Clarification on MRI results

[delainarichard]

Could someone please help me to better understand my MRI? For the past 2+ yrs I have been suffering with severe fatigue, muscle & joint pains, etc...which has affected my entire life (Holistically). Recently, upon getting out of bed when my feet hit the floor, my body followed. I loss all muscle control to my lower extremities for approx 20-30 mins. There was no warning prior to this happening. My legs have remained really weak since. I recently had an MRI done and this was what it said:

There is no enhancing mass or mass effect. Nonspecific tiny area of signal alteration is noted within the left posterior parieto-occipital region and in the right lateral basal ganglia and left frontal lobe. The ventricular system is not dilated. The brainstem & cerebellum appear normal in signal intensity. The is no extra-axial fluid.

IMPRESSION:
1. No enhancing mass or mass effect.
2. Several tiny nonspecific foci or signal alteration noted on the FLAIR pulse sequence within the white matter of both hemispheres. Findings may be secondary to chronic microvascular ischemic disease. Follow up MRI in 3-4 months would likely be of benefit.

I am a 39 yr old female now being told by my MD that ive had some mini-strokes with the early onset of dementia! I am a nurse since 2008, however I am not very familiar with all of this and would like someones input on possibly clarifying this for me.

Thank you,
Delaina

[Scott1]

Hi,

I think the reason they mentioned stroke is in the comment "microvascular ischemic disease" . Ischemia means there is an inadequate blood supply to some part of the body. It could be to an organ or to muscles.

You need to look at the quality of circulation. As you are a nurse, I suggest you read any or, preferably, all of the books on heart disease by Stephen Sinatra.

In particular, look at what he says about statins and their impact on coQ10.

The episode you have had is a very clear warning to modify elements of your lifestyle. I hope you don't smoke. If you do, stop now. Exclude added sugar and gluten from your diet. Significantly increase the volume of dark green leafy vegetables and try to derive most of your good fats from things like avacodo. (I eat a whole one for breakfast every morning). I am not anti meat but try to make it lean meats at this stage. If you eat offal, keep doing it as that is a valuable source of coQ10. Alternately consider taking a coQ10 supplement but make sure it is an oil base and preferably is mixed with d-tocopherol (Vit E)
Look up Louis Ignarro on the internet and try to get into the stream of work done by him and his colleagues about Nitric Oxide. He won the 1998 Nobel Prize so what is coming from that school of thought is worth considering.

You need to vasodilate better so you will have to change your lifestyle a little. What you said about fatigue would fit with your ischemic condition. Sinatra's ideas will help with that.

Regards,

[jimmylegs]

hi delaina i'm no pro on MRI, only having needed it once for dx (2006) and only bothered with 1 followup since (don't recall the specific year). so, i would only be able to contribute google searches on terms linking the findings, with the tech's impression.
the docs will just be working through a process and it doesn't sound like they're jumping on ms out of the gate.
since there is mention of chronic microvascular ischemic disease, i would personally be looking that up first, seeing which if any symptoms fit, also whether any of the potential contributing causal elements made sense in my case, and if so how i could make the most relevant and beneficial changes during the proposed 3-4 month waiting period for next follow-up.
since they mentioned strokes and early dementia i'd also personally be looking for any common ground among lifestyle contributors to those.

http://www.md-health.com/Chronic-Microv ... sease.html (includes a little mri info)
http://www.healthline.com/health/stroke ... ini-stroke
http://www.healthline.com/health/dement ... ning-signs

prevention info per the above:

1. You may be sent to physical therapy to deal with the effects on your body. They will also work to bring any other health conditions under control. This includes:
Strict blood sugar control for diabetics
Controlling hypertension
Quit smoking
Keeping cholesterol under control

2. You can do the following to prevent TIAs and strokes:
Don’t smoke.
Avoid secondhand smoke.
Eat a healthy diet with more fruits and vegetables.
Maintain a healthy weight.
Exercise regularly.
Limit your alcohol intake.
Don’t use illicit drugs.
Control your diabetes.
Reduce your sodium intake.
Limit your cholesterol and fat intake, especially your intake of saturated and trans fats.
Make sure your blood pressure is under good control.
Reduce stress.

3. Can you prevent dementia?
You can take steps to improve cognitive health and reduce your or your loved one’s risk. This includes keeping the mind active with word puzzles, memory games, and reading.
Being physically active, getting at least 150 minutes of exercise per week, and making other healthy lifestyle changes can also lower your risk.
Examples of lifestyle changes include stopping smoking if you smoke and eating a diet rich in:
omega-3 fatty acids
fruits
vegetables
whole grains
You can also reduce your risk by increasing your intake of vitamin D.

hope that helps take the pressure off on the ms front at least the docs will work through it. taking good care of yourself while they are figuring things out, should help make sure they are not having to sift through side effects of lifestyle problems in addition to whatever else is going on. the good news about that approach is, you can act now even while waiting for appointments

PS i see scott1 has chimed in since i started typing. same general thoughts in the mix, looks like!

[NHE]

Hi Delaina,
Welcome to ThisIsMS. I'm wondering if you've ever been tested for sleep apnea? It can cause changes seen via MRI that appear as "microvascular ischemic disease." Furthermore, untreated sleep apnea can cause dementia. Check PubMed. https://www.ncbi.nlm.nih.gov/pubmed

[delainarichard]

Scott1 & jimmylegs: Thank you for the info and I will definately look these up.

NHE: I have been tested for Sleep Apnea and the results came back showing "very mild".

That being said, I don't have hypertension, diabetes or high cholesterol. My only down fall is that I unfortunately do smoke. Approx. 1 pack a day. As a nurse I am aware that is not a very good thing. I am in the process of stopping. I apprieciate all of your replies and will definately initiate these findings in my daily life. Again thank you.

[NHE]

My only down fall is that I unfortunately do smoke. Approx. 1 pack a day. As a nurse I am aware that is not a very good thing. I am in the process of stopping.

The best time to quit is today! Smokers inhale quite a bit of carbon monoxide (CO) among a plethora of other toxins. You may recall that CO is toxic because it has a 200x greater affinity to hemoglobin than carbon dioxide (CO₂). In effect, your body has a hard time getting rid of it and you become oxygen deprived (hypoxic).

Also ask yourself which set of lungs do you want? http://www.thisisms.com/forum/general-d ... ml#p236289 If smoking did to people's outsides what it does to their insides, then the tobacco companies would quickly go bankrupt.

My professor in grad school smoked for many years. He's an incredibly smart guy, but the addiction still got the better of him as he was recently diagnosed with esophageal cancer that had spread to his ribs and had gotten into his bones.

[LizardKing]

Could someone please help me to better understand my MRI? For the past 2+ yrs I have been suffering with severe fatigue, muscle & joint pains, etc...which has affected my entire life (Holistically).:

Severe fatigue is a symptom common to a lot of neurological disorders.
Have you had any episodes of blurry or double vision last more than a day?

2. Several tiny nonspecific foci or signal alteration noted on the FLAIR pulse sequence within the white matter of both hemispheres. Findings may be secondary to chronic microvascular ischemic disease. Follow up MRI in 3-4 months would likely be of benefit.

I am a 39 yr old female now being told by my MD that ive had some mini-strokes with the early onset of dementia! I am a nurse since 2008, however I am not very familiar with all of this and would like someones input on possibly clarifying this for me.

Strokes and vascular diseases are much more common than MS and both can have lesion that look similar but because MS is so uncommon radiologists no longer list MS as possible unless you have a nice spread of Dawson's fingers.
Keep a close watch on unusual symptoms that last more than a day that can be neurological, google them up.
Make sure that you do not take whatever the doctors tell you as gospel and when they do tell you stuff research it yourself
and do get copies of your medical records.

[lyndacarol]

For the past 2+ yrs I have been suffering with severe fatigue, muscle & joint pains, etc...which has affected my entire life (Holistically). Recently, upon getting out of bed when my feet hit the floor, my body followed. I loss all muscle control to my lower extremities for approx 20-30 mins. There was no warning prior to this happening. My legs have remained really weak...

I am a 39 yr old female now being told by my MD that ive had some mini-strokes with the early onset of dementia! I am a nurse since 2008, however I am not very familiar with all of this and would like someones input on possibly clarifying this for me.

Hi Delaina.

As a nurse, you probably know that there are vitamin D receptors (VDR's) on almost every cell in the human body, including the intima of blood vessels. Vitamin D deficiency has been linked to strokes.

Fatigue, muscle and joint pain are consistent with vitamin D deficiency since any system can be affected.

Effects of vitamin D on Muscle Function and Performance: A Review of Evidence from Randomized Controlled Trials
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3513873
This article deals with the fact that a D deficiency has been associated with reduced balance, instability, weaker quadriceps, slower reaction times, and impaired postural stability.


Effects of vitamin D in skeletal muscle: falls, strength, athletic performance and insulin sensitivity. (2014)
CM Girgis, RJ Clifton-Bligh, N Turner, SL Lau, JE Gunton
https://www.ncbi.nlm.nih.gov/pubmed/24256495

Effects of vitamin D in muscle metabolic function, specifically insulin sensitivity, are also addressed in this review.



Vitamin D, muscle function, and exercise performance. (2010)
M Bartoszewska, M Kamboj, DR Patel
http://www.ncbi.nlm.nih.gov/pubmed/20538161

Abstract
Vitamin D has an important role in skeletal muscles. Previously recognized for its effects on bone, it is now known that vitamin D has a much wider spectrum of usefulness for muscle. Studies indicate that vitamin D deficiency is pandemic. Those affected include the young and otherwise healthy members of the population, including athletes. Controversy exists regarding the amount of supplementation required to reverse deficiency and the relative effect of such a reversal on overall health. This article reviews current data on the role of vitamin D on muscle function, and explores the potential implications of its deficiency and supplementation on physical fitness and athletic performance.

Vitamin D and Chronic Pain: Promising Correlates
Colleen E Nadolski, RN, MSN, ANP-C
US Pharmacist, July 18, 2012
https://www.uspharmacist.com/article/vi ... correlates

The case reviews and studies presented in this article suggest not only an association of low vitamin D levels with various pain syndromes, but also an improvement in symptoms with vitamin D repletion. Mechanisms underlying this association have not been identified or quantified.


Misdiagnosed Vitamin D Deficiency (9 min.)
with James E. Dowd, MD, FACR, ABIHM:


Interviewer: Because of what you said where a lot of doctors still aren't seeing this as a need to get tested for, vitamin D deficiency is probably still misdiagnosed as a number of other things… Is that correct?
Dowd: Yes, it probably is overlooked in a number of different diseases. Chronic pain, something that's rising significantly in the United States right now.


I suggest that it might be a good idea to request a simple, inexpensive (about $70) vitamin D blood test called the "25-Hydroxy D," if this has not already been done as part of the investigation into your symptoms. GrassrootsHealth (http://www.grassrootshelp.net) recommends that the serum vitamin D3 be at least 40-60 ng/mL.