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Ask DIEGO BONILLA Your Own Question
Category: Neurology
Satisfied Customers: 268
Experience:  Pulmonary/ Critical Care at Boston University
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38 Year old female with sudden onset of vertigo with

Customer Question

38 Year old female with sudden onset of vertigo with vomiting following a 2-day migraine related to onset of menstral cycle. Presented at emergency room with vertigo. Got MRI. Showed white matter lesion in the occital region. Patient has history of migraines (monthly). Discharged from hospital to follow up with Neurologist. 3 days later and the vertigo has no stopped and the difficulty walking continues after 72 consistent hours. Are there alternative diagnosis that would mimic the symptoms of MS? Or is MS the "go to" diagnosis here?
JA: Is the headache episodic or daily? And what about nausea?
Customer: Once per month usually 2 days before menstrual cycle. Nause is sometimes present with migraines but, not always. In this recent case which led to ER visit, nausea was day one only and has subsided.
JA: Anything else in your medical history you think the doctor should know?
Customer: History: Psoriasis, IBS, migraines, sacroiliitis, MRSA, herpes simplex, cesarean section, breast augmentation. I am 5 foot 8 inches tall and weight 150 pounds.
Submitted: 11 months ago.
Category: Neurology
Expert:  DIEGO BONILLA replied 11 months ago.


This is Dr. Bonilla

I understand your concerns. The episode you described could be related to different conditions including migraine, MS, laberynthitis and infections. The lesion on the MRI is suggestive of MS, however a full evaluation including spinal MRI is necessary before making a diagnosis. Other conditions that could mimic MS are acute encephalomyelitis, lupus, progressive multifocal leukoencephalopathy and vitamin b12 deficiency. For now you should follow with your doctor and complete the full evaluation.

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