Hello!  I am a 50 year old woman with mild high blood pressure which is controlled with medication.  I have recently had a MRI with and without contrast of my brain.  This was ordered because I have been experiencing burning nerve pain on face, on arms, hands, legs and feet for five months (after a bout of shingles). I am currently taking 100 mg. of gabapentin twice a day for the nerve pain.  This does not completely control it, but I do not like the side effects so I am trying not to increase the dosage.    A previous MRI without contrast (for numbness and tingling in face two years ago) showed some possible white matter lesions in right frontal lobe. At the time, I was told that I was experiencing "silent migraines"...no pain, just numbness and tingling.   This most recent MRI showed "slight progression minimal periventricular and moderate deep white matter disease since last MRI.  This is nonspecific and consistent with demyelinating process, vasculitis, or chronic small vessel ischemic change."  It also stated that "two new adjacent white matter lesions at the right frontal lobe centrum semiovale measuring appr. 1mm.  The remainder of the white matter lesions appear relatively stable on the right.  There are two new foci of T2 prolongation at the posterior aspect of the left frontal lobe deep white matter at the junction of the centrum semiovale and corona radiate also measuring on the order of 1 to 2mm."Should I be worried?
Hi, Thank you for posting your query. The MRI brain findings are non-specific and minor, and there is no need to worry about them. As your doctor suggested, they are most likely related to migraine, and the other diagnostic possibilities such as vasculitis and declination are unlikely in your case. The pain and burning are not related to MRI findings. Gabapentin dose can be gradually increased based on the relief from burning and possible side effects. If you are unable to tolerate gabapentin, then, other options include pregabalin and carbamazepine. Best wishes, Chat Doctor. 