About a month back I started noticing slight lack of sensation on right cheek - difficult to describe because if I touch on both cheeks with fingers it would feel the same but somehow the right side face would feel as if it has some glue on it or dry skin. Long story short, eventually went to neuro who prescribed brain MRI with and without contrast. By now I was convinced that this must be due to MS (I generally tend to settle on worst outcome expectations). The notes from radiologist came back with following -
"There is no evidence of an acute infarct on diffusion-weighted imaging. No intracranial hemorrhage or extra-axial fluid collections are seen. There is no mass effect midline shift. Sagittal images demonstrate normal midline structures.
No leptomeningeal or parenchymal enhancing lesions are seen postcontrast imaging. No significant white matter lesions are seen on T2 and FLAIR imaging. Few scattered foci are noted within the subcortical white matter.
The major intracranial flow voids are unremarkable on T2-weighted imaging. Ethmoid air cell and bilateral maxillary sinus mucosal thickening. Left sphenoid sinus small mucous retention cyst."
I thought this was a good news and may be sinus is causing it - until I saw the neuro back. As per the neuro the scattered foci hyperintensities does not indicate a perfect MRI and MS cannot be ruled out even though the images do not show classic MS presentation. As per what I was explained, those two spots of hyper intensities are not where typically MS lesions are found but yet at my age (40) I should not have those hyperintensities. So now I have been prescribed blood tests to check for lyme, lupus and other auto immune deseases as well as spinal tap. I have had no migraine headaches or any injuries in past. I do have alergy and sinus issues.
I had few concerned questions so thought to turn here for help -
1. How likely this indicates MS? I am wondering why would radiologist see the hyperintensities but yet say no demyelination or any other concerns? May be not an easy question to answer with such limited info but I'm curious.
2. What is the likely hood of spinal tap providing answer? I have not been presecribed Spinal MRI. Should I ask for it?
3. Is there any chance Vit-B12 deficiency could cause this? My vit B-12 level recently came 330, which is on the lower side but yet I am told by physician and neuro that it is within the range and levels have to be signficiantly below the range. They also said it doesn't usually cause any facial numbness.
I would like to wait for my diagnosis to come back but in the meantime, are there any good links for me to read on vegetarian diet with MS, drug options and how to consider the best option, how quickly upon finding about the diagnosis you would need to be on drugs ( currently I donot have any symptoms other than the slight lack of sensation I feel).
s, we can not speak about whether or not there is indication of ms, sometimes doctors are not even sure. The report you got on the mri was pretty informative about what was and was not going on, it is , in my opinion, seriously impressive. I have had plenty of mris and most have never rulled out anything. You got your money's worth.
And your neuro seems to be diligent.
There are many psots here about diet, what has worked for them and what has not. You can also check on nmss.org to see what they have posted, also multiplesclerosisnewstoday.com to see what they have to say.
You can ask the neuro why he thinks a spinal mri is not indicated and see if you agree with his impression or if you want to request one.
While we're not able to answer your medical questions, we do have some information on nutrition and disease-modifying treatments we can share:
I hope this is helpful - also hoping that you get answers soon.
Thank you for your replies and links. I am going to read up further on it.
Spintal tap results came back. Not sure what to make of it, have apptment in few days with the doctor.
CSF Oligoclonal Bands Number -
Following all showing in the range -
CSF IgG/Albumin Ratio
CSF IgG Synthesis Rate (<0.0 mg/day)
WBC, CSF (0/mm3)
Myelin Basic Protein
Angiotensin Converting Enzyme CSF
Nothing seems out of range on report at least so will see what the doc says as brain MRI didn't directly indicate MS either. In the mean time I took Vit B12 shots and started B-12 methylcobalamin supplement afterwards as well and want to believe improved significantly.
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