Do MRI results relate to neuro symptoms in possible MS?

Dear Ask The Doctor: I've been having neurological symptoms for over a year. What began as numbness and tingling in extremities, upper back and face has evolved to daily muscle weakness in legs and arms, electric shock feeling down side of neck, dizziness upon movement, intermittent sharp pain behind eyes, swallowing difficulty, extremely brisk reflexes, muscle spasms and just this past week, memory and cognitive deficits. A hot bath or shower makes these symptoms much worse...I often can barely walk after a hot shower, my legs and arms go numb and I have trouble processing my thoughts and even speaking. MRI results indicate: approx. 15 scattered T2 hyperintense subcortical white matter lesions in the supratentorial brain. This is a non-specific finding and most commonly relates to small vessel ischemic disease. The distribution of the lesions does not satisfy the imaging criteria for a diagnosis of multiple sclerosis, but the possibility that the subcortical white matter lesions relate to demyelination cannot be excluded. I saw a neurologist today who insists that the lesions are definitely NOT MS and even goes so far as to say that for a woman my age, 15 tiny lesions of this type is completely normal. She does not think these lesions relate at all to my symptoms and that they are just a normal part of aging. I am 46 years old and have never smoked or had high blood pressure or high cholesterol. I've worked out my entire adult life (up until these symptoms hit). I'm 5'4 and weigh 110 lbs and have been a vegetarian most of my adult life. I find it an incredible coincidence that the dr. went looking for abnormalities within my brain and found lesions and that these are not somehow related to my symptoms. Would so appreciate another opinion on this one.

Dear Faye: Multiple sclerosis (MS) is a progressive disease that attacks the central nervous system (CNS) and affects multiple systems of the body as a consequence of those attacks on determined zones of the brain. The disease is characterized initially by episodes of reversible neurologic deficits, which, in most people, are followed by progressive neurologic deterioration over time. The cause of the disease is not known, but it likely involves a combination of genetic susceptibility and an environmental trigger, resulting in a self-sustaining autoimmune disorder that leads to recurrent immune attacks on the CNS. The diagnosis is done by a combination of criteria as physical exam findings (emphasizing neurological examination), The Kurtzke Expanded Disability Status Scale (EDSS) which is used as a measure of disease progression by assigning a severity score (0-10) to the patient's clinical status, cerebrospinal fluid examination (which shows elevation of immunoglobulins G in approximately 85% of patients with MS), imaging studies (MRI showing the typical demyelinative lesions). Recent MRI techniques such as FLAIR have increased the ability to detect demyelinating lesions due to MS. Patients with normal-appearing white matter on conventional MRI may be found to have abnormalities by more and new specialized MRI techniques. As you see, to make a diagnosis of MS the person has to meet all or the majority of these criteria, not only the MRI images. Also in your particular case, you have been vegetarian for a number of years, it would be important to rule out a possible Vitamin B12 deficiency, by determine your Vitamin B12 levels.