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Adrenal Failure, Migraines, Short Term Memory, Imbalance. MRI Showed Mild Micro Vascular Disease. Multiple Sclerosis?

Posted on Fri, 22 Jun 2012

Question: Hello I am a 51 yr old woman who was hospitialiZed for adrenal failure. I also blew the pupil In my life eye MRI showed mild micro vascular disease a d mild white matter disease with dsyminlation( forgive spelling) I also have chronic migraines but for the last few months I'm having extreme short term memory problem I am a disability attorney for. 20 yrs and now I forget what I'm saying in the middle of the sentence I will pick up my I pad and immediately forget what I am looking for I was hospitalized in April 2011 I am seeing a new neurologist XXXXXXX 10th my close friends and family see the memory loss I do not pretend to be a physician but 20 yrs doing disability I'm inclined to think I have MS also I failed some balance tests my new endocrinologists gave me and I do stuble and fail and lose my balance on occasssion any ideas

Answered by Dr. Shiva Kumar R (3 hours later)

Hello

Thanks for the query

Firstly, I would like to reassure you that you are not suffering from memory problems, chronic migraines, white matter signal changes with microvascular disease on the MRI and diagnosed adrenal insufficiency. Possibilities in this case include
•     CNS vasculitis
•     Leucodystrophy
•     Pseudodementia.

So I personally suggest that you schedule a visit with your neurologist for a good physical exam and detailed neuropsychological tests for confirming the diagnosis and type of memory problem and proceed further based on the evaluation and consultation. You may also require additional tests like blood tests, Cerebrospinal fluid analysis (CSF) analysis and an electroencephalogram (EEG).

I thanks again for the query. I hope you found my response to be helpful and informative. If you have any additional concerns, I would be happy to address them.

Sincerely,

Dr Shiva Kumar R
Consultant Neurologist & Epileptologist

Above answer was peer-reviewed by : Dr. Aparna Kohli

Follow up: Dr. Shiva Kumar R (39 minutes later)

Ok I have no idea what the first two diagnosis mean but I'm pretty sure the third one means mental proplems did u not get the part where the MRI said white matter and microvasular now I forgot to mention I had decompression surgery for bells palsy please explain in laymens. Terms

Answered by Dr. Shiva Kumar R (5 hours later)

Hello XXXXXXX

Thanks for the follow-up.

Regarding the CNS vasculitis, it is a disease of the small blood vessels of the brain which gets inflammed and affect the blood supply to the brain. Clinical features include early dementia and microvascular changes on the MRI. Leucodystrophy means disease of the white matter of the brain which can present as memory problems, visual disturbances and rarely adrenal problems.

However rarely vasculitis can present as Bell's palsy also. So I personally suggest you to get evaluated for these problems after detailed neuropsychological tests. As the list of disorders causing memory problems are many, step by step analysis is required after the above tests.

I thank you again for the query. I hope you found my response to be helpful and informative. If you have any additional concerns, I would be happy to address them.

Sincerely,

Dr Shiva Kumar R
Consultant Neurologist & Epileptologist

Above answer was peer-reviewed by : Dr. Yogesh D