Can you have MS with no apparent lesions on an MRI?
 

Is this possible?

Yes, sometimes lesions don't show up at first or they are too small to detect.

There are a LOT of people here who are in limbo because they don't show any lesions on their MRI. There are folks who have white matter damage showing when they have a high Tesla MRI, but none when a lower T MRI is used.

MS attacks the gray matter in the brain too. The current theory is that it may be doing silent damage to the gray matter before any white matter damage shows.

The criteria for diagnosis (McDonald) calls for MRI lesions to be present.
The older criteria for diagnosis (Poser) also places a high priority on MRI findings
An even older criteria (Schumacher) did NOT call for MRI lesions, but that is because they didn't have MRI back then.

IMHO-There are a LOT of old neuros out there who do not keep up on clinical advances in diagnostic criteria because the way they have been trained has always worked for them OR they are not seeing people with MS, and when they suspect MS they send the person to a specialist. Some feel that the diagnosis will adversely affect the quality of life of the person and don't label it as MS, but just treat the symptoms.
My aunt has one of those neuros and I am shoving her kicking and screaming to a better doc so she can get a diagnosis for what ails her rather than just "treat the symptoms" treatment.

Further to what the others have said, they can really just not even be there. Disease activity is what causes lesions so the disease activity comes first.

Kristen, your anxiety is apparent, as well as understandable! There's probably not a person on this board who hasn't gone through what you're feeling. Keep us posted on your testing and know that you are not alone, whatever the outcome is! We have people here who have been officially dxed, people who have not been dxed with anything yet and even some people who have found out what they have is not MS but just stick around because we're all so lovable. :p

I just want to add that when you go through testing and get a Lyme test, try to do it through IGeneX. Just understand that one of the dilemmas with Lyme is that there can not only be false negatives but also false positives.

:hug:

Yes.

I didn't have lesions when I was dx'd with MS and I would have been dx'd under the Poser Criteria.

I often wonder if in my case I was just lucky to be referred to a neuro who had a professor that wrote a book about MS.

Best wishes, kristen.

Many MS centers will give the dx of MS even in the abscense of lesions, but based upon history, and symptoms.

its a scary time, and I wish you luck, and peace. :hug:

Mr Neuro calls a Pt that shows every aspect of MS, minus the presence of prominent lesions~ benign MS.

This being true and all MS drug trials basing their results on the number of lesions they see on MRIs, what does this say about the accuracy of the trial data? Just a thought.

Harry

I agree, Harry . . . lesions (and/or relapses) are probably not a good measure of efficacy. In fact, I don't think # of lesions are even a legitimate measure, are they? Isn't the primary measure a reduction in disease progression (as measured by our EDSS), and secondary, a reduction in relapses?

I think this is just a new way to try to market the efficacy of our meds . . . "More patients are disease-free with X med". What the he!! is "disease-free" . . . guess that means we are cured, huh?

Lesions, no lesions, inflammation, no inflammation, 3 months of good EDSS results . . .

TIME will tell.

Cherie

Thanks so much for all of you who have responded, I really appreciate it. I can see why so many just hang around :).

One other question in regards to my case, I started with the pins and needles in my left hand last year which lasted several weeks, I can't remember exactly how long but eventually it went away completely. Then I experienced it again several times with periods of nothing (making me think it was a fluke). Then my right hand started. Then eventually my feet. Now I feel the pins and needles further up each arm and leg. It seems to me that this is a sign of progression. I've only had one time where the pins and needles turned into a very painful experience for three days, it felt like fire in my hands (it had not progressed to my feet/legs yet). Has anyone else experienced this or heard of this in relation to MS?

I'm just trying to get a feel for this. If it's not MS then great but if it is then maybe I'll get a better handle on what to do and how to treat it?

Thanks for all the support.

Right now the Dr. is suggesting a lot of destressing activities, he is a family practitioner who practices integrative medicine which is why I'm seeing him, I like that approach. He's suggesting Raiki and visualization. I definitely believe in these things but my gut tells me that it's more than just stress causing these symptoms. I almost just wish that the MRI would show something if it is MS, it's frustrating.