Significance of Disappearing Brain Lesions in MS

[Sarahsmom46]

Dear Dr. Kantor,  

We have discussed disappearing lesions on this forum quite a bit lately and would appreciate your thoughts on this issue.  

Example:  I had 7 lesions on MRIs done 7 months and 4 months ago.  In my most recent MRI a few weeks ago, 2 lesions magically "disappeared"
.  
My question:  1. How did the lesions just disappear?  2. Are these lesions really gone-gone or just smaller and undetectable?  3. Are disappearing lesions "normal" in MS and if so, could this point more to a diagnosis of MS as opposed to other neurological conditions where lesions can also disappear?  

It has been a challenge to find anything I could truly understand on the web about this as the information was way over my head.  

Thanking you in advance for you response.

Julie

[Dr. Daniel Kantor, MD]

MS is a dynamic diagnosis, and if some lesions didn't come and other go (dissapear) I would doubt the diagnosis of MS.

There should be some dissapearing lesions. It is from a combination of healing scars ("sclerosis") and of the limitations of MRI.

[Dr. Daniel Kantor, MD]

yes -- remyelination is not always complete just like a broken bone does not always heal completely.

Neuromyelitis optica (NMO) may also have dynamic MRIs.

[Quixotic1]

Does remyelination play a role in the disappearance of lesions?

Are remyelinated lesions felt also to be scars - because the remyelination is imperfect?

Quixotic1

[jensequitur]

MS lesions have a specific appearance, and look different from those caused by carbon monoxide toxicity.  Brain lesions can be caused by many different things, like ischemic disease, Lyme, or sarcoidosis.

[terrics]

I just found out something very interesting. White matter lesions can come from carbon monoxide toxicity.  Sometimes people can be exposed to low levels of carbon monoxide and never know it.  These lesions can disappear if I understand it correctly.  I could be wrong though.

terric

[Sarahsmom46]

Thanks for the response.  Simply said and easily understood.  

One more question - Are there other demyelinatng or neurological disorders/conditions that would also have disappearing lesions?  

Thanks again.

Julie