other chronic diseases we'd all prefer to avoid.
it can be useful to know d3 status, decide on a serum target, and ensure nutritional cofactors are adequate to support efficient absorption (rather than throwing a bunch of d3 at a broken-down system that will waste it)!

i would highlight magnesium as a d3 cofactor of particular interest, not only from the lit indicating
-mag is low normal in ms and
-low mag is linked to low d3 status,
but from personal xp as well.

also, having read this in particular re vertigo: "caused most often by an imbalance in the metabolism of calcium carbonate crystals (otoconia) inside the semicircular canals" - calcium and magnesium need to be in balance for good health.

related article
Magnesium as an intrinsic component of human otoconia (2018)
https://www.tandfonline.com/doi/abs/10. ... 18.1467572

low magnesium would impair d3 status, so it all hangs together that low d3 (and low mag) could be in the picture in cases of vertigo.

all of that prompts me to ask whether you've had serum 25(OH)vit D3 and/or serum magnesium tested lately, and if so what were the results including units of measurement.

aside: if there's reason to suspect low vit b12, that should also be excluded when ms is in the picture. far less in the lit linking vertigo and b12 deficit however. so far, seeing one case study from the 70s...
https://scholar.google.ca/scholar?q=cob ... as_sdt=0,5
take control of your own health
pursue optimal self care at least as actively as a diagnosis
ask for referrals to preventive health care specialists eg dietitians
don't let suboptimal self care muddy any underlying diagnostic picture!

ElliotB
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Re: Two MRIs showing different things

Post by ElliotB » 2 weeks ago

Welcome to TIMS. Sorry you are not well.

MRIs can sometimes be difficult to read. You need to see a neurologist that specializes in MS and have that doctor review your recent MRIs.

Good luck!

LillyBloom
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Re: Two MRIs showing different things

Post by LillyBloom » 2 weeks ago

jimmylegs wrote:hi lili, welcome to the forum. sorry to hear you've been having a rough time and a confusing dx process.
others may be able to comment more knowledgeably than i on your specific xp. i don't know much about mris or diagnostics. i do know that lesions come and go, and from personal xp my own behaviour dictates how well or poorly i do over time.

i generally encourage all to examine any degree to which day to day status quo diverges from specific public health recommendations re diet and exercise.
look to improve those and worst case scenario you are in better condition to face whatever it is. also, at least going forward (and recognizing that it can take some time to 'dig out' of any long term figurative 'holes' dug prior), you get to exclude any potential muddying influence of poor day to day lifestyle on your diagnostic scenario.

a glance at google scholar, using search terms deficiency vertigo:
https://scholar.google.ca/scholar?as_yl ... as_sdt=0,5
d3 is commonly low among ms patients, not to mention a bunch of other chronic diseases we'd all prefer to avoid.
it can be useful to know d3 status, decide on a serum target, and ensure nutritional cofactors are adequate to support efficient absorption (rather than throwing a bunch of d3 at a broken-down system that will waste it)!

i would highlight magnesium as a d3 cofactor of particular interest, not only from the lit indicating
-mag is low normal in ms and
-low mag is linked to low d3 status,
but from personal xp as well.

also, having read this in particular re vertigo: "caused most often by an imbalance in the metabolism of calcium carbonate crystals (otoconia) inside the semicircular canals" - calcium and magnesium need to be in balance for good health.

related article
Magnesium as an intrinsic component of human otoconia (2018)
https://www.tandfonline.com/doi/abs/10. ... 18.1467572

low magnesium would impair d3 status, so it all hangs together that low d3 (and low mag) could be in the picture in cases of vertigo.

all of that prompts me to ask whether you've had serum 25(OH)vit D3 and/or serum magnesium tested lately, and if so what were the results including units of measurement.

aside: if there's reason to suspect low vit b12, that should also be excluded when ms is in the picture. far less in the lit linking vertigo and b12 deficit however. so far, seeing one case study from the 70s...
https://scholar.google.ca/scholar?q=cob ... as_sdt=0,5
I haven't had my Vitimin D checked recently but has been low in the past. My B12 is good because I require b12 shots monthly for pernicious anemia.

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NHE
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Re: Two MRIs showing different things

Post by NHE » 2 weeks ago

Welcome to ThisIsMS LillyBloom. I would recommend getting copies of your MRIs, writing down the history of your symptoms and then taking them to neurologist for a second opinion. An MS specialist might be a good idea since your first MRI suggested the possibility of MS. However, your second MRI indicated a non-demyelinating lesion so you may have something else going on.

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jimmylegs
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Re: Two MRIs showing different things

Post by jimmylegs » 2 weeks ago

ok so in the past have you been prescribed a vit d3 regimen? if yes, still on it or no? also if yes, any follow-up testing to check efficacy? was any target serum level in mind? or just 'not insufficient'?

fwiw ms patients are generally looking for a higher 'optimal' serum d3 level than those generally considered sufficient in the mainstream.
mainstream is typically ok with a level in the low 70s (in nmol/l). literature suggests 90-100 nmol/l is best for multiple outcomes, other research targets 100-150 nmol/l for things like immune health, reduced cancer risk, reduced ms risk. above that, you're into higher risk for other health issues - in some cases, related to cofactor depletion from excess d3 intake.

sounds like it could be worthwhile to assess mag status, eg:

1. routine mag intake in via diet and supplement sources.
a do you know your most dense whole food sources of mag consumed on a daily or weekly basis?
b do you know if you meet food guide recommended intakes (most do not)
c do you take any supplemental mag daily?
---if so, which chemical form, how much?
---also if so, is it taken on its own or in combination with other things eg as part of a multi?

2. any lifestyle mag depletion/interference factors.
a any physical or emotional stressors in the mix?
---exercise?
---surgery/trauma?
---stressful job or relationship(s)?
b mag-depleting medications like PPIs?
c routine calcium supplements?
d routine alcohol consumption?

3. serum magnesium level test, to ensure high normal status (ie probably right at the top of the local lab's reference/normal range)

hopefully there's something in there that could make sense as a useful consideration and possible action item :)
take control of your own health
pursue optimal self care at least as actively as a diagnosis
ask for referrals to preventive health care specialists eg dietitians
don't let suboptimal self care muddy any underlying diagnostic picture!

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