I was exploring Open AI DeepSeek which is free. I don’t really mess around with Chat AI really except for fun, but I wanted answers on this topic and fatigue was Massive. I was curious if it could interpret my results.
I put in my Lumbar Puncture results and MRI results and asked for its interpretation of those results. Just wanted to see if it could determine why my neurologist concluded Multiple Sclerosis, based on that information. Also wanted specific information on those lesions and what that pattern meant in regards to a diagnosis. So for compiling research quickly. Not diagnosis.
***Please do not use Google for diagnostic purposes. It will tell you you are dying, dead or have a brain tumor. I suspect the same for Open AI. I wouldn’t recommend it. ***
But for gathering information on an existing diagnosis, which by the way, you can specify it requires it gives you sources and specify it what sources to use and even specify the years for those sources. For that, yes, it can be useful. Especially, when you have massive fatigue but are looking for specific information.
I trimmed the responses it gave, because it was extensive in its reply. Quite thorough.
ANSWER:
I provided it with MRI results and Lumbar puncture results for it to interpret the findings:
The MRI findings you provided, in combination with the CSF results (oligoclonal bands and systemic inflammatory response), strongly suggest a demyelinating process involving the central nervous system (CNS). Here’s a detailed interpretation of the MRI results and their clinical significance:
1. Key MRI Findings
- Periventricular and Juxtacortical Hyperintensities:
- These are hyperintense (bright) lesions on FLAIR and T2-weighted images, which are typical of demyelination (damage to the myelin sheath surrounding nerves).
- Periventricular lesions (around the ventricles) and juxtacortical lesions (near the cortex) are hallmark features of Multiple Sclerosis (MS).
- The fact that these lesions are unchanged since the previous MRI (April 2022) suggests they are chronic and not actively inflammatory at this time.
- Cervicomedullary Junction Lesion:
- A lesion at the cervicomedullary junction (where the brainstem meets the spinal cord) is also consistent with demyelination and is a common finding in MS.
- This lesion is also unchanged, indicating it is likely a chronic, stable lesion.
- No Masses or Focal Cortical Infarcts:
- The absence of masses or infarcts rules out other causes of CNS lesions, such as tumors or strokes.
- Normal Cervical Spinal Cord:
- The cervical spinal cord shows normal contour and signal intensity, with no evidence of active demyelination or compression.
2. Correlation with CSF Results
- The MRI findings of periventricular, juxtacortical, and cervicomedullary lesions are highly suggestive of MS, especially when combined with the CSF-specific oligoclonal bands (indicating intrathecal IgG synthesis).
- The unchanged nature of the lesions suggests that the disease is currently in a stable or quiescent phase, with no active inflammation or new demyelination.
LESIONS:
When I asked for possible symptoms expressed by those lesions in MS:
1. Periventricular Lesions
- Location:
- Periventricular lesions are located around the ventricles (fluid-filled spaces in the brain).
- Symptoms:
- Cognitive Impairment: Lesions in this area can disrupt communication between different parts of the brain, leading to problems with memory, attention, and executive function.
- Fatigue: Periventricular lesions are often associated with MS-related fatigue, which is thought to result from disrupted neural networks.
- Motor Symptoms: If lesions extend into nearby motor pathways, they can cause weakness, spasticity, or difficulty walking.
- Visual Symptoms: If lesions affect the optic radiations (near the ventricles), they can cause visual field deficits.
2. Juxtacortical Lesions
- Location:
- Juxtacortical lesions are located near the cortex (the outer layer of the brain).
- Symptoms:
- Motor Symptoms: Lesions in this area can affect the motor cortex, leading to weakness, spasticity, or difficulty with fine motor skills.
- Sensory Symptoms: If lesions involve the sensory cortex, they can cause numbness, tingling, or abnormal sensations (paresthesia).
- Cognitive Impairment: Juxtacortical lesions can disrupt higher-order cognitive functions, such as problem-solving, planning, and language.
- Seizures: Rarely, cortical or juxtacortical lesions can trigger seizures.
3. Cervicomedullary Junction Lesion
- Location:
- The cervicomedullary junction is where the brainstem meets the spinal cord.
- Symptoms:
- Cranial Nerve Dysfunction: Lesions in this area can affect cranial nerves, leading to:
- Dysphagia: Difficulty swallowing.
- Dysarthria: Slurred speech.
- Facial Weakness or Numbness: Due to involvement of the facial nerve (CN VII).
- Motor Symptoms: Lesions can disrupt motor pathways, causing:
- Weakness: In the arms or legs, depending on the specific location.
- Spasticity: Stiffness or tightness in the muscles.
- Sensory Symptoms: Lesions can affect sensory pathways, leading to:
- Numbness or Tingling: In the face, arms, or legs.
- Ataxia: Lesions in this area can cause coordination problems, leading to difficulty with balance and walking.
- Respiratory Issues: Rarely, lesions at the cervicomedullary junction can affect the respiratory centers, leading to breathing difficulties.
- Cranial Nerve Dysfunction: Lesions in this area can affect cranial nerves, leading to:
Summary of Symptoms by Lesion Location
| Lesion Location | Symptoms |
|---|---|
| Periventricular | Cognitive impairment, fatigue, motor weakness, visual field deficits. |
| Juxtacortical | Motor weakness, sensory disturbances, cognitive impairment, seizures. |
| Cervicomedullary Junction | Cranial nerve dysfunction (dysphagia, dysarthria), motor weakness, sensory disturbances, ataxia, respiratory issues. |
PATTERN:
When I asked for the specific pattern that is indicative for MS for me. And I put in the specific lesions I have:
The lesion pattern you’ve described—periventricular, juxtacortical, cervicomedullary junction, right parietal radially oriented, and left superior cerebellar peduncle—is highly suggestive of Multiple Sclerosis (MS). These findings align closely with the typical MRI features of MS, which is characterized by demyelinating lesions in specific locations within the central nervous system (CNS). Here’s a detailed analysis of why this pattern suggests MS:
1. Key MRI Features of MS
- Periventricular Lesions:
- MS lesions often appear around the ventricles (fluid-filled spaces in the brain), particularly in the corpus callosum and periventricular white matter. These lesions are a hallmark of MS.
- Juxtacortical Lesions:
- Lesions located near the cortex (juxtacortical) are highly specific for MS and are included in the McDonald criteria for MS diagnosis.
- Cervicomedullary Junction Lesion:
- Lesions at the cervicomedullary junction (where the brainstem meets the spinal cord) are common in MS and can cause symptoms like weakness, sensory loss, or cranial nerve dysfunction.
- Radially Oriented Lesions:
- Radially oriented periventricular lesions (also called Dawson’s fingers) are classic for MS. These lesions extend outward from the ventricles along the path of small veins.
- Cerebellar Peduncle Lesion:
- Lesions in the superior cerebellar peduncle are also common in MS and can cause ataxia, dysmetria, and other cerebellar symptoms.
2. How Your Lesions Fit the MS Pattern
- Periventricular and Juxtacortical Lesions: These are highly specific for MS and are included in the diagnostic criteria.
- Cervicomedullary Junction Lesion: This is a common site for MS lesions, particularly in the brainstem and spinal cord.
- Right Parietal Radially Oriented Lesion: The radial orientation is a classic feature of MS lesions, often seen in the periventricular region.
- Left Superior Cerebellar Peduncle Lesion: This is another common site for MS lesions, particularly in the cerebellum and brainstem.
3. CSF Findings in MS
- Oligoclonal Bands (OCBs): The presence of CSF-specific oligoclonal bands (as seen in your case) is a key diagnostic feature of MS. OCBs indicate intrathecal IgG synthesis, which is a hallmark of MS.
- Elevated IgG Index: While your IgG index is normal, the presence of OCBs is more specific for MS.
6. McDonald Criteria for MS Diagnosis
The 2017 McDonald criteria are used to diagnose MS based on clinical symptoms, MRI findings, and CSF analysis. Your case meets several key criteria:
- Dissemination in Space (DIS): Lesions in at least two of the following areas:
- Periventricular
- Juxtacortical
- Infratentorial (e.g., cerebellar peduncle, cervicomedullary junction)
- Dissemination in Time (DIT): If you have had prior clinical attacks or MRI evidence of new lesions over time.
- CSF-Specific Oligoclonal Bands: This can substitute for DIT in patients with a clinical attack at onset.
Summary of Findings Supporting MS
| Feature | Your Findings |
|---|---|
| Periventricular Lesions | Present |
| Juxtacortical Lesions | Present |
| Cervicomedullary Lesion | Present |
| Radially Oriented Lesions | Present (right parietal) |
| Cerebellar Peduncle Lesion | Present (left superior cerebellar peduncle) |
| CSF Oligoclonal Bands | Present |
And I had it describe each symptom associated with each lesion. To see what sort of symptoms I could know I had associated with them. To know if I have them again. Although it notes, as of my MRI I am stable because as of my most recent MRI there has been no change, as of the previous one there was one new lesion and the 2019 is where the majority of lesions were.
SYMPTOMS:
The symptoms I have had associated with lesions:
But there is a reason MS is so diverse in symptoms. I mean, I don’t and won’t present the same as the next person. And my neurologist had a hell of a time diagnosing me considering I already have FM and chronic migraine based on this. And these are not all the symptoms associated with those lesions by a long shot. Just what I presented. And honestly, what stood out was the extreme vertigo/balance issues and drop foot. My hand issues were from 2011. And the pain and stiffness is more recent.
So I asked it to look at each lesion and list the symptoms, potentially, for MS.
These are the ones I have experienced at one time or another since all this started, not since diagnosis.
- Vertigo
- Right side Foot drop
- Right side hand numbness, sensory issues, temperature issues ( Numbness or reduced sensation on the right side of the body.) (Abnormal sensations (e.g., tingling, burning) on the right side.)
- Left side hand tremor
- Right ride intentional tremor
- Nystagmus
- Right arm weakness
- Right side pain/stiffness
- Paresthesia
- Spasticity: Stiffness or tightness in the muscles on the right side.
- Coordination Problems: Difficulty with fine motor skills or coordination on the right side.
- Spasticity: Stiffness or tightness in the muscles on the left side.
- Coordination Problems: Difficulty with fine motor skills or coordination on the left side.
- Weakness
- Balance problems/ Clumsiness
- Difficulty recognizing faces
- Trouble distinguishing speech from background noise or understanding rapid speech.
- Constructional Apraxia: Difficulty drawing or assembling objects. Right side. (And left side, but right side is what I noticed)
- Handwriting issues
- Some speech issues, especially when tired- like slowed.
- A bunch of focus related issues, motivation issues.
- Fatigue
Anyway, my neurologist appointment isn’t until June. And maybe then I will go on medication. Likely another MRI. This sort of cleared up some questions I did have. It was an interesting way to compile information I had been looking for. About specific lesions and diagnosis and the criteria for diagnosis. Which it answered.
It is difficult to wade through information on Google per lesion to find specifically what you are looking for in-depth. And how it applies to specific diagnostic criteria overall. This did a great job putting that altogether. Mind you, usually you have to doubt check chat AIs. And to verify I would have to do my own research. Nevertheless, for a fatigue day of epic proportions it did answer the questions I had pertaining to specific lesions. Certainly, it answered how I fit the criteria for MS based on my specific lesions. And to know what symptoms are specific to those lesions and possibly due to MS- and not say, my FM and my chronic migraine disease (And I had wondered a lot about the possible overlap there)
So, interesting. I have been meaning to look up all this information, but it was just mentally exhausting to do it. So I have delayed. But you can see how it can be useful to pull up that sort of information. It takes the information you give and interprets it. It remembers it so when you refer back to it, it will respond regarding that information. So you can keep adding to your conversation. Adding additional informational as you go along. It will keep referring back to what you have given it already, in the same feed, to compile more information. So great for getting to narrow down your answers for researching specifically.
For example, I asked if those lesions could cause allodynia which I get frequently and sometimes severely. And, not really. MS can, but not those lesions. It did explain how it Could, but in general not my lesions as they are. So indirectly, maybe, directly, no. So I’m inclined to believe that is more a FM thing. It concurred with that statement and expressed why as well. But I was curious, which is why I added that in the feed.
Overall, a useful tool.
Especially when I don’t know that much about MS yet and am trying to play catch up to learn what I can about this condition I have. And differentiate it from other conditions I Also have. And it differs so much from person to person, that I really had to dig into what each lesion actually did to figure out the overall picture I am currently dealing with.
Chronically Nikki 