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Old 04-22-2008, 07:32 PM #1
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Default Lesions vs symptoms

I thought this article quite interesting.
http://www.medhelp.org/health_pages/...show/61?cid=36

The article also discusses the Brain.

THE BRAINSTEM AND SPINE

The nerves in the brainstem and spine are all "eloquent" to some extent. They drive the functions and the movement of the body and they relay information like sensations from the body back to the brain. A small area of damaged myelin in the spine is "more likely" to cause a direct symptom or problem. Spinal lesions are a little less common than brain lesions, but more directly connected (in an obvious way) to our disease. But, also many spinal lesions are still invisible. One of the reasons for them being invisible is that they are harder to get good clear MRI images on. This appears to be one of the strengths of the newer generation of MRI machines. They have a higher magnet strength and because of this they have a higher resolution. They can see smaller lesions. The strongest MRI machines currently in clinical use today use a 3 Tesla magnet. Tesla is the "unit of measurement" of magnets, like "amps" is the unit of measurement of an amplifier. Older MRI machines, which are by far the most common in use, may use a magnet that is 1.5Tesla or weaker. Much stronger magnet MRI machines are being developed, but currently are used only in research.

Lesions in the brainstem and spine are stronger evidence for the presence of MS than are lesions in the brain. This is because there are many disorders that cause brain lesions, but many fewer that cause lesions in the spinal cord or the brainstem. And even though there tends to be a better correlation between symptoms or abnormal physical findings and lesions here, it is still often hard to draw connections between all of them.
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Old 04-22-2008, 09:03 PM #2
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Thanks Snoopy. Much of what was said here is what I've been trying to convey in various "spinal lesion" postings lately, but I haven't been able to say it quite so succinctly. Nice to see it in print.

Cherie
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Old 04-22-2008, 09:19 PM #3
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Thanks for that Snoopy.

Wow. That is the clearest explanation I have ever read about lesions in the brain. It clears up a lot.

One thing that strikes me in reading this is the complete randomness of MS in terms of whether or not it has hit eloquent or non-eloquent areas of the brain. So I guess it's just luck of the draw depending on what part of your brain your body decides to attack.

My diagnosis was relatively easy because of the "characteristic lesions" -- I had Dawson's Fingers (periventricular lesions) and lesions in the corpus callosum. Throw in optic neuritis for the first symptom and there wasn't much question I guess. But weirdly I had no oligoclonal bands in my spinal fluid. I don't really understand that because apparently 90% of people with MS have the O bands.

Anyhow, I guess there are only "typical" patterns that can serve as some guidance but as this article points out not every symptom matches a lesion and vice versa.

Not to throw a wrench into matters but I just recently read that researchers think there may be 4 identifiable "types" of lesions. All of the lesions one person has are only 1 type--they just may appear anywhere in the brain. If they can target whether you have type 1, type 2, type 3, or type 4 they may better be able to determine which drug will work for you.

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Old 04-22-2008, 10:23 PM #4
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I have to confess that I haven't stayed up with the current research like I used to. Being as instensely involved as I used to be only frustrated me because the more I learned, the less optimistic I was about my own personal situation.

I am, however, fascinated about the spinal lesion detection, or lack thereof. My last spinal MRI (two years ago) showed no lesions, but I've had horrible problems with spasticity in my legs for what seems like forever. Perhaps there are some of those little troublesome spinal lesions hiding somewhere.

You've awakened a sleeping curiosity in me, and I'll be looking more closely at this particular aspect of our malady.

Thanks for the info!
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Old 04-22-2008, 10:30 PM #5
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Quote:
Originally Posted by Natalie8 View Post
But weirdly I had no oligoclonal bands in my spinal fluid. I don't really understand that because apparently 90% of people with MS have the O bands.
I had two LPs five years apart and neither showed O bands. However, both showed elevated protein and the second also showed elevated IGG in the results. These were two of the factors that my specialist considered in making my dx. Many people are unaware that the elevated protein levels are consistent with MS. The same is true of the elevated IGG.

I learned a lot five years ago when I was on the verge of a dx after taking a break from neuros. I'm amazed that I remember this stuff!
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Old 04-22-2008, 11:03 PM #6
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Quote:
Originally Posted by dshesq View Post
I had two LPs five years apart and neither showed O bands. However, both showed elevated protein and the second also showed elevated IGG in the results. These were two of the factors that my specialist considered in making my dx. Many people are unaware that the elevated protein levels are consistent with MS. The same is true of the elevated IGG.

I learned a lot five years ago when I was on the verge of a dx after taking a break from neuros. I'm amazed that I remember this stuff!

I'm hoping my obsessive interest in the research and explanations will die down in a little while. I'm still in the early stages so I'm probably still unconsciously looking for THE answer of what my future may be like. But I bet you never forget what you read about in the beginning -- it's probably etched in the brain from the shock or confusion!
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Old 04-23-2008, 12:33 AM #7
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Default Thanks for that info Snoopy!

I have a very small C-spine lesion that causes havoc. I think it's responsible for my meltdowns when I get slightly overheated. This is good to know. I don't have that many brain lesions anymore (they don't show up as much?) I certainly feel like something the cat dragged in though on most days.

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Old 04-23-2008, 01:07 AM #8
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Quote:
Originally Posted by ewizabeth View Post
I have a very small C-spine lesion that causes havoc. I think it's responsible for my meltdowns when I get slightly overheated. This is good to know. I don't have that many brain lesions anymore (they don't show up as much?) I certainly feel like something the cat dragged in though on most days.

Wiz, how come you don't have many brain lesions anymore? Do you think the tysabri shrank them?
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Old 04-23-2008, 03:40 AM #9
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Quote:
Originally Posted by ewizabeth View Post
I have a very small C-spine lesion that causes havoc. I think it's responsible for my meltdowns when I get slightly overheated.

I have these meltdowns, too, when I get too hot. I dread this summer 'cause I know I'll be quarantined inside.

I just had an MRI yesterday morning and they did brain and spine so I'll be asking the Neuro when I see him on Friday if there are C-spine lesions (or any more lesions). I have a lot of spasticity in my legs, too.

Isn't this fun!!?? NOT!
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Old 04-23-2008, 04:27 AM #10
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thanks snoop interesting article and written so we can understand it thank you to the author on that note.

I think perhaps this article should be sent out to all neuros, just to take that assuming attitude out of them a bit, especially how many limbos have sx but no dx cause mri shows no lesion yet the lesion could be invisible

lucky for me my lesions are exahibationist(sp?) and show off in brain and spine, am curious what test can they do after mris are neg LP? what else

again thank you snoopy
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