Question:
Can an old case of Mono cause "multiple punctate lesions" of the white matter on an MRI of the brain?
Thomas L
2007-10-17 11:04:04 UTC
I had mono over 10 years ago and I just had an MRI of my brain and it showed multiple puncatate lesions of the white matter and all over the brain. The report looked pretty bad and there were several places where the report said, "too numerous to count." I just wanted to "expert opinion" to see if that would cause it!

Thanks for your help!
Five answers:
anonymous
2007-10-17 11:13:28 UTC
well mono virus is Ebstein Barr Virus (EBV) which is now being more popularly blamed for M.S. or multiple sclerosis. An autoimmune reaction to the EBV years after infection (maybe second primary infection?) I would like to know if you have any MS symptoms? IF so then the demyelination could be this otherwise I have no idea... sounds like EBV to me.
Blah?
2007-10-17 12:56:08 UTC
We can't make a cause-effect link just like that.



One very important piece of information needed: WHY did you have an MRI of the brain?



Just a clarification: NO definitive link has been made between EBV causing multiple sclerosis. If it had been made, then C. pneumoniae would also be right up there with EBV, based on the retrospective epidemiological studies on both pathogens' association with MS.



Addition: If the neuro mentioned those conditions, then you should have been scheduled for a lumbar puncture, if not already done, along with an autoimmunity panel. From the latter, they can test for antibodies suggestive of MS and lupus at the least (e.g. ANA, Anti-ds DNA, etc.), along with a Lyme serology. Obviously no one can come close to suggesting what you have from a distance, but these tests are the bare minimum if the neuro has the conditions you mentioned in mind.



If in fact tests suggest you have an autoimmune condition, then one thing to keep in mind: the data to date suggests autoimmunity is a combination of genetic predisposition and environmental triggers. In that case, it is conceivable that EBV could trigger an autoimmune reaction, but then again, so can other things; viruses especially.



Hope this helps.
?
2016-11-14 01:05:02 UTC
Punctate Lesions
?
2016-05-23 08:27:55 UTC
Sounds like multiple sclerosis. The immune system attacks the myelin sheaths that cover the nerves, this leaves scars that show up as white matter on an mri. The good news is there are a lot of new treatments available, and it can go into remission for years. Most people have normal life expectancy.
r j
2007-10-18 20:32:55 UTC
There is conflicting evidence linking EB with MS..I am attaching an article from the MS society.Please dont panic..There are lots of things that could cause the lesions..I can tell you first hand , If you do have MS, it's not the end of the world.MS can be a challange , but it's not the worst disease out there.Your Dr Is your best advisor.



Researchers Revise Previous Report of a Possible Link Between MS and Epstein-Barr Virus





June 3, 2005









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Researchers suggest that increased levels of immune antibodies that fight Epstein-Barr Virus (EBV), the virus that causes infectious mononucleosis and other disorders, may be associated with an increased risk of developing multiple sclerosis. Alberto Ascherio, MD, DrPH, and colleagues (Harvard School of Public Health, Walter Reed Army Institute of Research) originally reported their findings in the March 26, 2003 Journal of the American Medical Association. However, due to an error in the processing of the data, the authors have retracted the original article and published a revised report in the May 25, 2005 Journal of the American Medical Association. The revised report still found a relationship between EBV and risk of developing MS but that this relationship was age dependent.







The revised study reports on 83 cases (defined by the researchers as definite or probable MS), among 3 million military personnel, who were granted temporary or permanent disability because of MS, and whose blood samples had been previously collected and stored by the U.S. Department of Defense. For each of these 83 cases, the researchers identified the earliest available blood sample plus up to two additional samples collected before the onset of MS, and the first sample collected after the onset of MS. Using those stored samples, the researchers looked for elevated levels of immune antibodies (indicating prior exposure to an infectious agent) against EBV and another virus for comparison, searching for an association between these viruses and MS. For each case of MS, two control cases without MS were also studied.







Epstein-Barr virus is one of the most common viruses in the world, and by age 40 as many as 95 percent of adults in the U.S. show signs of having been exposed to it. In this study, the researchers found that all cases of MS and probable MS, and 96% of the controls, had evidence of previous EBV exposure. Among people who later developed MS, antibodies to EBV were similar to controls before the age of 20 years but consistently higher at all subsequent ages. The risk of MS increased with increasing levels of antibodies. The association was also present when analysis was restricted to samples collected five or more years before the onset of MS. There was no difference in antibodies to the second virus studied.







Interpretation: For many years scientists have been searching for possible links between MS and infectious agents including EBV. This interesting study, by a respected group of researchers, adds evidence of an age-dependent relationship between EBV infection and development of MS. So far, a causal relationship has yet to be established between any infectious agent and MS. It is possible that the immune dysfunction that leads to MS causes abnormal findings in immune responses to various infectious agents. It is also possible that infections of late childhood influence the immune systems of genetically susceptible individuals, altering defenses and later attacking the body’s own brain and spinal cord tissues. Further research into infectious agents and MS, which is ongoing, should shed further light on these questions.







-- Research and Clinical Programs Department


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