AmyTx101
05-28-2009, 09:10 PM
If I type out the report can any veterans give me any advice?? my son has left gaited issues that are getting worse. we though we were dealing with cerebral palsy so they did an mri.. he had the mri yesterday afternoon and his pediatrician was called immediatley and i went and talked with him today..he has an appt in one week with a pedi neurololgist..
mri said..
mri performed without contrast.sagital t1, axial t1,t2, flair, gradient echo, and difussed-weighted images obtained. coronal t2 images performed along with sagital flair images..
no mass no hydrocephalus. no axial fluid collection, craniocervical within normal limits.visualized upper cervical spinal cord within normal limits.no restricted difussion. no aprreciable sinus or mastoid disease.
the exam is positive for a number of white matter lesions bilatterally..some of these are periventricular and others are more peripheral.. there is an anterior/frontal predominance. none of these cause any appreciable mass effect.. there are some particulary evident on the sagital images in the right frontal periventricular white matter which line up perpendicular to the corpus callosum. some of these are near the gray-white matter junction. no definant posterier fossa lesions. there are some along the lateral margins of the basal ganglia but not convincinly within the basal ganglia or thalami.
impression:
multiple white matter t2 hyperintense lesions without mass effect, hydrocephalus, or extra axial fluid collection.
the differential diagnosis is quite broad. possibilities would include various leukoencephalopathies. demyelinating disease such as multiple sclerosis is possible.. finding are not typical of ADEM but that would be in the differential
diagnosis although apparently the patient is not encephalopathic but rather has gait disturbance developing over time and not necessarily acutely...
anyone know what this could be??his pediatrician said he wasnt sure what was going on but the nuerologist yesterday said to get him in asap..so we have an appt next week...
mri said..
mri performed without contrast.sagital t1, axial t1,t2, flair, gradient echo, and difussed-weighted images obtained. coronal t2 images performed along with sagital flair images..
no mass no hydrocephalus. no axial fluid collection, craniocervical within normal limits.visualized upper cervical spinal cord within normal limits.no restricted difussion. no aprreciable sinus or mastoid disease.
the exam is positive for a number of white matter lesions bilatterally..some of these are periventricular and others are more peripheral.. there is an anterior/frontal predominance. none of these cause any appreciable mass effect.. there are some particulary evident on the sagital images in the right frontal periventricular white matter which line up perpendicular to the corpus callosum. some of these are near the gray-white matter junction. no definant posterier fossa lesions. there are some along the lateral margins of the basal ganglia but not convincinly within the basal ganglia or thalami.
impression:
multiple white matter t2 hyperintense lesions without mass effect, hydrocephalus, or extra axial fluid collection.
the differential diagnosis is quite broad. possibilities would include various leukoencephalopathies. demyelinating disease such as multiple sclerosis is possible.. finding are not typical of ADEM but that would be in the differential
diagnosis although apparently the patient is not encephalopathic but rather has gait disturbance developing over time and not necessarily acutely...
anyone know what this could be??his pediatrician said he wasnt sure what was going on but the nuerologist yesterday said to get him in asap..so we have an appt next week...
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MSNik
05-28-2009, 11:07 PM
Sorry to hear your little one is going thru this. It must be scary for him (and you!) Unfortunatley, even as a vetern, its really tough to say what this could be or isnt..
The fact that the impression says it could be any number of demylinating issues, leaves it open to interpretation and more testing. The fact that the gait disturbance is not acute, but has taken place over time is also actually good. It isnt an infection which hit him immediately and left him weak on one side.
MS is diagnosed by ruling out everything else. There are so many things which mimic MS.....additional testing will include a multitude of blood tests, to look for deficiencies- there is NO blood test to prove MS. He might need a spinal tap, (lumbar puncture) which is not nearly as horrible as it seems (just dont look at the needle), this would rule out brain infections and other things which show up in Spinal Fluid....and lastly, I hope you know that white matter, or lesions, or scar tissue is almost always found in the brain. It can be caused by trauma, migranes, infections and other things...it isnt always MS.
ITs great that you are seeing a Neuro- get some attention to this as soon as possible....hopefully, the doc can help treat the symtoms while looking for the reason and potentially cure....but in the meantime, start keeping copies of all Films, reports and any lab tests which are done. Start a file for your son and keep everything handy. If G- forbid, you have to take him to an ER or need a specialist appt, youll have this for immediate viewing. You dont want to have to go thru the racket of waiting for copies...and its also a good idea to make sure this Neuro is either an MS specialist, or has one he can refer you to, if he still isnt sure what he is dealing with. MS specialists both rule out and confirm MS.....however if he is a Neuro with an extensive patient load with MS, then he is probably just as good. Just ask those questions. Hate to see you going to a Neuro who specializes in Migranes or Parkinsons, when looking to rule out MS!
Hang in there....this must be very hard for you. Ill say a prayer for strength for you and health for your child.
Let us know how it goes..
Nikki
The fact that the impression says it could be any number of demylinating issues, leaves it open to interpretation and more testing. The fact that the gait disturbance is not acute, but has taken place over time is also actually good. It isnt an infection which hit him immediately and left him weak on one side.
MS is diagnosed by ruling out everything else. There are so many things which mimic MS.....additional testing will include a multitude of blood tests, to look for deficiencies- there is NO blood test to prove MS. He might need a spinal tap, (lumbar puncture) which is not nearly as horrible as it seems (just dont look at the needle), this would rule out brain infections and other things which show up in Spinal Fluid....and lastly, I hope you know that white matter, or lesions, or scar tissue is almost always found in the brain. It can be caused by trauma, migranes, infections and other things...it isnt always MS.
ITs great that you are seeing a Neuro- get some attention to this as soon as possible....hopefully, the doc can help treat the symtoms while looking for the reason and potentially cure....but in the meantime, start keeping copies of all Films, reports and any lab tests which are done. Start a file for your son and keep everything handy. If G- forbid, you have to take him to an ER or need a specialist appt, youll have this for immediate viewing. You dont want to have to go thru the racket of waiting for copies...and its also a good idea to make sure this Neuro is either an MS specialist, or has one he can refer you to, if he still isnt sure what he is dealing with. MS specialists both rule out and confirm MS.....however if he is a Neuro with an extensive patient load with MS, then he is probably just as good. Just ask those questions. Hate to see you going to a Neuro who specializes in Migranes or Parkinsons, when looking to rule out MS!
Hang in there....this must be very hard for you. Ill say a prayer for strength for you and health for your child.
Let us know how it goes..
Nikki