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khagihara, Doctor
Category: Neurology
Satisfied Customers: 6415
Experience:  Trained in the multiple medical fields for many years.
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T2 hyperintensities periventricular matter. on MRI. Aside

Customer Question

T2 hyperintensities periventricular white matter. on MRI. Aside from MS and vascular disease, is there any other auto immune disease(s) that could have this MRI finding? Symptoms mirror that of MS and recently had a change in bloodwork- Vitamin D Deficiency and hypothyroid - symptoms were present when bloodwork tested normal and now the bloodwork is back to normal but still have symptoms after treatment. Dont these two issues correlate with MS? 3 MRIs, multiple bloodtests, nerve conduction test, lots of blodwork, 8 moths later Neurologist has stated she doesnt think I have MS but has also offered no differential diagnosis. Does want me to have a lumbar puncture thou. Where should I go from here?
JA: Do you keep personal medical records to help track this?
Customer: yes
JA: Anything else in your medical history you think the doctor should know?
Customer: I have psoriatic arthritis and major depressive disorder
Submitted: 2 months ago.
Category: Neurology
Expert:  khagihara replied 2 months ago.

A common error is to over-interpret multiple hyperintense lesions on MRI as equivalent to MS in the absence of clinical symptoms consistent with the diagnosis. Some central nervous system inflammatory or infectious diseases may produce multifocal lesions with or without a relapsing-remitting course, including the following:

●Systemic lupus erythematosus, which can present as a recurrent neurologic syndrome before the systemic manifestations appear

●Sjögren's syndrome

●Polyarteritis nodosa

●Behçet's syndrome


●Retroviral diseases

●Cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy

●Susac syndrome, a rare microangiopathy characterized by the triad of encephalopathy, branch retinal artery occlusions and hearing loss

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