HomeAnswersNeurologymultiple sclerosisShould I be concerned about the unusual structures in my MRI report?

Could my symptoms and MRI scan be indicative of multiple sclerosis?

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The following is an actual conversation between an iCliniq user and a doctor that has been reviewed and published as a Premium Q&A.

Answered by

Dr. Hitesh Kumar

Medically reviewed by

iCliniq medical review team

Published At October 7, 2023
Reviewed AtOctober 7, 2023

Patient's Query

Hello doctor,

I am a 29-year-old man with a muscular, athletic build. I used to engage in distance running regularly and was in excellent shape. However, I began experiencing debilitating symptoms that impacted my career last year. These symptoms include heart palpitations, chest pain and pressure, nausea, muscular weakness, muscle spasms in various areas of my body, sensitivity to temperature, digestive issues, and other symptoms. I have a family history of multiple sclerosis (MS) and brain tumors. I underwent an MRI to investigate the possibility. Fortunately, no plaques indicative of MS were detected on the MRI. However, the scan did reveal some unusual structures extending from the back of my head to just behind the ear. These structures appeared as black voids, white signal activity areas, and masses of black squiggly lines. Notably, the appearance of this side of my brain, which I believe is the right side, differs significantly from the other. My physician, who specializes in nutrition, hormonal issues, and general practice, stated that it is not MS but did not provide further insight I have attached my MRI scan, which shows the progression from the back of my head to around the ear, with the areas of concern circled in blue, while the remaining areas are the original MRI colors. One image in the scan shows a view from below (possibly) with a spot of bright signal activity corresponding to the structures in the other images.

Although my physician reassured me that there is nothing to be concerned about, I am seeking a professional opinion on whether I should consult a neurologist to explore this matter further. Please help.

Thank you in advance.

Answered by Dr. Hitesh Kumar

Hi,

Welcome to icliniq.com.

I read your query and understand your concern.

I would like to obtain further details about your condition:

  1. When did you first start experiencing these symptoms?

  2. Are these symptoms episodic and persistent, or did they only happen once last year?

  3. If episodic, how long do these symptoms last during each episode?

  4. Please explain each symptom separately to gain a better understanding.

MRI (magnetic resonance imaging) brain is always interpreted by features of a lesion in all sequences, including T1 (T1-weighted), T2 (T2-weighted), FLAIR (Fluid-Attenuated Inversion Recovery), GRE (Gradient Recalled Echo), CISS (Constructive Interference in Steady State), and Contrast. You have provided only one sequence (attachments removed to protect the patient's identity). I suggest you send all images (all sequences) for a comprehensive evaluation. Please upload the entire CD through the icliniq software.

I hope this helps.

Please feel free to ask if you have any further questions.

Thank you.

Investigations to be done

Investigations to be done are: 1. ECG. 2. 2D Echocardiography. 3. CBC/ LFT/ KFT. 4. T3T4TSH. 5. Serum Vitamin B12. 6. MR angiography. 6. Venography brain with contrast. 7. Ophthalmology reference for looking at fundus.

Regarding follow up

For follow-up, kindly revert to the above-mentioned information for better understanding and judgment.

Same symptoms don't mean you have the same problem. Consult a doctor now!

Dr. Hitesh Kumar
Dr. Hitesh Kumar

Neurology

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