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What did your lumbar puncture show?
what is your age? Are you also having problems with widespread body pains?
Your post indicates you are 40. Are you currently taking any medications?
Have you had your CRP and ESR tested?
Have you had any evoked potential studies done?
The most commonly used evoked potentials in patients with MS are Visual Evoked Responses (VER), Brain stem Auditory Evoked Responses (BAER), and Somatosensory Evoked Responses (SSER). Approximately 75% of MS patients exhibit abnormal VER regardless of whether or not they have a history of optic neuritis.
So your work up for MS did not substantiate the diagnosis, it would appear. Is the going theory that your symptoms and hyperintensities are from a migraine syndrome. This would seem reasonable given the above. If so, migraine prevention therapy might be in order. Have you discussed this with your doctors? Ask them about a trial of topamax or depakote.
Migraine syndromes do not always include headaches. In fact, they can mimic TIAs or strokes. They can also cause aphasia in rare instances. Atypical seizures can also cause aphasia, so you should get an EEG if you have not had one already.
You're very welcome. Hope all works out for the best for you.