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Q: MS and lesions on the brain
asked by: DoctorQuestion on February 8th, 2008
I went in because of the migraines but also some occasional pressure in the back of my skull and dizzy spells. I have lost my vision twice for just a few seconds and the episodes were at least a year apart. I have a strong family history of MS but no real symptoms. Because of the spinal results and lack of findings in CTA the doctor is leaning towards and MS diagnosis. I know migraines can cause lesions on the brain so maybe they aren't MS lesions. I am wondering if the fungal infection and/or herpes could have affected the results of my spinal tap or blood work. My doctor seems to be at a loss of what to do or where to go with this. We haven't found a cause for the symtoms I went in with and I don't want to be quick to write this off as possible MS if there is a chance something is being overlooked. My doctor never mentioned the fungus or herpes so I really don't know what to think about the affect they have on anything. HELP please.


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Dr. Nikola Gjuzelov , MD
replied on February 11th, 2008
Genetic Disorders Answer A3653
YOU WROTE:

Current medical status: MRI head w/ contrast found a few lesions, MRI neck, mild degenerative change in mid cervical spine and focal small left disc protrusion 3. CTA negative for vasculitis 4. spinal tap- oligoclonal bands high at 11, IgG syntheses rate elevated, 18.78, IgG index indicated at 1.27. melin basic protein normal at 0.6. Pressure mildly elvevated at 22 cm of water. 5. blood work- AST-low, WBC-high, Abs. Neutrophil-high, ESR-high, FANA-slightly elevated at 1.2. VDRL negative. Nail fungus on 2 tonails and positive genital herpes
Current medical treatment: Topomax 50 mg twice daily for migraines, imitrex as needed. wellbutrin 150 mg, twice daily and multi vitamin. I see a chiropractor for help with migraines.


Migraines don't cause brain lesions. The causes of a migraine are unknown. Brain lesions are not present in cases of migraines. Fungi and herpes can cause a brain infection but only in people with a compromised immune system (such as during case of AIDS, leukemia etc.).

Further, blood vessel inflammation (vasculitis) is not present during multiple sclerosis (MS); rather, inflammation of the nerve tracts in the white substance of the brain occur. The myelin coverings of the nerves and nerve tracts’ in the brain and spine are attacked in a process called demyelinisation. Glial cells or neuroglia accumulate in the places with nerve damage, also called plaques. Plaques can be seen using a CT-scan or MRI.

According to your positive MRI-report, positive serological reports (high oligoclonal band and elevated IgG-production in the liquor) and strong family history of MS you could be experiencing multiple sclerosis (MS). Symptoms of the disease can vary, so we can’t always rely on them. You can consult a neurologist for further help.





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