Q. Does my MRI explain as to why am I feeling lost and confused?

Answered by
Dr. Hitesh Kumar
and medically reviewed by iCliniq medical review team.
Published on Jul 22, 2017 and last reviewed on: Oct 09, 2018

Hi doctor,

I am a 29 year old woman who has been experiencing mental confusion, concentration problems, memory loss, blurry vision, burning sensation in my head, personality change, and short-term memory loss. I forget conversation, repeat questions over and over, zone out when people are talking to me, and I do not feel like myself. I got a CT scan done, but they did not find anything. I also had an MRI done without contrast, but could not understand the findings. I tried to go to my doctor to explain my problem as a walk in, but he left early. 

The MRI said ventricles are normal in size; subarachnoid spaces are not prominent, no mass, midline shift or hemorrhage. White matter is normal, and there is no diffusion restriction. Significant mucosal inflammatory thickening and signal change in frontal sinuses, ethmoid sinuses, bilateral maxillary sinuses left greater than right. Sphenoid sinuses are clear. Cerebellar tonsils are in normal location. Impression: Sinusitis otherwise negative.

 I want to figure out what is wrong with me. I got an appointment with my doctor only after a month. I feel as I am going blind and losing my mind. I need your help. Some years back, I broke my nose and had a rhinoplasty to get it fixed. I do not have any breathing problems.

#

Hello,

Welcome to icliniq.com.

Your MRI of the brain is normal, except some sinusitis.

I would like to ask a few questions. Since when are you experiencing these symptoms? Do you have a headache or vomiting? Is there any history of seizures or loss of consciousness? How is your sleep? Are you taking any medication?

I would suggest you get the following investigations done.

  1. EEG (electroencephalogram).
  2. Contrast study of MRI brain.
  3. If required lumbar puncture and CSF (cerebrospinal fluid) examination.
  4. Thyroid profile.
  5. Anti-TPO (thyroperoxidase) antibodies.
  6. Kidney and liver function test.
  7. Vitamin B12 level.

The differential diagnosis of your condition are as follows:

  1. Depression.
  2. Limbic encephalitis.
  3. Encephalopathy.

Revert with more information to a neurologist online --> https://www.icliniq.com/ask-a-doctor-online/neurologist


Hi doctor,

Thank you for replying. My symptoms are getting bad. I have noticed changes in my personality. I am more withdrawn and have lost interest in everything that I used to do. I do have jerks in my body sometimes. I get headaches and feel like my scalp is burning. I am not on any medication. I sleep and wake up in the morning and cannot go back to bed and I have dreams that I cannot remember. I do not seem to form thoughts. I  have been trying to get help because I do not feel like myself and do not know what to do.

#

Hello,

Welcome back to icliniq.com.

I feel you are having more of depressive symptoms like feeling withdrawn, loss of interest, lack of sleep and concentration problem.

But short-term memory loss and jerks in the body are things which should be evaluated further to rule out other medical problem, although that also can happen in depression and anxiety.

You can try antidepressant medications as follows. Please consult your doctor in person because these medications should be taken under the supervision of a physician.

  1. Tablet Amitriptyline 25 mg, at bedtime.
  2. Tablet Etizolam 0.5 mg, twice daily.

I suggest you get the investigations as mentioned above done.

For further queries consult a neurologist online --> https://www.icliniq.com/ask-a-doctor-online/neurologist


I had an eeg done i unfortunately I'm not insured so I can't afford to get everything done. Also I had an MRI berfore without contrast that didn't show anything but sinusitis. My eeg camed back and I like to get a second opinion my doctor doesn't think I have encephalitis but I think I do. What do you think?
#

Hello As you mention your MRI brain and EEG were normal before Then i feel its depression which is affecting you.

  • But you must get T3T4TSH & Serum Vitamin B12, Because thyroid problems and low vitamin B12 are major secondary causes for depression.
  • And have you started medications as i suggested? or other antidepressent medication?
  • how you feel after taking them?

Hi doctor,

My MRI showed sinusitis. My EEG is showing signs of seizures and that is what he said. I am trying to get a second opinion. Did you look at the charts? I do not recall having seizures ever but he gave me Oxcarbazepine 600 mg generic for trileptal. He said it as silent ones. I am trying to figure out if I continue to take this would it help my memory. Also, I am trying to figure out if there is something else happening that I need to test for. Please help.

#

Hi,

Welcome back to icliniq.com.

The EEG graphs which you sent does not seem to show any epileptic discharges though an EEG has to be seen completely (preferably on computer screen in different different montages). Have you a written report for your EEG (other than graphs)? If you have, can you send that?

  • If you never had seizures, then your symptoms are unlikely to be due to silent seizures. Sinusitis in MRI also does not explain your symptoms of mental confusion, concentration problem and memory loss.
  • I am still in more favor of it being depressive symptoms along with anxiety. You should get T3, T4, TSH and serum Vitamin B12 levels.
  • Have you started taking tablet Amitryptiline 25 mg HS and tablet Etizolam 0.5 mg BD? If started, are you feeling any improvement? It will be better if you can consult neurologist in person for better and detailed clinical assessment.

Revert with the report to a neurologist online --> https://www.icliniq.com/ask-a-doctor-online/neurologist

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