An mri has shown white matter build up in the periventricular area. without other symptoms of ms, and with a history of diabetes and hypertension, how likely is ms as a diagnosis? can it just be bp?

Vascular: It is more likely inflammatory vascular changes but see your doctor. If it is ms or vascular you need to be treated.

Unlikely: These changes usually reflect alterations in the white matter as a result of narrowing of small blood vessels to the white matter. This is called chronic microvascular ischemia. Your history of diabetes and hypertension are likely the cause of these changes but they are commonly seen in the elderly. Ms usually has a different distribution of white matter changes.

MRI and Hypertension: Ms can present in different manners and some of them can be very subtle. Diabetes, hypertension, and ms can all lead to white matter lesions in periventricular area. A neurologist may help you to differentiate between these.

PV white matter: White matter changes in the periventricular area are very common. They are especially common for people who have had high blood pressure or diabetes mellitus. We have never found these changes correlate with future illness. Without a history of MS symptoms, this should be considered an incidental finding. It is very unlikely that you have MS. Hope that helps! Good luck.