MRI brain 65y/o woman with lifelong history of narcolepsy with concomitant ADD who developed CFIDS/ME?

6/29/2018 MRI brain 65y/o woman with lifelong history of narcolepsy with concomitant ADD who developed CFIDS/ME as adult concerned about increasing ADD symptoms, new STML, et al. “I’m more out of it like.” Contributed to recent emotional trauma by her primary care MD. We are retired RNs who have known each other for 50 years & insisted on further study. REPORT READS:
1) Scattered punctate areas of increased T2 signal in the periventricular and deep white matter both cerebral hemispheres. These could be due to small vessel ischemic disease versus demyelinating disease.
2) No MR evidence of acute infarct , mass or hemorrhage.
I was with her at her next appt. and told by PCP brain MRI results ‘normal.’ We are thus asking you to tell us what the above 2 sentences mean, may potentially mean – may develop into – with a few examples of vascular ischemic diseases and demyelinating diseases that the writer refers to; and what to do about it? (Her PCP told her to get more counseling and referred her to psychiatry for her behavioral health issues. I know her too well – and have talked to her counselor – he does not think these increasing symptoms are dt her ’emotional issues,’ either). Thank You

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Dr. Deepak Patel

Hello. The MRI report suggests there have been changes to the small vessels of the brain, this results in damage to the brain’s white matter. This is small vessel ischemic disease and this can be quite a common occurrence with age. There could be negligible consequences or more serious consequences such as cognitive issues, depression etc… Treatments include lifestyle changes, lowering blood pressure, controlling cholesterol, exercise etc.. The report does not seem to conclude there is any demyelinating disease – of which Multiple Sclerosis is the most frequent occurrence. Regards