Thanks for using the forum. I am happy to address your questions, and my answer will be based on the information you provided here. Please make sure you recognize that this forum is for educational purposes only, and it does not substitute for a formal office visit with your doctor.
Without the ability to take a history and examine you, I can not tell you what the cause of your symptoms is. However, I will try to give you some information.
The symptoms you describe are multiple and nonspecific. Some of them may present along with others in different neurologic conditions, one of them being MS as you mentioned, but the symptoms themselves are not diagnostic and not specific for this condition.
MS is a demyelinating disorder that affects the central nervous system. It manifests with focal neurologic deficits, such as visual loss, numbness, weakness, coordination problems, etc. There are criteria to make the diagnosis, and the criteria uses clinical evaluation (history, symptoms and physical signs), along with imaging such as MRI, and sometimes (not all the time) other tests are required, such as lumbar puncture and evoked potentials.
To make the diagnosis, basically there should be some objective evidence of at least 2 or more events, affecting 2 or more areas of the brain. Therefore your history helps if there have been clear episodes of focal neurologic deficits in 2 or more occasions, and there should be confirmation with MRI showing 2 or more lesions consistent with MS. Sometimes it is not as easy as this, and either the clinical findings are not evident, or the MRI findings are not clear neither, and so repeated imaging over time helps. If there is still doubt, the other tests should be considered.
“White matter” lesions in an MRI are nonspecific, and should be taken into the context of the patient’s history. Could be related to MS, but also could be related to hypertension, or diabetes, and even these “white matter” lesions could be just an incidental finding, and many times the clear cause is not known, but should be observed over time if there is any concern.
Regarding POTS, again the symptoms you describe are nonspecific, and could be related to a condition like this, but may not. Patient’s with POTS describe dizziness, lightheadedness, weakness, blurred vision and fatigue mainly upon standing. Also palpitations, tremulousness, anxiety and GI symptoms. All these symptoms are nonspecific. The key finding in POTS is an exaggerated increase in heart rate on standing, and this is objectively evaluated with tilt table testing. Patients with other autonomic disorders, such as autonomic neuropathies or specific problems with the autonomic nervous system can have similar findings. Detailed history and examination can help suggesting a possible diagnosis of autonomic disorders or POTS.
There are physicians who are specialized in autonomic disorders and deal with POTS and other autonomic conditions. Usually they are under a subspecialty of Neurology. However as it is not clear if this could be the problem, I think you should discuss this possibility with your neurologist, and if needed, get an consultation with an autonomic disorders specialist. There are neurologist who see autonomic disorders at the Cleveland Clinic, however I think you should discuss this possibility first with your neurologist.
Without being able to obtain a history and examine you, and without being able to see the images of the MRI, I cannot tell you what you have. I think that discussing your concerns with your neurologist, and having a repeat MRI will help determine the diagnosis. I hope this helps.
Neurologists at Cleveland Clinic who deal with autonomic disorders are: Dr. Kamal Chemali, and Dr. Robert Shields.
Again, you should discuss with your neurologist to see if your problems are consistent with autonomic disorders, and if there is concern about this problem you should see an autonomic disorders specialist.
Than you for answering as I know my symptoms are puzzling. I may try to get appointment at Cleveland Clinic as it is probably closest to home. Any certain physician that might be best suited to cover the neuro symptoms I am describing?
I will also follow up with MS specialist In Indy in Dec. Again thank you for your time and reply.