Lesion Question
 

Hello all :)

I had my 1st MRI in October and according to the radiology report it was normal. I also got a letter from the nuero saying it was normal. However when I went in for my follow up with the neuro's PA she told me that there was a lesion on the occipital lobe of my brain.

I am being sent for visual evoked potentials testing because of continuing vision problems in my right eye. The eye is blurry all of the time and it is not corrected by my glasses or contacts.

The PA told me that this lesion was due to my history of migraines. If this is the case, do I need to be worried about this lesion? Do migraines cause lesions? I have heard of them increasing your risk of stroke but didn't know that they could cause lesions. :confused:

TIA

I think migraines are thought to cause lesions.

http://www.neurologyreviews.com/mar0...migraines.html

I don't know if there's any way to determine the CAUSE of a lesion, be it multiple sclerosis, migraines, etc. Sometimes they can be differentiated by size/location or appearance or pattern. MS is also known to produce headaches too, so it becomes very difficult to say what causes what. I really don't think a PA is qualified to say that an occipital lesion is due to migraines and has no relationship to your vision troubles. The occipital lobes play a part in vision.

See here:

http://www.neuroskills.com/tbi/boccipit.shtml

Multiple sclerosis requires more than one neurologic event separated in space and time from another. So one lesion normally won't qualify you for a diagnosis unless there is a distinct other neurological event at some other point. Of course it could BE MS, but it usually isn't diagnosed until there is more than one event or evidence of more than one neurological event (i.e., more than 1 lesion).

Thank you for your reply and links pantos :)

Right now they are saying it is NOT MS (thank goodness!) but they want to see how the VEP's come out. I also have to keep going back every 6 months. I suppose I should keep a symptom diary of some sort.

Pantos is correct, Sibyle. Migraines (as well as other conditions) can cause lesions, and generally it is the size/shape/location that might HELP determine if the are of the "MS" variety.

Pantos' feedback on "more than one neurologic event separated in space" is also correct.

MS is basically a dx of exclusion, whereby if we present with a number of suspect symptoms, they will try to rule out everything else first. They will be looking for certain markers; lesions, "O" bands in our spinal fluid, evoked potentials results (as well as other testing results). However, there is no single test that "proves" we have MS.

If x + x + x exists, and there is no other logical explanation, then we may get dx with "possible/probable" MS (rather outdated terminology, but they still seem to do it this way...). In time, if we have similar symptoms that "pop up" again, then they will often retest to look for changes. That is when we often get the dx, but this can take years.

Cherie