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Unread 12-22-2006, 07:03 PM   #1
Garney
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Default White spots brain

I am new to the MS board. Usually on Epilepsy, but someone told me to ask this queston here. Started having seizure activity few mo. ago. Feel strange before episode, then told blank eyes, mouth frozen in deep frown, Right hand and arm curl up tight. Unable to speak, but can here what is going on. Try to respond only sounds come out, eventually repeating same word. Right side weakness for a few days. MRI said to be normal except for a "few white spots" that I was told are probably due to my age. I am 46.
At times off balance, always very cold, at times blured vision, get very tired suddenly, get numb, tingle sensation in feet, and legs along with sharp pains or just a heavy tired sensation in.
Has anyone else been told that white areas in brain just your age
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Unread 12-23-2006, 01:44 AM   #2
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Hi Garney, Welcome.

The trouble with lesions is that they could be from a lot of things. I was never told they were because of age though. Maybe the Doc meant that the lesions were from an old injury or something like that.

Does Epelepsy cause lesions? I don't know. Do you suspect MS? If you do, you should discuss this with your Neuro and have him give you some of the other tests that will either confirm it or rule it out.

Nice to meet you, and do let us know what you find out.

I wish you well,
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Unread 12-23-2006, 10:28 AM   #3
lady_express_44
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Yes, aging can cause lesions and attached is some info on types of lesions:

http://spinwarp.ucsd.edu/NeuroWeb/Text/br-840.htm

Cherie
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Unread 01-07-2007, 01:11 AM   #4
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Quote:
Originally Posted by lady_express_44 View Post
Yes, aging can cause lesions and attached is some info on types of lesions:
http://spinwarp.ucsd.edu/NeuroWeb/Text/br-840.htm
From the above site:
"As a result of the high sensitivity of T2-weighted spin-echo pulse sequences, MR images frequently reveal high-signal foci within the subcortical white matter. Estimates of the incidence of these hyperintensities in the brains of healthy, elderly persons have ranged from 30 to 90 per cent. , , Gerard and Weisberg3 found subcortical lesions in only 10 per cent of patients older than 60 years unless cerebrovascular symptoms or risk factors were present; if both were present, the incidence increased to 84 per cent. To a certain extent, the presence of these hyperintensities limits the sensitivity of MR for white matter disease. They are often normal variants or related to deep white matter ischemia, but they can be mistaken for, or can obscure more serious pathology."

I'm the one who suggested Garney check you all out Since Garney had evidence of lesions, I would hate for MS to not even be considered, since MS can destabilize the brain and result in seizures (I've straddled both MS and epilepsy for four years now, so have learned a lot from both groups here). I was also interested in the subject of lesions and age because of my sister's recent discovery that she has 6 lesions (in her late 30s). I don't think that the above article would support that my sister's lesions could be due to age: she aint "elderly" (although some youngsters may argue the opposite ).
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Unread 01-07-2007, 01:58 AM   #5
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Hi Footprints (and Garney) ,

If a person has symptoms of MS, and their MRI shows lesions, this should certainly give reason for a Neuro to check out the possibility.

MS can be quite difficult to dx, and it can take many years. A Neuro will look at the patient's history of symptoms/apparent relapses, do a clinical examination (test for neurological deficit), then generally send them for an MRI, if warranted.

"Lesions" just means "damage to the brain". They are looking for a specific size, shape and location to determine whether they are likely to be of the MS-variety. Lesions can have many causes (some of which were discussed on that website), so it would be up to the radiologist/neurologist to determine if these were likely "MS" lesions.

Even if MS was suspected, many Neurologists take a "wait and see" approach (especially if there are other health factors that would be more likely be the cause of symptoms/lesions). They will often monitor a patient, wait for another episode, or another MRI, then review the prior information.

If I were in Garney's situation, I would first make an attempt to find out why the doctor/neuro thinks that these lesions are from aging. The MRI report findings should give some indication of why this is the best guess at this point in time, i.e. what exactly were the reported findings?

There is also other tests they can do, if warranted; Evoked potentials, spinal tap, etc.

If I had any question beyond that, I would visit another Neuro for a second opinion. If the finding are questionable, then it may come down to a situation of wait and see (or more testing). In the meantime, it is worth keeping a journal of symptoms/changes on a daily basis.

Attached is a list of the more some common symptoms of MS:

http://www.mult-sclerosis.org/mssymptoms.html

Cherie
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Unread 01-07-2007, 08:59 AM   #6
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Hi Garney,

B12 deficiency and gluten sensitivity/celiac disease are two other things that can cause lesions on the brain, and the symptoms can be very similiar to MS as wel (as can Lyme Disease)l. Both B12 deficiency and gluten sensitivity can cause seizures. If you are early in the diagnostic phase, I hope you ask your doctor to test for these things if he hasn't already. If you are interested in learning more about these possibilities you can check out The Gluten File linked below....the pages regarding the Neurological Manifestations (of gluten sensitivity), B12 deficiency and symptoms, Epilepsy, and MS.


Here are a few abstracts I've gathered across time that may be of interest.

Hope this helps!

Quote:
Multiple Sclerosis (MS) and vitamin B12 deficiency share common inflammatory and neurodegenerative pathophysiological characteristics. Due to similarities in the clinical presentations and MRI findings, the differential diagnosis between vitamin B12 deficiency and MS may be difficult. Additionally, low or decreased levels of vitamin B12 have been demonstrated in MS patients. Moreover, recent studies suggest that vitamin B12, in addition to its known role as a co-factor in myelin formation, has important immunomodulatory and neurotrophic effects. These observations raise the questions of possible causal relationship between the two disorders, and suggest further studies of the need to close monitoring of vitamin B12 levels as well as the potential requirement for supplementation of vitamin B12 alone or in combination with the immunotherapies for MS patients.
Vitamin B12, demyelination, remyelination and repair in multiple sclerosis. PMID: 15896807 May 2005

Multiple changes in antibodies against various antigens are found in multiple sclerosis (MS). Results - Highly significant increases compared with controls were found for IgA and IgG antibodies against gliadin and gluten. IgA antibodies against casein were significantly increased. Anti-endomycium and anti-transglutaminase antibodies were negative.
IgA antibodies against gliadin and gluten in multiple sclerosis. PMID: 15355487 Oct 2004

Two atypical patients with a multiple sclerosis (MS)-like illness and evidence of occult celiac disease (CD) were managed by the authors. This prompted screening of a further 49 unselected MS cases for serologic evidence of CD. IgA anti-endomysial antibody was found in one case (2%). IgG anti-gliadin antibody was found in 12% of patients and 13% of blood donors.
Multiple sclerosis and occult gluten sensitivity. PMID: 15210909 Jun 2004

Unfortunately the rate of misdiagnosis remains around 5%-10%, indicating that 1 in 20 patients thought to have MS has, instead, a condition resembling MS. Conditions often confused with MS may be inflammatory (systemic lupus erythematosus, Sjogren's syndrome, vasculitis, sarcoidosis, Behcet's disease), infectious (Lyme disease, syphilis, progressive multifocal leukoencephalopathy, HTLV-1 infection, herpes zoster), genetic (lysosomal disorders, adrenoleukodystrophy, mitochondrial disorders, CADASIL), metabolic (vitamin B12 deficiency), neoplastic (CNS lymphoma) and spinal (degenerative and vascular malformations) diseases.
The differential diagnosis of multiple sclerosis: classification and clinical features of relapsing and progressive neurological syndromes. PMID: 11794488

Neurological manifestations of gastrointestinal disorders are described, with particular reference to those resembling multiple sclerosis (MS) on clinical or MRI grounds. Patients with celiac disease can present cerebellar ataxia, progressive myoclonic ataxia, myelopathy, or cerebral, brainstem and peripheral nerve involvement. Antigliadin antibodies can be found in subjects with neurological dysfunction of unknown cause, particularly in sporadic cerebellar ataxia ("gluten ataxia").
Neurological manifestations of gastrointestinal disorders, with particular reference to the differential diagnosis of multiple sclerosis. Ghezzi A, Zaffaroni M. 11794474
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Unread 01-07-2007, 12:31 PM   #7
Garney
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Default Great Info

Thank you all for the great info. Many years ago I suddenly became very ill. Swollen glands(lasting 4-6 wks.) Rash on face that eventually sread down body,conjunctivitis, tired, weak, swelling of joints, finally unable to climb stairs. saw several Dr.s(each one sent me to another specialist) and told few different things. X-rays of chest reveal sarcoidosis, Neuro thought possible MS or Lupus. Positive test for Lupus, but another Dr. didn't think that was it. Had started have migrains in twenties(Occationaly) but with this started having a lot. Told I had symptons of early onset Parkinsons. Didn't really know who was right. One neuro told me after going over all tests that he stongly suspected encephalitis. Infectious Disease Dr. said I had come to him too late, but that what ever it was had compromised my immune system.

After many months of this, I seemed to get better and better.Would have bouts of swollen glands lasting weeks(at one time 6 wks.). Always told same thing, "some sort of virus." Always cold to point of blue nails and fingertips. Had a cartiact issue 6mons back. Again told from virus? Then started having seizures at 46. Sorry for the length of this, just wanted to show big Pic. Left out some things for length sake.

Not a lot of faith in med profession
Thanks to those that got through this.
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Unread 01-07-2007, 02:29 PM   #8
jccgf
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Gosh... even well into the diagnostic process, then, I'd still take a close look at gluten sensitivity/celiac disease. Delay of Diagnosis

So many things you mention are ringing bells...the frequent swollen glands, rashes, possible lupus, early cataracts, migraines, sarcoidosis.

Quote:
At times off balance, always very cold, at times blured vision, get very tired suddenly, get numb, tingle sensation in feet, and legs along with sharp pains or just a heavy tired sensation in.
I had these same symptoms with a B12 deficiency... which can be a result of malabsorption due to gluten sensitivity/celiac.

You wouldn't have anything to lose by a six month gluten free (also casein free, for good measure) dietary trial ...except for the effort and a little inconvenience. However, I would recommend blood testing for gluten sensitivity/celiac disease first, but would recommend a dietary trial no matter what the results. Do not experiment with diet prior to having blood tests run as you need to be consuming gluten for tests to be accurate... and insist they include the antigliadin IgA and IgG with the celiac panel. Also nothing to lose by taking 1000-2000mcg of methylcobalamin B12 daily, along with a multivitamin with boosted B-complex.

Might also want to scan some of the articles by by Dr. M. Hadjivassilou...as there is one on gluten sensitivity masquerading as SLE.

Gluten sensitivity masquerading as systemic lupus erythematosus. Nov 2004 - free full text

Gluten sensitivity as a neurological illness. May 2002 - free full text

Headache and CNS white matter abnormalities associated with gluten sensitivity. Feb 2001


On sarcoidosis:
Quote:
The dermatological lesions improved during the following weeks with a gluten free diet and relapsed each time this diet was stopped. Many clinical associations with coeliac disease have been described with numerous visceral and skin-mucosa involvements. Eight cases of coeliac disease associated with sarcoidosis affecting the lung have been reported: in five cases, coeliac disease preceded sarcoidosis and in one case sarcoidosis relapsed each time gluten was reintroduced like in our case.
[Celiac disease associated with cutaneous sarcoidosic granuloma] PMID: 9500002

These findings suggest that in patients with sarcoidosis, there is an altered gastrointestinal mucosal immune response, accompanied in about 40% of patients by specific sensitisation to wheat protein.
Altered gastrointestinal immune response in sarcoidosis. PMID: 3265402



I will leave it with that, but if you have any questions or are interested in more info... check out the Gluten Sensitivity/Celiac Disease forum, or you can email through The Gluten File.

Good luck in finding answers!

Cara
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Unread 01-08-2007, 05:55 PM   #9
Footprints
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Quote:
Originally Posted by lady_express_44 View Post
Hi Footprints (and Garney) ,
"Lesions" just means "damage to the brain". They are looking for a specific size, shape and location to determine whether they are likely to be of the MS-variety. Lesions can have many causes (some of which were discussed on that website), so it would be up to the radiologist/neurologist to determine if these were likely "MS" lesions.

Even if MS was suspected, many Neurologists take a "wait and see" approach (especially if there are other health factors that would be more likely be the cause of symptoms/lesions). They will often monitor a patient, wait for another episode, or another MRI, then review the prior information.
http://www.dls.ym.edu.tw/neuroscience/progmig.html
Website explaining the research that suggests women with migraines sometimes show lesions (assumed to be caused by the migraines). The location of the lesions sounds very similar to MS lesions, doesn't it? Periventricular?

My sister said that the neuro was not concerned about the lesions now, after all; that they could (!) be caused by her migraines. The End. I will try to get her to send me the MRI report with descriptions of the lesions, but I suspect she's gonna blow it off. She just had the surgery to repair the cervical herniations, which the neuro is now saying was responsible for her loss of feeling and balance, etc. The lesions.....who cares.

But they never did do any lumbar puncture (I had suggested they sample the spinal fluid today since they were gonna be in her neck, literally, anyway, but they didn't).

I know it makes some sense to just wait and see, but dang, if she has MS, I'd rather she get on preventative meds. I never had a positive LP, and I certainly had symptoms, so maybe it's not always 100% proof.

Garney, my sis is kind of like you. She finally started on anti-seizure meds a little while ago. Neurontin, I think. So she has the seizures (like me, and like my mom!), has lesions, has been diagnosed with migraines, has had these neurological probs (supposedly all assigned to the cervical herniation problem). Where do you draw the line? Limboland and watching it, or just not really watching it and saying it's migraines (or age, or whatever)?

If I had had lesions, or a positive LP, my neuro would have kicked me out of Limboland and into MS. My sis has lesions, but she's "got migraines". Hmmmm. Not that I *want* her to have MS; but I don't want her left untreated for something that she may have!!!!

Garney, I hope you get better answers! What do you do if the neuro explains lesions away by saying aging (or migraines) can cause lesions (both true). Pat pat on the head, now go away..... My sister got that two years ago (well, she wasn't even told about the lesions at that time). I've heard neuros are the most egotistical of all medical professions, and I don't doubt it. Hard to grill them, I would think.
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Unread 01-16-2007, 12:10 PM   #10
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Hi Garney! I guess I'm old too (45). I certainly feel that way lately, but I can't see that our brains should have degenerated that quickly! Although my brain feels that way lately too. Do you have hypothyroid or epstein-barr? You might get a blood test and see if they add these to all of your symptoms. Every time I go to a new doc, they find something else that is wrong, but have not gotten to the core problem yet (if there is one). My thinking is that the docs want to find one thing to feel like they've accomplished something and then stop looking for anything else. I've been passed around for the past 6 months and finally see a neurologist on Thursday. There are a lot of different mimickers as everyone has pointed out and it seems as though you have been diagnosed with a few of them. Don't give up, maybe you'll run into a doctor who can get to the bottom of it. BTW, the wait and see approach could waste valuable time that a person could be receiving one of the medications that might help prevent or put off a relapse, right? That seems to be one of the acceptable approaches that I have read about.
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