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Causes of lesions in brain (apart from MS)

(51 Posts)
Pyra Tue 26-Feb-19 11:31:22

I have recently had a brain MRI after experiencing mild persistent headaches, and peripheral neuropathy / tingling in hands and feet, for the past few months. The MRI did not show a tumour or nerve compression, but it did show a few lesions which looked white in the images I saw. I had an MRI of the cervical spine which was clear - it showed some straightening of the neck which isn't significant. I was told this could be caused by posture, muscle tension. I had an EMG done which showed mild carpal tunnel in one hand but was clear otherwise.

My (quite experienced) neurologist thinks this is likely an incidental finding, but has referred me to a colleague who specialises in MS. He said that the lesions observed would have been totally normal had I been, say, 50 years old, but since I was 40, he would rather have his colleague see me. He mentioned that migraines could cause the lesions, but my headaches didnt resemble migraines.

I am gutted at not getting an all clear, and at the possiblity of MS. I do feel tired several days, but i put that down to having 2 young children and working part-time. The last couple of years have been very stressful, in one way or other.

Keen to hear what else, apart from MS, could cause these lesions which I should probe the next neurologist about? Can lesions heal or do they get worse (with worsening neurological symptoms)? I am self-employed and don't have private medical insurance, so all these investigations are so far self-funded. I have an NHS referral for MRI but that isn't for a couple of months.

Thank you.

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DifferentWorldNow Tue 26-Feb-19 11:36:59

Not an expert but as far as my limited knowledge goes, unless you're elderly, lesions usually indicate MS, when put alongside your symptoms.

But the treatment for MS is generally much better now than even 10 years ago, what with stem cell therapy and monoclonal antibody treatment which is available on the NHS.

clairethewitch70 Tue 26-Feb-19 11:41:36

I have neurological symptoms and white lesions on brain scan. Clear emg and failure of lumbar puncture due to spinal anatomy. Was told the white lesions were probably hardening on the arteries. I was 45 at the time.

BlackInk Tue 26-Feb-19 11:41:51

I think that some vitamin deficiencies can cause neurological damage that shows as lesions in an MRI? Have you had things like B12 and folate tested? B12 deficiency is known to cause neuropothy symptoms like tingling hands, and people seem to report that you don't have to be below the NHS range to experience symptoms...

DifferentWorldNow Tue 26-Feb-19 11:46:38

My understanding is also that 12 weeks is far too long for an mri scan, unless it's a follow up to make the diagnosis? If they want to leave it a certain amount of time between scan 1 and scan 2 to see if new lesions form (which confirms MS) then 3 months would be reasonable - I had to wait 6 months between my two scans.

DrMadelineMaxwell Tue 26-Feb-19 11:53:17

I had white patches on my mri at age 40. I also have a nerve compressed by an artery which causes my tn pain.

They put the white patches down to...
Age
And migraines despite mine only being aura migraines with no pain.

Pyra Tue 26-Feb-19 12:02:47

Clairethewitch70 what neuro symptoms did you have which led to the MRI? Has there been any progression in symptoms since then?

DifferentWorldNow i didn't understand what you meant by 12 weeks beeing too long for an MRI. I have had an MRI of the brain, and of the cervical spine in the last month. I don't know if the new neurologist I will see will repeat the MRI of the brain.

BlackInk yes I had comprehensive bloods done and am sporadically supplementing B12 although this was well within range when tested in October. The tingling is better than before (or perhaps I am getting used to it) but I don't know if this is because of improved B12. Folate was borderline OK.

My diet has been quite bad past several years, but I doubt this can cause brain lesions. I don't have high blood pressure.

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Pyra Tue 26-Feb-19 12:06:35

PS and I had an eye test recently which was clear. The mild tingling / buzzing is the only odd neuro symptom, and this moves around - hands, feet, even arms.

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HoptoitDufflepuds Tue 26-Feb-19 12:18:49

I was diagnosed with a vit E deficiency as being the cause of my tiredness, pins and needles, headaches etc. I am currently on a High dose supplement and it does seem to be helping the symptoms.

SproutsMexicain Tue 26-Feb-19 12:51:16

What a timely thread! I am having my second brain MRI next week to check for changes, to summarise, I have fibromyalgia and but no pain, just neurological symptoms, I had a brain MRI 4 years ago (I was 44) and it showed numerous high signal areas in the white matter, had to have a lumbar puncture but that came back negative. I was told to watch and wait and I take Gabapentin for the neurological tinglings and paraesthesias.

just a few months ago I developed a new neurological symptom that I had not had before so am having another scan.

bit stressed about it to be honest. I have tried and tried to research what can cause these lesions but I still dont know

bringincrazyback Tue 26-Feb-19 12:53:44

Transverse myelitis?

I don't know much about it, but a friend of mine has it and apparently it shows up lesions on the brain...

I could be completely wrong, I'm no doctor but just putting it out there.

Pyra Tue 26-Feb-19 13:04:36

SproutsMexicain I am sorry to hear that and hope the MRI is clear or at least shows no change. May I ask what (old and new) neurological symptoms you experience apart from tingling? And is the tingling unilateral or bilateral? Mine is bilateral, and milder now than before, although I don't think that indicates anything.

Until today's discussion with the neurologist, I was pretty sure the tingling was probably being caused by anxiety. Stress and anxiety seem to make me hyper-aware of my body, if you see what I mean.

Even if it isn't MS, I read that white matter hyperintensities may indicate potential problems in the future, so I am going to do more research into this.

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Yogagirl123 Tue 26-Feb-19 13:06:15

Was the MRI just head OP? Did the Neurologist not ask for cervical and whole spine? I would have thought they may have done to rule out MS.

I have RRMS and have lesions on my brain and two areas of inflammation on my spinal cord & paling to optic disc.

The symptoms you describe are very similar to what I experience daily. The blood tests will rule out other possible underlying causes.

Good luck OP.

Pyra Tue 26-Feb-19 13:13:50

Yogagirl MRI was just of the head, and another of the cervical spine (neck). The current neurologist, although very experienced, doesn't think it is MS, but it isn't his area of expertise. He wasn't looking to rule out MS, but referred for an MRI to see what may be causing the recent onset headaches (which have since eased a little) e.g. nerve or disc compression. Headaches are not typical for me and started 2-3 months ago but I have had neck and upper back pain on and off for years. Neurologist thinks the WMHs are an incidental finding.

Apart from lumbar puncture, what other tests do you reckon would be suggested? Are there any blood tests at all which indicate MS (I don't know much about the condition). Would MS typically be diagnosed at this age with these symptoms, and in that case perhaps likely to be progressive rather than RRMS?

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Yogagirl123 Tue 26-Feb-19 13:51:37

Just dug my letter out! Blood tests I had were for lupus sarcoid, B12, ANA, serum ACE and a chest x Ray, all of which were fine.

As far as I know MS can’t be dx by a blood test. But I am not a clinician just been on this journey.

I was dx originally with Transverse Myelitis as I had two areas of inflammation within my spine and white matter lesions within brain. I was told at the same time it was probably a first attack of MS, which was confirmed two years later after a further relapse. I never had an LP all done by MRI.

I was age 40 at the time, my children were 10 & 8. MS is often dx in 30’s 40’s or 50s from my understanding.

If you want to know anything else, please ask.

BlackInk Tue 26-Feb-19 14:02:59

Ladies, do you mind me asking how you came to be referred for MRI?

I've had possible neurological symptoms for a couple of years (twitching, stiffness, pins and needles, spaced out feeling, blurred vision, invisible sore patches on skin.... etc.) and there's been no mention of an MRI. I saw a neurologist very briefly right at the beginning. He did a few basic mechanical checks and discharged me.

I've since found out I have low B12, but GP says it's unlikely to be causing my symptoms, which are mainly as above, plus horrible stomach issues.

I really don't mean to hijack, just looking for some advice.

Thank you!

Pyra Tue 26-Feb-19 14:07:55

Not sure about vision and stomach problems, but from whatever I have read, low b12 could possibly cause your sensory symptoms I think? I had my MRIs privately, but given recent onset headaches, my GP has also referred me for a brain MRI. This is another 2 months away, though. I don't think they may have referred me only for the tingling etc. in there were more severe neuro symptoms.

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Yogagirl123 Tue 26-Feb-19 14:16:36

Initially, GP did examination and referred me to Neurologist urgently.

Pyra Tue 26-Feb-19 14:20:04

Yogagirl123, may I ask what your presenting symptoms were?

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Yogagirl123 Tue 26-Feb-19 14:23:05

I will PM you.

SinkGirl Tue 26-Feb-19 14:27:20

BlackInk from what I know it could be b12 deficiency. Have a look at the b12d.org site, it has a symptoms calculator thingie.

I’m experiencing similar symptoms - no headaches but blurred vision, neuropathy in legs and hands. GP is considering a neurology referral and I’m having an eye test tomorrow.

BlackInk Tue 26-Feb-19 14:45:37

Thank you Pyra and SinkGirl

I tick most of the boxes on the B12 website, but GPs have been totally dismissive. I did have 5 B12 injections over 2 weeks in November, but symptoms haven't improved and they don't want to do anything other than wait 6 months then retest my B12. In the meantime I feel like I'm falling apart.

DifferentWorldNow Tue 26-Feb-19 14:50:04

* DifferentWorldNow i didn't understand what you meant by 12 weeks beeing too long for an MRI.*

I thought time from referral to mri should be 4-6 weeks if it's query MS, but has to be different if you've had your first scan and this is a diagnosis interval scan, which it sounds like it is.

SproutsMexicain Tue 26-Feb-19 14:56:33

My tingling is on the left side, started in face, cheek, tongue, a crawling sensation/creeping flesh that starts on the left side of scalp, moves down in waves over left side of face, and down left shoulderblade. I have a feeling on my left scalp like my hair is moving/tingling. I have patches of skin that feel sunburned in different areas, I have had them on the right side too though. I have a feeling of cold or hot water running down my legs or like a spider is on me but there is nothing there. A couple of years ago I developed double vision on looking extreme left this is still here. I have really bad balance/dizziness too, sometimes I have periods when I am ok, then I will be really bad again for weeks.

The new symptom that started was right lower eyelid twitching, it started intermittently, then it was continuous for weeks, it was really obvious and was even doing it in my sleep! It has now largely resolved in that I cannot see it in the mirror but I can feel the muscle twitching/quivering,

I expect I will be told it is fibromyalgia again after this scan unless it is different from the last one. I started being ill in 2006

Pyra Tue 26-Feb-19 14:59:48

I doubt the GP suspects it is MS since the presenting symptoms I consulted her for were the recent onset headaches. NHS does not yet know I have had a private MRI already (last week). I was just given a referral code by my GP clinic, and booked the first available MRI online at a London hospital, still several weeks away. I did see my GP for tingling earlier, and she tested strength in hands and feet cursorily and told me it could be stress linked, as so much seems to be according to her :-)

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