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Migraines causing white matter brain lesions?

#1

Ive been doing some research on Migraine and the link between MS… apparently according to good old google it is in fact possible that Migraines can cause white matter lesions on the brain - which I do infact have on my own brain scan, hence having the MS diagnosis. This is very interesting I have never questioned this before as I wasn’t under the impression Migraines cause such injury to the brain.

Had anybody had a MRI brain scan and found lesions?

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Just diagnosed, scared, and don't know what to do. PLEASE HELP ME!
#2

Yes. The “bright spots” or white areas on an MRI—which are associated with MS—are also characteristic of migraine patients, as I understand it. My GP called me after my MRI to explain that my scan had the bright areas but that since I did not have the other symptoms of MS, she didn’t think that was what I had. She sent my scan to neurologists who specialize in MS but they declined me as a patient because I did not meet the criteria that disease. I subsequently saw different neurologists who diagnosed chronic migraine. My further online research turned up a few sources that confirmed the correlation of the MRI white spots and migraine. So—these spots on the MRI do not (necessarily) mean that you have MS; they could in fact confirm a migraine diagnosis. (Please note I am not an expert; just a self-informed patient.)

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#3

As a follow-up, not much seems to be known about the long-term health implications of these spots on the MRI. This article encouragingly suggests that long-term effects are minimal. (Enough to worry about with this condition, right?)

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#4

This is very interesting and something I will speak with my neuro about in a couple of weeks. I did have a lot of MS/Migraine symptoms I suppose what is difficult is to distinguish whats what when alot of the symptoms do mimic one another. Obviously I hope I dont have MS but I suppose it is possible that it could be Migraine as I have always had the symptoms since seeing my neuro 9 years ago. Im over it now and am not looking for a new diagnosis - and I am not trying to cling on to the fact that I might have been mis diagnosed because I don’t think I have. I just find it fascinating. I guess migraines have the power to do all kinds of things to us!!

Thanks for your imput! :grin:

#5

Nobody ever went through my MRI with me by way of explanation. I was just told it was all clear of ‘nasties’. I just paid up and stuffed the DVD in a sideboard drawer!

I revived this thread though when I noticed references in the presentation (which @napagirl has already posted elsewhere on here) and which I’d bookmarked but never previously read. It mentions increased white matters lesions being used as a distinguishing point between MAV and Menieres. Helen

https://www.ean.org/fileadmin/user_upload/Tarnutzer_vm_vs_MD_ean_2018_v1.pdf

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#6

Do we know if these ‘lesions’ exacerbate the condition or cause other problems?

#7

From what I’ve read, WMLs resulting from vascular disease (arteriosclerosis) have been linked with cognitive dysfunction and dementia. WMLs associated with migraine, seem to be considered “harmless” by most Dr’s. Some researchers disagree, and theorize that they also herald some process with the potential to cause cognitive issues. So I guess the answer is probably not, but they don’t know…

FWIW, I had a brain MRI at age 23 (I’m 51 now) for migraine headaches. The radiologist told me that it looked like the brain of an elderly man, and since I was so young, it was probably MS. This was right when they were starting to see these in migraneures. Another radiologist from UCLA mentioned that they were probably associated with migraine. Neuro confirmed, and I did not have MS.

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#8

“Between 12-47% of patients with migraine have these white matter lesions”
From Hain’s page. An interesting read…
https://www.dizziness-and-balance.com/disorders/central/migraine/white-matter.html

#9

Good link … I note the following statement:

"we note roughly a 4:1 ratio of women to men in our migraine population. "

Not far off the population split on here?

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#10

I am interested in having this conversation with my neuro next week. I am sure she isn’t going to second guess herself but I am eager to see what she has to say about the matter. I received a report on Monday about my latest MRI scan 1 month ago. My neuro is suggesting we talk about Disease modifying drugs for (ms) at my next appointment. I am a little concerned that these lesions are not owing to MS and are perhaps due to my migraine relapse at Christmas.

I love my neuro and in no way want to offend her or imply I do not believe her but I feel I am within my rights to question this? Any ideas how I can approach this without sounding like I have no faith in her whatsoever?! I feel she looks after me very well so I want to be respectful to her.
:thinking:

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#11

@MNEK18 Firstly, I will say that my Neuro has said to me that there is a certain pattern, “look”, and location to lesions associated with MS. Also, there needs to be clinical correlation with imaging. Although it seems like almost anything is possible with migraine, migraine Neuro symptoms tend to “add” vs causing a deficit like with MS. Example- scintillating scotomata in migraine is appearance of bright scintillating flashes vs a loss of vision. Tingling in migraine vs loss of motor function (except the rare hemiplegic migraine). Also I’ve been told by both opthamologist and Neuro that MS symptoms are much longer lasting than those due to migraine. Example- years ago I came down with blurred vision in one eye. I used drops- still wouldn’t clear. Finally I went to bed, and the next morning it was normal again. Saw opthamologist and she said that blurred vision from MS would not go away overnight- that it usually would require steroids to normalize.

As far as asking your Dr and not offending, you could just ask, What are the differences between WMLs seen in migraine and those seen with MS? And perhaps then say, Can you show me on my MRI? I would hope all Dr’s wouldn’t have a problem with being asked this? I obviously know there are some jerks out there, but most Dr’s seem to enjoy explaining things as it shows off their knowledge😉

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#12

Thank you for your very informed reply.

I will absolutely ask her about this I am sure she will oblige, she is very compassionate and caring, I think she would happily show me.

A very appropriate way of asking :wink: thank you! Ahh so, lesions are quite specific in MS and migraine! Your explanation is very helpful!

Thanks again! :two_hearts:

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#13

Seems it’s another area in much need of research! Cause, Effect? Chicken, Egg?

And, which may seem more relevant after reading @napagirl’s comments

https://jnnp.bmj.com/content/74/1/94

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#14

Spinal tap is required for definitive MS diagnosis. It cannot be based on white lesions as most migraines have white lesions.

#15

Spinal tap is the main deciding factor usually. I have lesions and they are diagnosed as a result of migraine and concussion. I went to the top MS neuro in my area when all this started, he said the reason they use the spinal tap on the end is hes had patients present with lesions like mine that ended up being just migraine/concussion related, and a small few patients who actually have MS but dont present with lesions (this is very rare)

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