### instruction:
If you are a doctor, please answer the medical questions based on the patient's description.

### input:
Had numbness with almost a menthol sensation from my foot to my face on July 5th...all on my right side...included leg, outer torso, arm and half my face...lasted approx 5 hours. Have also had numbness/tingling around my eyes and nose over the last year...none of these symptoms caused blurred vision or slurred speech and was able to function normally. Had an MRI on July 21st...Here are the findings: There is a focus of the T2 bright signal demonstrated in the subcortical white matter of the left frontal lobe. This measures approx 4 mm in diameter. The findings are nonspecific, although in a 45 year old woman do include demyelinating and disc spinous processes such as multiple scierosis. EDEM, vasculitis, or Lyme disease can give similar appearance. Small vessel ischemic change is also possible. Diffusion weighted sequences are unremarkable without an acute process seen. The ventricles are normal in size and configuration. The orbit and paranasal sinuses are within normal limits. Impression: Solitary small focus of white matter change in the left frontal lobe of unknown clinical significance. My history...Had an Head MRI in 2010 due to family history of aneurysms...MRI was clear. Also was diagnosed with Lyme 5 years ago...suffered joint pain in right knee/left arm...took 30 days antibiotics...one year later had similar symptoms and antibodies were high(not sure it that is correct term) so went on another round of antibiotics. Have recently had similar joint pain, but very inconsistent and not frequent(3x for only a few minutes over the last month...comes on w/o any cause). current Meds...25 mg Adderall for ADD/125 mcg of synthroid for hypothyroidism and just added 81 mg of aspirin as a precaution incase I had a TIA. Hadn t heard from Neurologist until I called today...was told not life threatening and they would go over results at my follow up which is at the end of August. After hearing this I requested the MRI report...I am looking for some thoughts of what might be going on or what my next step should be. I do have a Great Aunt on my mother s side that had MS. Thank you!

### output:

Hello Small hyperintense focus in deep white matter of brain may be due to ischemic changes resulting from involvement of small blood vessels(vasculitis), demyelination, post Lyme infection,post-traumatic etc. Ischemic changes resulting from blood vessels changes in diseases like hypertension, diabetes mellitus, dyslipidemia. So, you need monitoring of conditions that leads to ischemic changes like hypertension, altered lipid profile, diabetes mellitus so that further progression of disease can be halted. You need investigations like routine hologram, RBS,LFT, RFT, Lipid profile, ultrasound of abdomen. Proper treatment depend upon findings. You also need follow up scan. Multiple sclerosis(MS) is associated with many findings, it needs clinical correlation. Take Care Chat Doctor. 