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Radiology/Differentiating Chronic Migraine from MS lesions on MRI


Hello, I am not (at least not yet) diagnosed with MS. I'm a 25 year old female, and for the past couple of years, I've been receiving treatment for Chronic Migraine and unrelenting muscle spasms in my face, shoulder, arm, neck, and back.

My doctor recently ordered an MRI of my brain because he thought I may have MS due to some other symptoms I was having, but when I went in for my appointment, he couldn't find my MRI report (or possibly hadn't received it yet from the radiology place).

I have another appointment in April when I'll speak with him about the MRI, and also receive Botox injections. He's also referring me to see an neurologist.

Anyway, in the mean time, I have a copy of my MRI report from the radiologist, which reads in the conclusion section: "Abnormal hyperintense signal predominantly within the periventricular white matter as well as within the left centrum semiovale. Some of lesions have a perpendicular configuration relative to the lateral ventricles. Findings may represent sequelae of demyelinating disease and further evaluation with gadolinium-enhanced imaging is suggested. At that time, saggittal T2 FLAIR imaging should be considered."

I know that migraines can sometimes cause lesions, so is there a way for me to tell from the report if the locations of mine are more indicative of migraine versus MS?

Any help would be greatly appreciated. Thanks!

Hello Tina,

I think seeing a neurologist is absolutely the right next step.  While MRI does not diagnose MS but only supports the work up in certain cases, the  report uses certain descriptors of the lesions emphasizing characteristics of the lesions that are typical of MS rather than migraine. However, this by no means is diagnostic of anything, and further blood and perhaps even a spinal tap may be useful to arrive at the correct diagnosis.

Let me know if I can be of further help.  



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Michael K.


Almost any kind of questions regarding any types of radiology exams, procedures, meaning of radiology reports etc...


12 year experience in the field of radiology

American Society of Neuroradiology, Senior Member Society of Pediatric Radiology, Active Member

Radiology Seminars in pediatric neurology American Journal of Roentgenology American Journal of Neuroradiology

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