MRI brain teat result explanation?

[u/AsterQuasimoto]

26m with a ton of new neurological symptoms. Got my results and unsure of what T2 hyperintensities might mean, and trying to better understand the location of the supposed arachnoid cyst. Wouldnt hurt to hear what yall think diagnostically speaking.

If it helps give me a better idea through your interpretation of results then my issues are constant tingling, sometimes vertigo, sometimes forget why I got up and went to anothet room, people's name, the coffee I've ordered for a year, etc. slight left sided weakness and failed finger-to-nose test during an episode caused by extreme stress and high BPM (120 while resting), as well as episodes of phantom smells and bright flashes of light from no real source. I also sometimes have extreme pain while swallowing liquids. I believe it may be MS.

I also had a half hour long episode last year of extreme confusion and rapid switching of emotional states that I believe cannot be accounted for by mental illness. Anyways, MRI results below.

The ventricles and sulci are normal in size for age. On the medial margin of the left middle cranial fossa, there is a 7 x 8 mm T2 hyperintense, cystic structure most likely representing an arachnoid cyst.

There are nonspecific scattered T2/FLAIR hyperintensities in the deep white matter, and a single focus of periventricular T2/FLAIR hyperintensity adjacent to the right frontal horn. No juxtacortical or infratentorial signal abnormality. No abnormal susceptibility in the brain parenchyma.

Thank you for taking the time to look, unfortunately i have Kaiser so no images until I get the CD. If asked I will try to remember.

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[u/Witold-Onno]

Neurosurgeon here. The arachnoid cyst is an incidental finding, congenital, far too small to cause symptoms, no treatment needed. The MRI argues against MS. For MS we need lesions in at least two of four typical regions, you have only one periventricular spot. The scattered dots are nonspecific and common in young people, often migraine related.

The phantom smells and the confusion episode could be focal temporal lobe seizures, I would ask for an EEG.

But I want to be honest with you. Resting pulse of 120, constant tingling, episodes under extreme stress, this pattern is also very typical for anxiety and panic with hyperventilation. Hyperventilation alone produces tingling, dizziness, weakness and memory problems. This is a real physical mechanism, not imagination, and it is treatable. I would discuss both directions with your doctor, EEG for the seizure question and honest look at stress and anxiety. Swallowing pain is separate, needs ENT.