MS MRI Lesions VS. "Benign" White Matter Lesions Explained by Neurologist

One of the challenges of accurate multiple sclerosis diagnosis is the high prevalence of T2 bright white matter lesions in the subcortical white matter seen on MRI scans done on people without MS. These "unidentified bright objects" (UBOs) are associated with migraine and vascular risk factors such as smoking, hypertension, and diabetes. This video differentiates between MS demyelinating lesions and UBOs/vascular disease, showing various examples and key differences.
Errata: the comment “Being a radiologist is easier than it looks” at 11:25 is an error. I of course meant to say “Being a radiologist is harder than it looks,” but I somehow missed this until I edited and uploaded the video.
Selected sources:
Radiology assistant article with images: radiologyassistant.nl/neurora...
Risk of white matter hyperintensities in chronic migraine is ~75%: bmcneurol.biomedcentral.com/a...
Comment or ask questions below! I would be happy to answer!
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Check out my book “Resilience in the Face of Multiple Sclerosis” FREE on Amazon: amazon.com/dp/B07WP7H5LK It's about 5 people with MS who live incredible lives, the science and psychology of resilience, mindfulness, and ho’oponopono. Paperback priced to generate $0 royalty.
Dr. Brandon Beaber is a board-certified neurologist with subspecialty training in multiple sclerosis and other immunological diseases of the nervous system. He is a partner in the Southern California Permanente Medical Group and practices in Downey, California (South Los Angeles). He has several publications on MS epidemiology and has participated in clinical trials for MS therapeutics. You can follow him on twitter @Brandon_Beaber where he regularly posts about MS news and research.
Follow me on twitter: / brandon_beaber
Music: INNER GRACE - Copyright 2018 Wilton Vought Source: Really Really Free Music Link: • Video T
he video material by Dr. Brandon Beaber is general educational material on health conditions and is not intended to be used by viewers to diagnose or treat any individual's medical condition. Specifically, this material is not a substitute for individualized diagnostic and treatment advice by a qualified medical/health practitioner, licensed in your jurisdiction, who has access to the relevant information available from diagnostic testing, medical interviews, and a physical examination. To the extent that Dr. Beaber endorses any lifestyle change, behavioral intervention, or supplements, the viewer should consult with a qualified healthcare professional to determine the safety and efficacy of the intervention in light of their individualized information.

[@andrewreisinger6860]

My MRI is so crazy scary. I've had MS for almost 30 years (EDSS 6.5). I have mostly periventricular lesions, Dawson's fingers, and white picket fence lesions, plus lesions throughout the cervical/thoracic spine. But the scariest part is the massive amount of brain atrophy. I'm 51 but my brain looks about 80. You don't need to be a neurologist/radiologist to see my brain and say "whoa". I am amazed I am not bedridden.

[@colleensmith3374]

Wish u continued mobility

[@andrewreisinger6860]

@@colleensmith3374 Thank u and God bless

[@younney1533]

Hi Andrew just wondering did you had severe headaches btw lasting btw 1 to 2 months. They told I had some white matter lesions. And I have tension headaches n sometimes really bad anxiety that last for 1 month. It’s scary I have started feeling super depressed n just praying to god.

[@Irish_sean.]

God's good ✨

[@madjack8893]

For anyone interested, you can look up this study. A team of international researchers has found that the Tsimane indigenous people experience less brain atrophy than their American and European peers. The decrease in their brain volumes with age is 70% slower than in Western populations. Accelerated brain volume loss can be a sign of dementia. SEVENTY percent slower. USC Leonard Davis School of Gerontology

[@kristencatton7499]

Excellent content Dr Beaber!Thanks so much for these videos! You present things in an easy to understand manner & that helps a great deal!

[@rw1557]

I got a diagnosis of CIS from a neurologist after a bout of symptoms and an MRI showing 3 small lesions. He wanted to see me again in 3 months but he stopped practicing. I had to go to other neurologists and they all said my MRI didn't show Ms and that a lot of people have lesions. I also got a bout of optic neuritis during this time but no diagnosis. They kind of became dismissive of the eye issue but sente for new MRIs. They said I have small ones but some of my symptoms could even be from having a bad neck. So on their request I went to a neurosurgeon to look at my MRIS. He brought in a colleague to look as well and they went over the whole ordeal. They looked at multiple slices of my MRI just like in this video. They told me that I probably have MS and everything points to it and referred me to an MS specialist. The Specialist spent an hour with me doing a physical and looking at my MRI reports. She gave me a diagnosis of RRMS and I'm currently on Tecfidera. I remember wanting to go back and scream at the other Neurologists for me wasting a year of my life. I was advised to find an MS support group andvI quickly realized soooo many people go thru hell trying to get a diagnosis. One person waited 9 years

[@ellymay7238]

I’m struggling. I have small lesions. No more than 5. And the symptoms are awful. But the dr is so dismissive. I’m currently looking for a new doctor

[@harryjackson4832]

Was falsely diagnosed with MS. I went numb from the neck down A tingly numb like when your leg falls asleep I could still walk and move around I just had to watch my feet while walking. I couldn’t type any more. I made it through college and worked full time It was very difficult My home doctor said I was stressed out and to listen to my body Eat what it tells me to eat I went to a neurologist Had mri had white blotches all over brain All the specialists said I had MS I couldn’t afford medication so 2 years later still numb from neck down I seen my home doctor again He said quit stressing. Don’t stress about anything no matter what and eat what my body craved I did just that and within months it went away I quit stressing and ate a lot of friut It came back once a few years later and was just my leg and didn’t last but a few weeks and it’s been 30 years since then and never happened again

[@DrBrandonBeaber]

Thanks for sharing.

[@younney1533]

Hey harry did you also had headaches every day for 1-2months. In my first episode I had symptoms of paralyzed arms n legs but then went away. Did you sleep normal hours n what did you eat.

[@EvenSoItIsWell]

Brilliant video Dr. Beaber! So helpful to see the images and have the explanations. Thanks!

[@DrBrandonBeaber]

I'm glad you liked it Vicky.

[@jenshere2090]

This was very informative! I was diagnosed with Cadasil which sometimes is misdiagnosed as ms. I am grateful to the radiologist who read my MRI and interpreted my results. He stated to rule out Cadasil of which my neurologist had never heard of. Her plan was to go down the MS road because of the extensive lesions. (My MRI looked like the 90 year old woman’s…I was 58 at the time!). I did a google search of Cadasil and new that’s what I had because of my family history of early deaths of strokes and “ms”. A DNA blood test confirmed it. Unfortunately there is no treatment or cure for Cadasil…but a good sense of humor goes a long way 😉

[@colleenhurley7507]

Hugs

[@madjack8893]

For anyone interested, you can look up this study. A team of international researchers has found that the Tsimane indigenous people experience less brain atrophy than their American and European peers. The decrease in their brain volumes with age is 70% slower than in Western populations. Accelerated brain volume loss can be a sign of dementia. SEVENTY percent slower. USC Leonard Davis School of Gerontology

[@DoctorGretchenHawley]

This is SO interesting!! Thank you for sharing these findings!

[@jeannetteampersand728]

Thank you so much! I feel like I can finally sleep better tonight. I saw some very scary scans recently, but they don't look like MS according to your video. We see a cardiologist and neurologist soon for their professional opinions, but I feel like I can relax some until those appointments now. Thank you again for such concise information!

[@DrBrandonBeaber]

Best of luck to you.

[@jeannette9]

@@DrBrandonBeaber His MRI and follow up CT were clean!

[@844raha]

I love it when you say being a radiologist is easier than it looks! it is definitely not easier than being a neurologist, who always has an easy diagnosis for every one. It is psychological! Poor patients who are labeled psychopath while they have serious neurologic disorders! Good video though!

[@DrOmarDanoun]

Thank you for sharing your experience... Interesting to see how much people over read these scans

[@DrBrandonBeaber]

Indeed. Nice channel by the way.

[@DrOmarDanoun]

Thank you!

[@mywaterbaby1]

Thank you very much for your explanation always amazing and to the point

[@luciece]

Thank you for great informative video, always wished I could understand my MRI scans myslef at least to some extent. Could it theoretically happen that a radiologist mistakes a new MRI lesion for a "benign" one in patient with MS? For future video recommendation, I'd like to see explained comparison of SC versus IV administration of anti CD20 DMT (I remember there was some new study on this topic). I'm currently in clinical trial for SC Ocrelizumab, so bit biased:)

[@desiredecove5815]

This is an excellent video Dr Beabs, “ Self diagnose at your own ⚠️ risk” needs to be on a T-Shirt. #Sharingiscaring

[@desiredecove5815]

Heavy on the medical lingo

[@DrBrandonBeaber]

Haha. Maybe I'll get this T-Shirt.

[@desiredecove5815]

@@DrBrandonBeaber it HAS to be done!

[@hamcki]

awesome, pls more mri. thx! 👍

[@minibobber]

I know it's maybe impossible to answer but how much worse is the prognosis with cervical lesions generally contra only brain lesions? And does having one lesion increase the chance of more lesions forming nearby? I'm aware that placement and size matters more than amount but there must be some ballpark figure. Thank you for everything BB!

[@ninacee9140]

Dr. Beaber, an interesting study on the benefits of CAR T-cell therapy for lupus has been conducted by Friedrich Alexander University. While I'm sure it is very early days to speak confidently, there is speculation that the results may show promise for future potential for other autoimmune diseases like MS. I wonder if you would be able to do a video on this research and it's possibly implications for MS therapies. Additionally, my understanding is that MS is not a immune cell-specific autoimmune disease, on that no one specific class of immune cells has been identified as being responsible for MS activity. Would this be a constraints for therapies like CAR T-cell therapy or can it work more generally like the way HSCT stem cell therapy works for MS?

[@colleensmith3374]

Dr very much appreciate your expertise & explanation of MRI’s

[@DrBrandonBeaber]

:)

[@annbass1535]

​@@DrBrandonBeabercould I send you my MRI for review? Kind regards

[@DrBrandonBeaber]

@@annbass1535 Unfortunately I cannot help you personally.

[@MadMax2022]

Dr B another great episode of your show !! great information Do lesions themselves cause ms or ms like symptoms ? If A person has lesions caused by migraines could they have difficulty walking and be did with ms ?

[@DrBrandonBeaber]

MS lesions can cause symptoms or can be asymptomatic. Typically, "unidentified bright objects" associated with migraine headaches are not associated with specific symptoms.

[@danielhernandez-fo3mj]

grate video i now see why nce my lisons grew to touch my corpus colosum did i get my ms diagnosis best decoding ms lisons video I've found thanks

[@archie2217]

Thankyou so much for the info doctor.

[@MrInfiniteGuy]

Is it a cause of concern to have benign white matter hyper intensities at a young age (I.e 22?) I was told I have some on the right matter of my frontal lobe that may be cause due to migraines (yet I don’t really get any migraines…). Does it increase the risk of strokes and dementia? And have I or will I become cognitively impaired?

[@timbuk2.019]

Thanx for the info 👍🏾

[@Thephilosophia]

Dr. Beaber- thank you for this video. I was still curious- what if you have small foci of T2 hyperintensity seen in the periventricular and subcortical white matter? No history of migraines, or vascular disease indications- in a 36 year old female (first noted in a 33 year old female) with a history of tremors, falling, and other symptoms indicating that person is experiencing neurological issues? I understand that non-specific WML are common, but can these lesions be an early sign of MS? Would it be rare for them to exist but not progress in 3 years?

[@DrBrandonBeaber]

There would be way to comment on this without seeing the films. "unidentified bright objects" are not a precursor to MS.

[@tfood3]

Thank you so much for your video very informative. Just wondering if you think it is normal and of no concern to have two tiny foci of hyperintense signal in the right corona radiate for a 34-year-old female. Would these be considered UBOs? Thank you

[@authenticmslife]

This is so fascinating! Have you read Dr. Bill Code's book _Solving the Brain Puzzle?_ As a doctor who has also had MS for decades, through his research he has come to believe that MS is a vascular disease, not primarily an autoimmune condition. I find that so interesting because my MRIs most often look far more like the vascular ones you showed here than the MS ones. Maybe there is a connection?

[@DrBrandonBeaber]

I have not read the book, but there is a theory proposed by Dr. Paulo Zamboni that MS is caused by venous insufficiency. My video on this here: kzbin.info/www/bejne/qaLSfGx4oK5pnZI There is actually extremely strong evidence that MS is largely immune mediated. I may do a video on this topic at some point.

[@authenticmslife]

@@DrBrandonBeaber thank you for the reply. Yes, Dr. Code had the CCSVI liberation therapy twice, and I think that's what started his investigation, though not in exactly the same direction as Dr. Zamboni took. Obviously venoplasty is not a final solution since the procedure was not ever investigated or developed well enough to provide lasting improvement. But it's certainly an interesting direction that I think needs a lot more research still. I agree that there must be some kind of autoimmune component too, as we know how things like infections (UTI, for example) can have such an impact on relapses, etc.

[@Valtar698]

Dr Beaber great information. Question: I am 50 yrs old with the only symptom being hypertension. I got an MRI and everything was normal BUT there was a sentence that says ""Subtle periventricular area of abnormal signal is appreciated. The possibility of white matter changes has to be considered". What does this mean? Can this be MS or White Matter Disease, etc? I feel just fine with no symptoms. I just want to know what does this sentence on MRI means?

[@teslapolarisz1816]

Dr.B great info as always. I am very impressed that you keep coming up with valuable MS information videos. Do think MRI’s showing lesions in both the spine and the brain are more apt to be a MS? That’s how I was diagnosed and My neurologist send that I did not need a spinal tap to confirm MS.

[@barbaradascalos4411]

it's multiple so if you have brain and spine you have it.

[@isabellegranier9233]

Thank you for your video

[@taralynnravenfire6892]

Can MS Be misdiagnosed as Idiopathic intracranial hypertension? I guess what I am asking is can it be possible on mri swelling that is apparent Papilledema and IIH be hiding lesions from being seen due to the swelling/inflammation?

[@alexandreturgeon465]

Dear Dr, I was wondering why MS has the reputation of being such a difficult condition to diagnose. Since a brain MRI can basically confirm or rule out MS, what exactly can make the condition so hard to diagnose ? I know you mostly gave an answer in the video while talking about lesions and other diseases, but still. Once again, thank you very much for your time !

[@DrBrandonBeaber]

The diagnostic criteria are quite complicated and not based solely on MRI explained in this video: kzbin.info/www/bejne/f6nRpGtri55oY7s Although most people with MS have an MRI scan of the brain highly consistent with the disease, there are exceptions.

[@lexzuna2431]

Amazing video explanation, Dr. Beaber. Why can someone, confirmed with MS from Cedar Sinai team, have many lesions (30+ with Dawson fingers) still be fully functional with a 1 EDSS?

[@DrBrandonBeaber]

T2 brightness on MRI says little about the function of the tissue. Some people have extensive lesions and extensive remyelination ("shadow plaques") on MRI. Disability is more correlated with T1 "black holes" and atrophy than T2 bright lesions.

[@lexzuna2431]

@@DrBrandonBeaber Appreciate all your informational videos! On your silent MS symptoms video, there are two unique and rare visual symptoms that MS seems to cause which is Oscilopsia and retinal ganglion cell loss. Are there any DMTs or HSCT that halts or helps with those?

[@oweigeralddariah907]

Very helpful, but can you possibly give a more elemental basic “101” of how to read MRI’s and even possibly CT scans? Especially for older docs like me who graduated before the advent of MRI’s 😭😭

[@karym0205]

What is means in a MRI scaretted t2 hyperintense foci within cerebral white matter are nonspecific? And in the right frontal there are a couple subcortical foci of increased flair signal non specific for patients of this age? Please thank you.

[@DrBrandonBeaber]

I can't comment on this. The report from the radiologist can be ambiguous in many cases.

[@ana-mariazait1800]

They said all my cervical lesions are typical of MS but not all my brain lesions are typical of MS. So I have MS lesions and UBO lesions?

[@Khalidsvt101]

i would like to take a survey.. how meny of you had stress or depression before they were diagnosed with ms ?

[@kehoe210]

Can non specific white matter lesions heal go away reverse I had mri sadly sober year and had 2 vaccines got covid all around same time year ago I'm on waiting list for nueroligest,

[@elizabetapereira9827]

Thank you so much I have learnt so much? Can you please look at my MRI? It’s so hard to find a good Dr like you

[@theheatdeathiscoming]

Could you make a video on nervous system hyperexcitability disorders (benign fascination syndrome, cramp fascination syndrome, isaacs syndrome and morvans syndrome)? As youtube's resident expert on neurological autoimmune diseases I think you would be uniquely qualified to give an interesting perspective. There isn't a ton of good quality information on them and there's almost no information on youtube from a neurologist's perspective.

[@FaydraGirl]

Huh. My mri shows scattered mild perevintricular, subcortical with no enhancement. I assume its vascular but from the breakdown here shouldn't they not be pereventricular or subcorticale? I may have misinterpreted the discussion in this video tho.

[@mariaarroyo5223]

I got done all that I got all that stuff that you mentioning because they've been treating me since I was in Florida so it's been a long time they been treating me since Florida

[@Chris-ph5sf]

I'm 38 diagnosed at 35 and have lesions in spine & brain but always felt I have a vascular issue as I wake up with numb hands then goes away after I lift them up to drain the blood. Just confirmed I do have bilateral thoracic outlet syndrome. So is it possible that vascular could cause anything in spine...or are spine lesions strictly MS? Thanks so much great video. 👍

[@DrBrandonBeaber]

I can't comment on your specific situation, but we do not see "unidentified bright objects" in the spine. it is possible to have injury to the spine due to vascular problems such as a stroke, but these lesions are generally not typical of multiple sclerosis.

[@Chris-ph5sf]

@@DrBrandonBeaber thank you so much for your response :)

[@arr2820]

I apso have numb hand or leg after I wake up every now and then(not often). I guess this is a ms thing. My ms is benign.

[@natashaflynn3554]

I have a few small white matter spots on my brain but have been told it’s from migraines. Yet I have so many MS symptoms. It’s a constant battle with my own body and me also thinking my doctors are reading my scans wrong.

[@soldier2152]

I have same issues I have white matte in my brain mri few spots I’m 43yr old the doctor said it’s normal , I did have dizziness symptoms vision issues can’t focus , I’m not put on any medicine ,I was alcoholic for 10yr maybe that’s why I got these spots my blood pressure was high those days now I haven’t drink in 1yr my blood pressure is normal I’m not in med it was high because of alcohol and have heart issues because of alcohol my heart hey skip beats and pacs , I enjoy those 10yr alcohol is something I was unhappy without it I was very happy with life when I was drinking I’m not regret we going to die one day I hope I get to live to see my 50 haha 😂

[@natashaflynn3554]

@@soldier2152 do you get migraines? I just went to see a balance/dizziness specialist & with every test I have had done & let me tell u, I’ve had 12 MRI’s, she said the only thing that makes sense is I have vestibular migraines with dizziness. Kinda hard to believe bc my dizziness is 24/7. I was put on Nurtec for preventative migraines and have been on that for 3 months. No help at all. So frustrating.

[@whatsonmymind4848]

My Neurologist told me my two spots are scar tissue from demyelination, but I am so scared that the official report from the radiologist will say it’s just migraine because I had a strong pain for a few seconds and that’s why I ended up in the MRI machine. I do however have all the MS symptoms and they checked my nerves in arm/hands and legs/feet and they were okay. I’m 26 and usually don’t have migraines, but numbness, tingling, nerve pain, fatigue, can’t swallow and choke on food and water, can’t walk for long because all my muscles in my body hurt and I constantly feel sore, vision problems that come and go. Like… no one can explain it….

[@natashaflynn3554]

@@whatsonmymind4848 sorry you’re going through all that. It’s not fun. I’m 2 years in & still have no answers for my issues. I hope you find someone that will be able to help you soon. Crazy how we can have so many symptoms yet nothing shows up & they have no idea what’s going on with us.

[@katec2922]

Ugh me too. So desperate for a diagnosis in the hope of treatment and improvement or at least less decline

[@WarpedTrekker]

@Dr. Brandon Beaber, have you yourself had an MRI? Curious if doctors find this in their brains too. Im 52 and current mri shows a lesion and several spots all over the brain. i had none back in 2011. mri summary says something about vascular disease and that its more advanced for people my age. I see a neurologist next week to go over results. Is there some way to remove lesions and help stop it?

[@DrBrandonBeaber]

I have never had an MRI. I can't comment on your specific situation but many people in the general population have nonspecific "unidentified bright objects." They cannot be removed, but it's generally advised to have a good diet/lifestyle and control vascular risk factors to prevent future problems.

[@bobbiewavrin5385]

My lesions look like the not ms lesions in this video but my symptoms present like ms and my mri say atypical MS and I just got a possible diagnosis of ON and waiting to see a neuro ophthalmologist to confirm. "10 years of we don't know. " to this.

[@yari8775]

i have multiple white lessions, the neurolog suspect it might relate to microvascular and migraine, i do have migraine, difficult to think, constant headache, yet i'm only 26, what could it be : /

[@Angelicnorth]

I have had 3 mri scans ms mentionef on 2nd but then svd, third one after 4 years, show 7mm lesion in peritoneal lobe, periventicular and occipital. Worst part is is prominent extra axial csf? Any ideas what causes that please, thankyou

[@PetiteMinina]

I really hope that I only have migraines. I asked if I could go to a migraine specialist but was told I need another MRI just to be sure there are no new spots. my last MRI looks very boring (7 lesions with 3 only ms-like) compared to the ones shown here, so hopefully my symptoms are just migraines and I'll get treatment for that soon 🤞

[@DrBrandonBeaber]

Best of luck to you.

[@PetiteMinina]

@@DrBrandonBeaber thank you 🥲💖

[@aizaming]

"patchy discrete foci of t2, flair hyperintense signals in the bilateral frontal deep white matter" - what does this mean? 😢 Thank you.

[@forgetthis2607]

Did you ever find out? I have the exact same wording on my results

[@TTG1973]

I have lesions in the subcortical and the periventricular area and symptoms of MS…does that mean I have it?

[@CherryKissings-ee1xl]

So if a mri tech says consistent with demyelinating disease dose it mean that's what it is or they just say that because Nero says no he just puts that and is fibromyalgia who's wrong

[@navodiniroshika6057]

In MRI what does it mean small non specific areas of t2 flair hyperintensity is noted within the deep white matter of the left frontal lobe and right parieto occipital lobe

[@DrBrandonBeaber]

I think the video makes the point that you would have to discuss this with an experienced provider who has personally reviewed the films.

[@John-xp8fc]

I've heard ozone ear insufflation can go after these problems, with great success .

[@lunluong4235]

What magnetic field are these scans? Would a higher field 7T give you a better diagnosis? I have seen a Siemens 7T promotion video diagnosing a lesion on a girl who keeps getting seizures before going into the 7T mri. The high field mri detected a lesion in her brain and operated and she is now living seizure free.

[@DrBrandonBeaber]

There is evidence that a 7T MRI is better at seeing small lesions, though they are not readily commercially available. The films in this video are 1.5T/3T scans.

[@lunluong4235]

@@DrBrandonBeaber The 7T is just too expensive to buy it for most hospitals. I know they have been commercially available for nearly 8 years now as I worked on the first one Siemens sold commercially.

[@chetanrs]

Hello Dr. Beaber -- what does " Few discrete non-doecific FLAIR Hyperintensities noted in the subcortical white matter" mean ? Thank you.

[@SarahCSarah]

Hi, I had the same results in may last year , the Did an orbit Mri in December and showed that what I have is a pituitary adenoma . I don’t know is it’s correlated, I forgot to ask the neurologist because I got scared with the adenoma in my brain

[@BartonEnglish1]

I was told that “non-doecific” or “nonspecific” are good terms to see in a report. and that they indicate the sort of lesions that don’t alarm my doctor.

[@aprilbowersock7927]

Hi! 42 yr old year female with bradycardia, avid long-distance runner with low BP (average 106/68), strength train 3x week, 90% healthy diet, no alcohol, and no history of migraines but who has white matter disease. As you mentioned, I read it in my report but had no discussion with the doctor. I had an MRI in December of 2021 for concern of MS (weakness/pain/numbness in my left side, prior Epstein Barr diagnosis and low vitamin D). Instead, there was a subependymoma sitting in my 4th ventricle. It was removed via craniotomy in February of 2022, there is a residual tumor on my stem cell but I have no complications. The removal also did not make any of the left-side symptoms disappear. I am afraid that the diagnosis of WMD may be incorrect, and can actually be MS? Is that a valid concern?

[@DrBrandonBeaber]

I cannot comment on your specific situation, but I wish you good luck.

[@user-tl3ty2pt2z]

Do 10mm lesions will cure by antibiotics?

[@corinaharris9095]

My left earloab goes kmumb now Getting MrI this week I don't know what where your syptoms

[@RAHvdK]

I would like to add my lower back scan up for research. Ive had an lower back injury, fractured cardialage due to heavy lifting as an 28 year old. A couple years back. Yet the radioligist woman told me I had brain fluids of an 14 year old in that scan as if I am still growing. Id like to add that those btainfluids are a mental meditation state yet I preclared it was stress or something because I was scared being told I might have a delusion over paranormal activities or w/e. Luckely I didnt need an operation for the back and got feeling back after six weeks in the numb leg spots. Also the pain is alot less only after bending over with cleaning or lifting. Didnt even need morfine whilst others need to come back for their first shot after 6 weeks. Catharina hospital Ehv.

[@Heimdall01]

Reminds my why we not use MRI as the sole diagnostic tool here in Europe...

[@pattischmitz2680]

Does a regular mri show ms.. or do you need one with contrast and a spinal? Thank you!!

[@DrBrandonBeaber]

MS lesions are evident without gadolinium contrast dye. active lesions are associated with a breakdown of the normal blood-brain barrier, allowing dye to extravasate into the brain, causing lesions to "enhance" (appear very bright) with contrast dye.

[@pattischmitz2680]

Thank you so much for your quick response!!This is why I was asking.. my dr said he doesn’t know how to read this..and has no idea what this means.. but says it doesn’t say it’s ms? @@DrBrandonBeaber FINDINGS: There are a few small areas of T2/FLAIR signal hyperintensity within the bilateral white matter, nonspecific, but likely reflecting chronic microangiopathic change. There are no findings of acute infarct or acute intracranial hemorrhage. There is no midline shift or other significant mass effect/herniation. The cerebellar tonsils are normal in morphology and location. The globes and other intraorbital structures appear normal. The imaged paranasal sinuses are free of significant disease. The imaged calvarium and skull base are unremarkable. Impression 1. No acute intracranial abnormality. 2. Sequelae of microangiopathic change, within expectations for age.

[@pattischmitz2680]

I know you can t diagnose me.. but is this a generic report? Thanks again!!!

[@DrBrandonBeaber]

@@pattischmitz2680 I do not feel comfortable commenting on this. You would have to talk to your own provider. Best of luck to you and hopefully you will get some answers.

[@pattischmitz2680]

@@DrBrandonBeaber thanks for your response.. I totally understand.. but my pcp dr said theres no indication that its ms.. he said the radiologist would have seen ms.. been just sick about it😢

[@shoabmdshoab1502]

🎉excellent

[@annbass1535]

Dear Doctor - could I send you my MRI for review?

[@ramazan9857]

Can you please tell me when the definitive treatment of ms disease will come out? what people are wondering is when will it be possible to stop ms and repair myelin

[@DrBrandonBeaber]

It is impossible to answer this question

[@barbaradascalos4411]

it's already here..alemtuzumab and hsct have put people into long term remission with normal .2 brain atrophy. Something that Ocrevus and Tysabri can't really do. Problem is HSCT is impossible to get in u.s. and Alemtuzumab is rarely used in u.s.

[@arr2820]

@@barbaradascalos4411 you never talked about alemtuzumab before. All you said is hsct and hope for ebv vaccine.

[@barbaradascalos4411]

hsct is far better...more effective less side fx see "hsct vs. lemtrada ms news today"

[@arr2820]

@@barbaradascalos4411 there is new promising treatment with T cell therapy as well.

[@Asrarejahan69]

Hi dear doctor، Im iranian woman and live in Iran،I suspect ms one doctor tells me that I have ms and another Says no، could I email you my result to determine if I have ms or not ?

[@jodiclark7263]

Thank you for this very informative video. I'm newly diagnosed and My Mri showed NO lesions but due to symptoms and CSF findings my doc diagnosed MS. Is this common to have no lesions visible? Thank you 🙏

[@DrBrandonBeaber]

I can't comment on your specific situation, but it is very rare to have no MRI lesions with MS. I do have one patient who has primary progressive MS who did not have any lesions on their initial MRI scan of the brain. Subsequent films did show a small number of lesions typical of MS.

[@jodiclark7263]

@@DrBrandonBeaber thank you so much! Maybe sometime you could do a video for those of us who have rarities in MS. You are so very kind for answering back and I look forward to your videos every Wednesday. Bless you Dr. B

[@BurlingtonWI]

Can small vessel disease have enhanced lesions

[@DrBrandonBeaber]

Generally speaking, small-vessel disease is not enhancing. In some cases, an acute stroke can have enhancement with a distinctive gyral pattern (but generally not for a small-vessel stroke even if it is acute)

[@lesliex7894]

Why do radiologist read the MRI before it goes to the neurologist?

[@DrBrandonBeaber]

Radiologists are very good at interpreting medical imaging and help us to see things we might otherwise overlook. For example, one of my patients was incidentally found to have a nasopharyngeal carcinoma on an MRI scan of the brain I almost certainly would have missed.

[@whatsonmymind4848]

@@DrBrandonBeaberMy Neurologist looked at the MRI with me together before we had the official report and he pointed out two round spots on each side and first said that these are scar tissue, when I asked later again what exactly these spots are he said it’s demyelination, but before he can give me medicine he has to wait for the official report, so we know if there are more of them or not. How does he know that it’s demyelination and not like vascular/white matter disease? A migraine attack? How does one see the difference? I’m 26 and have numbness, tingling and strong nerve pain in my hands and feet and muscle pain in my legs, arms and shoulders/neck. Am fatigues and can not walk for long because I’m so much in pain. I also have trouble swallowing food and drinks, checked my thyroid and it is okay. But I ended up at the Neurologist because I had a strong pain in my head, only for a few seconds tho.

[@charles2675]

I lost my vision and all thought process 3 times. I was a blank.!!!!! What was that.??????

[@soravrathi2273]

Sir is it possible no lesions on brain as well as spine mri and my symptoms are worsening day by day . My main symptom is weakness in legs. Plzz tell sir my age is only 24 and m very confused

[@Andrei3342]

hey, did the weakness go away? We are of similar age and my main symptom is also weakness in legs

[@akshatsgupta895]

Can you review the brain MRI if sent to you please sir ?

[@DrBrandonBeaber]

I unfortunately would not be able to help you personally.

[@realstorm2351]

Does MS cause hearing loss?? i have sudden hearing loss on left ear, nearly 80% hearing loss, when taking MRI white matter lesions present in my brain, doctor diagnosed it as MS... But i don't have any other symptoms except hearing loss....

[@DrBrandonBeaber]

hearing loss is a very rare symptoms of MS, but it has been reported.

[@realstorm2351]

@@DrBrandonBeaber Ok Thank you Doctor...

[@manachannel5442]

What is causes for 2 tiny white matter

[@DrBrandonBeaber]

The cause of "unidentified bright objects" is believed to be vascular disease

[@jessicaisnetto9935]

Can you do a video about MOG lesions?

[@DrBrandonBeaber]

Thanks for the suggestion. I may do this at a later time. I do have a single video on NMO where I mention this briefly: kzbin.info/www/bejne/rnOmnJhridh3faM

[@jessicaisnetto9935]

@@DrBrandonBeaber thank you, or about MOG in general, there is not a lot of information out there as the antibody was only discovered about 5 years ago, but I can say, one thing I learned is if you are treated with an MS immune modulator and you have MOG or NMO you quickly clinically deteriorate. Any of your insights and opinions would be very helpful for some of us I think.

[@DrBrandonBeaber]

@@jessicaisnetto9935 For NMO, certain MS disease modifying therapies like glatiramer acetate and interferon beta are known to be ineffective. Many disease modifying therapies in MS such as rituximab are also effective in NMO.

[@jessicaisnetto9935]

@@DrBrandonBeaber True, and some of the recent theories are showing Natalizumab to be ineffective for auto antibody diseases like MOG as well

[@DrBrandonBeaber]

@@jessicaisnetto9935 Indeed

[@MadMax2022]

To be ms or not to be ms that is the question

[@msmartian]

Can you have both of these? I have MS and lots of heart problems Now I'm curious, lol!

[@DrBrandonBeaber]

Yes. You can definitely have both multiple lesions and UBOs.

[@msmartian]

@@DrBrandonBeaber thank you!!

[@darrinburnette6916]

I was told LYMES DISEASE can mimic MS?

[@DrBrandonBeaber]

It can in some cases. I have a video addressing this: kzbin.info/www/bejne/d5yTZYN_mN2Visk

[@km70387]

Why would myasthenia gravis have these white spots?

[@kevinfitzgerald7474]

What are the actual causes of these lesions.

[@annileehosford8900]

Ms is an autoimmune disease

[@illtemperedklavier-ir9fy]

I wish any of my neurologists watched this video.

[@nurtenayaz5193]

Türkce açıklamasıda lütfen dokdor bey 🇹🇷🇹🇷🇹🇷

[@DrBrandonBeaber]

Sorry Nurten. I can't help you with that.

[@charles2675]

And was more to this

[@bishnuchetry7849]

Sir, will you provide your mail. I want to show you a MRI report

[@DrBrandonBeaber]

Sorry, but I would not be able to help you personally.

[@Esty-gk4ju]

More reading.

[@Young3blu]

6:05

[@shoabmdshoab1502]

11:32

[@jonm4501]

Did you mean to say " ... being a Radiologist is easier than it looks"? 11:24 An unintended dig ... LOL

[@DrBrandonBeaber]

Of course I meant to say "not as easy as it looks."

[@poolmotorrepairguyFL]

jay the Florida I get no help (He's Faking it) Or there's nothing wrong with you! that was good info 2 know 👨‍🔧 Dr. BB

[@game1414]

Have you seen solid evidence that physiotherapy works on people with abnormal gait when walking? Appreciate that’s not your expertise.

[@DrBrandonBeaber]

Yes. There are numerous studies including randomized controlled trials demonstrating benefits of exercise and physical therapy.

[@game1414]

Thanks

[@charles2675]

Brain

[@teddylabis4837]

1st

[@nurtenayaz5193]

Teşekkür istiyoruz

[@shoabmdshoab1502]

Please give your email address, thank you so much. Dr AKM Shoab, MD, FAAN; Assistant Professor of Neurology