Questions for Neurologist Regarding MRI and Symptoms
Greetings! I’m a 52-year-old female, maintaining a healthy weight, with normal blood pressure and A1c levels. I do not smoke or consume alcohol, and I follow a strict vegan diet. Additionally, I have no deficiencies in vitamin B12 or any other essential minerals. I still experience regular menstrual cycles and engage in physical activities like weightlifting, using a rowing machine, and horseback riding several times a week. My height is 5 feet 3 inches, and I weigh 120 pounds. I have been diagnosed with hyperprolactinemia attributed to a pituitary tumor, which is managed with cabergoline at a dose of 0.5 mg weekly. Furthermore, I have Hashimoto’s thyroiditis and take 137 µg of Synthroid for management. Recently, I have been experiencing a resting tremor in my left arm, accompanied by persistent tension in my shoulders. If I remain still for too long, my body begins to shake uncontrollably. Occasionally, I encounter sudden jerking motions that I cannot control, alongside feelings of imbalance that occasionally lead to falls—most recently, I fell in my closet last week, resulting in bruising on my tailbone and potential displacement of my L4 vertebra over L5. I also experience what feels like electric shocks that intermittently travel down my arm, usually lasting a couple of hours, with sensations firing every few seconds. On days when I’m not experiencing shocks, I sometimes drop objects unexpectedly. Additionally, my handwriting has deteriorated despite being right-hand dominant. As an artist, I find that my ability to create fine drawings has become challenging, though it isn’t due to tremors; it simply feels like my coordination has weakened. Moreover, I’ve noticed a significant decline in both my sense of smell and taste, which has persisted for a few months without any cold symptoms. My latest MRI from last month showed no new growths on my pituitary gland but did reveal "scattered small nonspecific foci of abnormal T2 FLAIR signal elevation in the cerebral white matter." I have an upcoming appointment with a neurologist in a few weeks but would appreciate any insights regarding my symptoms. Could these issues possibly indicate a demyelinating disease like multiple sclerosis? Thank you in advance for any guidance you may provide!
Answers (1)
3/30/2025, 8:10:46 PM
OpenHealth AI
It’s great to hear that you are taking proactive steps towards understanding your health, especially given the complexity of your symptoms and medical history. Your concerns about the tremors, balance issues, and other neurological symptoms are valid, and it’s good that you have a neurology appointment coming up.
Main Points:
- Your symptoms, including the resting tremor, balance issues, and tingling sensations, could point towards several conditions, including potential neurological disorders.
- Your MRI results showing "scattered small nonspecific foci of abnormal T2 FLAIR signal elevation" require careful interpretation, but they are not definitive for any particular diagnosis.
- Monitoring your symptoms, coordinating your care between specialists, and preparing for your neurology appointment are essential next steps.
Explanation:
Your medical history is quite complex, with hyperprolactinemia, Hashimoto’s thyroiditis, and current symptoms suggesting various neurological issues. The tremors, unexpected jerking motions, balance fluctuations, and sensory disturbances (electric shock-like sensations) can be linked to neurological conditions, including demyelinating diseases like multiple sclerosis (MS). However, the MRI showing "nonspecific foci" is not conclusively indicative of MS. Nonspecific findings can be seen in numerous conditions, ranging from small vascular changes to prior migraines.
Next Steps:
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Keep a Detailed Symptom Diary:
- Track your symptoms daily, noting the frequency, duration, and triggers (e.g., what you were doing when the shaking or losses of coordination occurred). This information will be invaluable for the neurologist.
-
Prepare for Your Neurology Appointment:
- Write down all your symptoms, when they started, any recent changes, and how they impact your daily life. Bring this list to your appointment to ensure you do not forget important points.
-
Practice Safety Measures:
- Given your recent falls, consider using assistive devices temporarily (like a cane) for stability, especially during the tremors or when you feel unstable. Make your home environment safer by removing tripping hazards.
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Discuss Your Symptoms Thoroughly:
- During your appointment, discuss all your symptoms, including the decline in your sense of smell and taste, handwriting difficulties, and any other cognitive changes or concerns. These details can guide diagnosis and treatment.
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Follow Up on MRI Findings:
- Ask about the interpretation of the MRI findings, what they could mean, and if further testing is necessary (like a spinal tap or additional imaging).
You have already been diligent in your health management and should continue advocating for yourself through these ongoing concerns. Trust that your neurologist will work to identify the cause of your symptoms and develop a suitable management plan. Do not hesitate to reach out for more support or clarification if needed!
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