25 y/o female, BP 100/60 normal 65" and 170lbs with wiggly lines in field of vision, problem stops after 30min, frequent headaches. One episode of visual disturbance prior (2008). Brain MRI with 3mm nodule WMH subcortical left parietal in t2/FLAIR? Neuro made no further mention of probably migraine headache and referred me to an MS specialist with no dx, and no explanation. Very scared, no answers and no explanation. Help!
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White matter hyperintensity t2/FLAIR
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5 UpVoted this answer
Be assertive with your neurologist and your "MS" specialist. You need information that involves your health and well-being and they have that information. Respectfully demand it!
4 UpVoted this answer
Based solely on the symptoms you describe, you are most likely suffering from migraines. It is difficult to make much of one three millimeter spot on your brain MRI and certainly a diagnosis of MS can not be made from that finding alone. A neurologist needs to obtain a thorough history and if nothing further of concern is elicited than likely you will be treated for migraines and have a follow-up MRI in a year or sooner if further symptoms develop. On the other hand, if a careful history.brings up possible other neurologic issues than further evaluation including a lumbar puncture may be required (a lumbar puncture when performed by an experienced physician is safe and generally not particularly painful.)
3 UpVoted this answer
Please consider seeing a Neuro-Ophthalmologist, if available in your area, if not ophthalmologist can obtain a Complete Visual field test (Humphrey's) and evaluate condition of your eyes; you may need migraine preventive medication; MRI findings may or may not be from MS; if MRI was done with contrast to see if that lesion enhances; but just one such lesion may occur with migraine; subcortical lesion may not be MS, which generally occurs near ventricle wall (much deeper); may consider full blood tests, lupus, coagulation studies, CBC-chemistry and can get second opnion from another neurologist; hope this helps, but act soon.
3 UpVoted this answer
I agree with all of the above. But when I hear a young female complain about frequent HA's, I always think about psuedotumor cerebri. I have worked closely with our local neurologist for years and he is amazed at how many I send over that end up having that. Do all that has been recommended and also get a dilated eye exam to make sure your optic nerves aren't swollen. If they are, let your new neurologist know and he will take it from there. If they aren't, then you have ruled out one more possible cause of the HA.
1 UpVoted this answer
Symptoms are most likely from MIGRAINE, but followup with a good neurologist is necessary to make sure it is nothing else, as MS. The abnormality on the MRI sounds like a "red herring", an independent problem and needs to be followed up with followup MRI, again, ordered by a GOOD neurologist. Given your age and the duration of your sx and the predictability of having similar symptoms recur all favor MIGRAINE. The best advice I can give is find a GOOD neurologist. Ask your primary care or family physician to help you in your search, as long as you have confidence in your family physician. It's a lot harder to find a neurologist on your own than a family physician whom you trust. Take it from there.
Carey M. Delcau, M.D.
St. Louis, MO
Carey M. Delcau, M.D.
St. Louis, MO
1 UpVoted this answer
Headaches can have different causes. Often, is mportant to identify other symptoms associated with the headaches, like visual problems or nausea, etc. to help narrow down the possible cause.A thorough dilated eye exam can rule out any ocular or visual explanation for the headaches. If no visual or ocular reason for frequent headaches exist, which may or may not be your case, you would need an MRI, to identify tumors, MS or other diagnoses. Since your neurologist has identified a lesion in an MRI and referred you to an MS neurologist, it seems that he is unsure and his dx is "posible (not probable) MS", or migraine headaches. Hopefully the MS neurologist explains things to you, specially if the MRI is repeated to make sure nothing is changing.
Migraine could also be possible, so discuss this with the new Neurologist as well.
Thank you Dr. Peterson, I agree that I need a better neurologist :)
I have an appointment with the specialist on 8/4, so we'll see how we do together. Your response definitely provides some relief. The neurologist's mere suggestion of seeing an MS specialist scared the pants off of me!
Thank you again.
I have an appointment with the specialist on 8/4, so we'll see how we do together. Your response definitely provides some relief. The neurologist's mere suggestion of seeing an MS specialist scared the pants off of me!
Thank you again.
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