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What Does This MRI Report For Recurring Vertigo Indicate?

Posted on Mon, 3 Aug 2015

Question: Went to the doctor for severe vertigo. On and off for months. Sent me for MRI. Stated I had supratentorial white matter. Sequels of moderate chronic microvascular ischemic disease. I do NOT have diabetes, high blood paid, high cholesterol...nothing. what could this possibly be?

Answered by Dr. Ajay Panwar (47 minutes later)

Brief Answer:
Age-related white matter changes(WMC).Should not be the cause of vertigo.

Detailed Answer:
Hi XXXXX,
Thanks for being on healthcaremagic.com.
I am Dr.Ajay Panwar,a neurologist,here to answer your query.

Chronic microvascular ischemic changes can be age related.These changes are common in elderly and not pathological.What is your age?
Further,These white matter changes don't cause vertigo.The cause of vertigo must be different.

Besides,there can be several other causes of such white matter changes like vasculitis,autoimmune diseases,brain infections,Thyroid dysfunction and several more.But,with just vertigo,extensive evaluation is not needed.
We,the doctors,treat patients and not the MRI's.

Please upload your MRI report,so that I can answer it further.

If you have any further questions,I shall be glad to answer.

Regards
Dr.Ajay Panwar,
MD,DM(Neurology)

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Ajay Panwar (6 hours later)

Thank you for responding. I am 55. Generally in good health. I went to the doctor for vertigo. Have dizzy spells that last four hours then subside. Happens a few times a week to a few times biweekly. He wanted to check the ear, etc. All that came out fine. I was diagnosed with what I mentioned before except that I was also diagnosed with low blood flow to the small vessels of the brain.

Everything I read states that this is common with high blood pressure, diabetes, high cholesterol, migraines. I have non of those.

With that information, what could I possibly be looking at???

Answered by Dr. Ajay Panwar (6 hours later)

Brief Answer:
Psychosomatic dizziness/Vestibular Migraine variant.

Detailed Answer:
Hi XXXXX,
Thanks for being in follow-up.

Brain white matter changes are probably age related.However,following investigations should be done to rule out the common causes for the same-
1)Thyroid function tests
2)Erythrocyte sedimentation rate(ESR)
3)Lipid profile

A CT/MR angiogram of intracranial vessels can be done to see the vascular changes,if any.However,I would like to have a look at MRI report/MRI images before suggesting you to go for an angiogram of brain vessels.

So,please upload your MRI report/scanned images.

Further,the probable causes of your dizziness are-
1)Psychosomatic dizziness
2)Vestibular Migraine variant

Meanwhile,I suggest you to start a trial of -
1)Tab. Escitalopram plus clonazepam(10/0.5) 1 tab once a day,

and observe for the response.You'll probably show improvement on this.At the same time,please start doing regular mental relaxation exercises like meditation/yoga.That will further add up to the benefit.

Please get back to me anytime you have a query as I would like to track down your future clinical developments.

Hope that I have answered your query.If you have some follow up questions,I shall be glad to answer else please close the thread,rate it and write a review as your rating will be of help to me.

Regards
Dr.Ajay Panwar,
MD,DM(Neurology)

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar