Where should ms hyper-intensities be?

[Carissa1981]

I am a 32 year old female. I have had 2 mri tests done. One in 2012 and one last week. Both show multiple bright areas on flair imaging they do not contrast enhance. By multiple i mean several. Many in the deep white matter, periventrical area, frontal and temporal lobes, and a few in the corona radiata. There are a few new ones since 2012. I am confused if these are in typical ms areas and if it could be ms if they do not contrast enhance. They are small but there are many. Some of my symptoms are consistent with ms: fatigue, muscle spasms, ms hug in ribs and sometimes neck, slight blurred vision at random times, trouble concentrating, confusion, zap like sensations on head and tongue, random numbness, memory trouble, clumsiness, ect. Can anyone shed light on this for me?

[Anonymoose]

I'm not an expert but I think periventricular is the trademark location but they can be elsewhere and other diseases present with periventricular lesions as well. I've got lesions in all of the other places you've mentioned as well (about 9 in total). Lesions will only light up with the gadolinium when the bbb is open. I've had two mris as well and no enhancement either time. I think it is quite possible that some of the lesions occur as a result of immune reaction within the CNS so even if the lesion is active, it might never light up.

I'm sorry you are dealing with neurological mysteries. It's not a lot if fun. I've found a lot of my neuro symptoms are related to nutrient deficiencies and can be greatly reduced if not eliminated through diet and supplements. I'm not an expert on that either but I am certain the expert will soon give you some helpful guidance.

[jimmylegs]

well good morning, anon! ;) welcome to the forum Carissa

periventricular lesions sound like good old 'dawson's fingers' - which to this point I have not seen associated with anything other than ms.

curious if any of the docs have run nutrient tests or referred you to a nutrition specialist?
do you have your own copy of any test results they might have done?
unrelated to ms, has anyone ordered serum ferritin?
and related to possible ms, have they tested serum vitamin b12 and/or serum 25-hydroxyvitaminD3?

if not, just for nutritional context I have a few questions, if I may ask:
-do you have any particular dietary habits or preferences?
-where do you sit on the active/fit to sedentary spectrum?
-do you have children, and if so how many?

[Carissa1981]

I have had all my levels checked... Specifically b12, d, magnesium, normal ANA, RA factor normal. I eat a nutrious diet with perhaps too many carbs( i am not diabetic) i am active, i intensly exercised until november when fatigue took over. I have 4 kids yet i am sure my symptoms are not stress related. I do have stress symptoms but i can easily distinguish the difference. I do have have a disc with my mri tests on it. On flair imaging some of the pictures look like the starry night sky in certain sections. My lesions are roundish but the dont enhance which suprises me because i really feel like they are active. I see a ms nuerologist at fletcher allen hospital in burlington vermont on the 27th. I am suprised that they got me in so quick. My gp said it could take weeks. I guess i am nervous they will say not ms and then i will be left without an answer. I dont want ms, but i also dont want to go down a lonely road with no answers and more symptoms.

[jimmylegs]

OK! great info.

could you post or private message the levels (with specific test type, units of measurement, and range) of b12, vit d, and magnesium?
it's KEY that ms patients have LOW TO MID NORMAL results for essential nutrients. 'normal' is not good enough.

I'd look REALLY hard at athletic nutrient depletion. serum ferritin will be an important one for you. and I'm extremely interested in your magnesium results. that test is notoriously bad. if you're not at the extreme top end of the normal range or higher, you could well be deficient.

carbs can be a key antinutrient; could be having a large impact on nutrient retention from total dietary intake. can you describe your daily intake of whole and processed, simple and complex carbohydrates?

re 4 kids, I'm not talking about stress at all - pure nutrient depletion from building entire human beings, repeatedly!

if you take the nutrition angle seriously, you can at least take control of some of your own care and in the worst case scenario you can rule out problems. but standard medical practice is NOT equipped to do this for you. at this stage of the game patients need to be their own advocates when it comes to nutrition. luckily that particular road is NOT LONELY. not here anyway

a dec 2013 chat on athletic nutrient depletion (comes up regularly on the forum)
http://www.thisisms.com/forum/undiagnos ... ml#p218944

a post from the other day, with link to scientific research on problems with the magnesium 'normal' range
http://www.thisisms.com/forum/undiagnos ... ml#p220446

2012 chat re maternal nutrient depletion (by a mom of several little ones)
mom exploring nutrition connection to symptoms http://www.thisisms.com/forum/general-d ... ml#p190398
happy ending http://www.thisisms.com/forum/general-d ... ml#p193710

[Carissa1981]

I dont know my specific levels but i could request a copy of the report. I did have the EPV in 1998 that kept me out of school with a home tutor for a month. I feel like i havent been the same since. My caffeine intake is high but i dont know how else to get through the day.

[jimmylegs]

EBV? if so - a family member of mine had chronic EBV infection - and with enough attention to nutrient status we finally beat it down and in time achieved good lab results re antibodies etc (wasn't easy, mind you - in the process I flew across country twice to deal with it in person - teaching the best food and supplement choices, ensuring correct blood tests were done and so on).

will be really worthwhile to see what results you have on file!

[Carissa1981]

Yes EBV. I make many spelling and grammatical errors which i find frustrating.

[jimmylegs]

for sure. once you get your lab results we'll be able to see what might be done to help

[Carissa1981]

I guess i am still curious about what else would cause hyperintensities in the areas where mine are. Any input?

[jimmylegs]

not from me - I'm not really an mri expert :S sry

i can tell you that my neuro said only my spine lesions were consistent with b12 deficiency, not brain lesions.
I've seen studies since that contradict that assertion. like this one:
Cranial magnetic resonance imaging findings of nutritional Vitamin B12 deficiency in 15 hypotonic infants
http://www.sciencedirect.com/science/ar ... 9811001553

other than that.. there should be someone around who would be better at answering your specific mri question!

[slghmevp]

I am sorry to post to this thread but there is disucssion about lesion types, I was wondering are paraventricular lesions same thing as periventricular? My MRI report says 4-5 paraventricular lesions of 1mm size. Neuro said this is not MS so I was wondering if somebody similar lesions here.

[jimmylegs]

I am no expert but just based on google it looks like paraventricular lesions have to do with the hypothalamus.

check out these results

https://www.google.ca/#q=%22paraventricular+lesion%22

https://www.google.ca/#q=hypothalamus+p ... lar+lesion

[Carissa1981]

I got a copy of my labs today and all of the values fall into the appropriate ranges

[jimmylegs]

excellent! do you mind posting or private messaging the numbers and units?
you said you had serum vit b12, serum vit d3, and serum magnesium, correct?

is your serum b12 at least 500 pg/mL, serum 25(OH)vitD3 at least 40 ng/mL, and serum magnesium level at least 2.7 mg/dL?

recall:
The underestimated problem of using serum magnesium measurements to exclude magnesium deficiency in adults; a health warning is needed for "normal" results.
http://www.ncbi.nlm.nih.gov/pubmed/20170394

also

...ms patients and healthy controls can typically all be described as 'normal'. the difference between patients and 'healthies' is RELATIVE deficiency, generally found within the normal range, eg low normal vs high normal.

.. more at http://www.thisisms.com/forum/regimens- ... c2489.html