OpenHealth Q&A

Seeking Guidance: Is an MRI Necessary?

I am a 48-year-old woman, measuring 5 feet 3 inches and weighing 120 pounds. I’m experiencing distressing symptoms that seem to involve my brain, right eye, bladder, the left peroneal nerve, and encompass issues related to my nervous system. I have a history of several medical conditions including oscillopsia, mal de debarquement syndrome, a peroneal nerve injury, osteoporosis, dropfoot, neuropathy, and GSM. Currently, my medication regimen includes Actonel, Trintellix, Trazodone, and a Dotti patch. I have tried Lyrica but had to discontinue due to it making my dizziness worse. Since April 4, 2025, I have been dealing with constant dizziness that feels like being on a never-ending boat ride. It is not the classic spinning vertigo, but rather a persistent sense of instability that is sometimes accompanied by panic-inducing sensations. At night, I experience frightening dreams where my dizziness amplifies, often picturing myself in turbulent waters or losing my balance. This unsettling sensation occurs regardless of my position—sitting, standing, or lying down. The only slight relief I find is during passive motion. According to my general practitioner, my condition could be BPPV. Meanwhile, the ENT specialist suggested it might be mal de debarquement, confirming definite oscillopsia affecting my right eye. I also find sleep to be thoroughly draining. My visual health is deteriorating, particularly in my right eye, where I experience oscillopsia, blurriness, double vision, and regular pain and stinging sensations. This eye feels unusually bulged, and because each eye perceives dissimilar images, it exacerbates my balance issues. As a result, I am relying heavily on my left eye. In recent months, I’ve been facing increasing urinary urgency—particularly alarming episodes of discomfort that have led me to urgent care on multiple occasions since April 4. However, tests have consistently ruled out urinary tract infections, despite needing to make over 30 bathroom visits within a day at the worst times. Additionally, I've been managing left-sided dropfoot following a perineal nerve lesion since 2009, which started suddenly and caused immense pain. I woke up one day to find I could no longer stand without my left leg collapsing. This has resulted in tibial nerve paralysis, causing my toes to form contractures due to immobility. An EMG conducted in July 2024 indicated a severe yet incomplete lesion on the left peroneal nerve, alongside other abnormalities like hyperreflexia and absent reflexes. I now find that symptoms like tingling, numbness, electric pain, and a sensation of limb heaviness are coming on more quickly and affecting larger areas of my body, with prolonged recovery times. My balance has severely deteriorated; I was previously able to walk in a straight line with my eyes closed, but now I struggle even to step backwards without feeling on the verge of falling. The EMG was performed through a neurologist via an insurance referral, but unfortunately, the report did not make it into my medical file, although I have a physical copy on hand. It’s difficult to read, and I apologize for the lack of a digital version. Since April 4, I’ve been overwhelmed by persistent fatigue that leaves me unable to exercise. Even sitting for a few minutes feels overwhelming. Activities such as yoga, where my head is below my heart, are impossible due to the intense sense of instability. I am seeking guidance on how to approach the need for MRI scans or additional testing, considering my situation. I concur with those recommending that a neurologist’s opinion is necessary. My GP has referred me, but I won’t be able to see a neurologist until February 2026. Furthermore, an ENT referral has fallen outside my insurance network, presenting a daunting cost of $900 just for an initial consultation, making it an impractical option. I sincerely appreciate any advice on the next steps I should take. Thank you for your understanding regarding the EMG’s legibility.

Answers (1)

6/29/2025, 9:40:43 PM

OpenHealth AI

Based on the complexity and distressing nature of your symptoms, particularly those affecting your balance, vision, and urinary function, it is essential to take a structured approach to address your concerns regarding the need for an MRI and further evaluations.

Key Points

1. Comprehensive Symptom Overview: You have a history of multiple health issues and are currently experiencing a range of troubling symptoms, including dizziness, visual disturbances, and urinary urgency.
2. Potential Need for MRI: Given the neurological implications of your symptoms, an MRI could be crucial to rule out structural causes and further understand your condition.
3. Immediate Steps for Symptom Management: There are strategies to help manage your current symptoms while awaiting your appointments.

Understanding the Situation

You are experiencing significant challenges related to your nervous system and balance, which makes it understandable that you are seeking clarity on whether an MRI is necessary. An MRI can provide valuable information about brain structures, the spinal cord, and any potential lesions or abnormalities that may be contributing to your symptoms. While your GP and specialists are assessing your situation, the delay in seeing a neurologist can understandably add to your anxiety.

Next Steps

1. Document Your Symptoms: Keep a detailed diary of your symptoms, noting their frequency, intensity, and possible triggers. This could be helpful during your upcoming appointments and in discussions about the necessity of MRI scans.

2. Explore Your Current Treatment: While you wait, consider discussing with your GP the possibility of adjusting your current medications or adding symptomatic treatments for dizziness and anxiety that might provide you with some relief.

3. Seek a Second Opinion: Since your insurance poses a barrier to accessing certain specialists, consider looking for alternative options within your network. Some clinics offer sliding scale fees or financial assistance for those in need.

4. Telehealth Consultations: If available, explore telehealth consultations with neurologists or ENT specialists who can review your situation digitally. This could save costs and time, allowing for earlier input into your condition.

5. Support Networks: Engage in support groups, whether online or in-person, for others dealing with similar issues. Sharing experiences and coping strategies can provide emotional support and practical tips.

6. Lifestyle Adjustments: Focus on gentle activities that could help manage your dizziness, such as specific balance exercises advised by a physical therapist. Ensure you’re staying hydrated and maintaining a nutritious diet to support your overall health.

Conclusion

Your current situation is challenging, and seeking clarity on the necessity of an MRI is entirely reasonable. The outlined steps should help you manage your conditions until you can see a neurologist and receive a comprehensive evaluation. Your health concerns are valid, and it’s important to continue advocating for yourself and exploring all available options. If your symptoms worsen or change significantly, consider reaching out for more immediate medical advice.