OpenHealth Q&A

Is a Contrast MRI Necessary in My Case?

I am a 22-year-old female, standing at 5’5” and weighing 40 kg. I’m of Ukrainian descent and do not smoke. Since April 2024, my health has been on a decline, starting with balance issues. I have recently been diagnosed with several conditions, including epilepsy, autoimmune thyroid disorder, and dysautonomia. To manage these conditions, I have been prescribed Keppra along with medication to support my thyroid, as well as vitamins B and D, magnesium, and selenium. However, it has been indicated that my symptoms may not be related to these diagnoses. At this stage, I have consulted multiple neurologists, each offering varied theories regarding my health issues. My primary concerns include difficulties with walking and maintaining balance, frequent fatigue, irritability, extreme sensitivity in my eyes, unsettling spasms in my abdominal area (which feel like my muscles are seizing and blood is being restricted), and fluctuating pain experienced throughout my body. To provide more context: - My eyes often feel as if they are under pressure from within, leading to prolonged discomfort and migraines. - I struggle to lift my legs, which were evaluated through electromyography with normal results. - Walking straight is challenging; I often veer uncontrollably to the left. - At times, I feel limited in my control over my lower body, resulting in a sensation of wobbliness. - Pain generally occurs in my feet, legs, pelvic region, middle section of my spine, fingers, and hands. This pain can vary from sharp to dull and I also experience odd sensations around my ribs. - The spasms in my stomach are unusual and hard to articulate; it feels as though there is a painful connection between my stomach and spine. The only temporary relief I find is by lying on my stomach, though the discomfort persists, making breathing difficult. - My irritability often manifests as tears and an overwhelming sense of empathy, leading to emotional fluctuations where I feel either intense self-loathing or an urge to cry incessantly for the suffering of others. One neurologist examined my spine and raised the possibility of MS, recommending both brain and spinal MRIs. However, she did not mention the use of contrast, so the spinal MRI was conducted without it, revealing herniations and protrusions. Subsequently, another doctor recommended a brain MRI with contrast, which identified only a Rathke’s cleft cyst. Now, I am left pondering whether I should have the spinal MRI redone with contrast. Might this provide additional insights? I feel lost regarding the next steps to take in my health journey.

Answers (1)

9/11/2025, 9:40:46 PM

OpenHealth AI

It seems that you're navigating a complex set of health issues, and your questions about the necessity of a contrast MRI reflect your desire for clarity in understanding your condition. Here’s a concise response to your query regarding the spinal MRI and whether it should be redone with contrast.

Main Points:

1. Considering the possible diagnosis of MS and symptoms you’re experiencing, a contrast MRI could indeed provide more detailed information.
2. Contrast agents enhance the visibility of certain structures in the body, revealing issues that might not be seen clearly on a standard MRI.
3. Your ongoing symptoms warrant careful monitoring and assessment.

Explanation:

A contrast MRI can help identify inflammation, lesions, or other abnormalities in the brain and spinal cord that may be important for understanding neurological conditions like multiple sclerosis (MS). In MS, for example, contrast can show active lesions that are currently inflamed, which a non-contrast MRI might miss. Given your reported symptoms and the previous recommendation for imaging, it may be beneficial to follow through with this.

While the spinal MRI without contrast revealed some herniations, having a detailed view could help rule out or confirm potential other conditions contributing to your balance issues, fatigue, and other symptoms.

Next Steps:

1. Discuss with Your Neurologist: Bring up your concerns regarding the contrast MRI with your neurologist. Ask if they believe the additional imaging could clarify your diagnosis further.

2. Monitor Symptoms: Keep a detailed symptom diary to note any new or worsening symptoms, which can be helpful for your doctor in providing further treatment options.

3. Consider a Multi-disciplinary Approach: Given the complexity of your symptoms, collaborating with specialists in neurology, rheumatology, and perhaps pain management could provide comprehensive care.

4. Seek Emotional Support: Your emotional fluctuations and overwhelm are important too. Consider speaking with a mental health professional who can help you manage these feelings as you navigate your health journey.

5. Stay Informed: Understand your conditions and the implications of your test results; don’t hesitate to ask questions about the tests and treatments you undergo.

You are not alone in this, and it's important to keep seeking the support and answers you need as you move forward in managing your health. Please do not hesitate to ask if you have more questions or need further clarification on any of these points.