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Udate: Still more tests to run.
Lovelyhzleyes posted:
My neurologist got my MRI results back and still wants to run more tests. My MRI results findings were ... Multiple punctate non-enhancing white matter foci primarily in the frontal lobes raises differential of migraine vasculitis and MS, although less typical in appearance. Could this possibly mean that my first neurologist was wrong by saying she couldn't figure out whether I was experiencing stroke or MS symptoms? If this is only a migraine, then how can this possibly relate all of the symptoms I have been having for years? I'm very confused, but still have some more tests to run in hopes to find an answer. Can anyone help me understand this?

~ Tanya ~
hackwriter responded:
Dear Tanya,

Your first neurologist wasn't wrong by acknowledging two of several differential diagnoses. Temporal lobe lesions can be caused by stroke, MS, migraine, and a list of other things, and that's why she needs to run more tests. You might indeed suffer from migraines, and you might also have MS, or you might have had a cerebral vascular accident, or you might possibly have suffered all three, for example. An MS diagnosis is a process of elimination; when it can't be anything else but MS, you'll be given the diagnosis. And to muddy the waters further, many MS patients have a history of migraines, I certainly did. What made things a bit simpler for me was that I had no brain lesions at all on my first set of MRIs, so that ruled out stroke and migraine right from the get-go.

Testing and retesting over time will make things clearer to a doctor. Seeing the presence of new lesions on the second or third or fourth series of MRIs is one clue. A lumbar puncture positive for o-bands along with abnormal evoked potential tests and a worsening of neurological symptoms over time helps a doctor narrow it down further.


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