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Active lesions
I see my neuro next week and will pursue this question, but can someone comment of how one tells if lesions are active or not?  My understanding is that you tell by any new or worsening of symptoms.  I have multiple symptoms, two of which are impaired cognition and walking. But these are already bad but I dont know if they are active or not.  And because they are already causing dysfunction, I am not sure that any changes would be noticeable.

Also, isn't the type of tx you receive such as steroids, dependent on whether the lesions are active. Or would one receive the treatment even if the lesions are not active?  Getting really confused here.
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560501_tn?1383616340

    While new and / or worsening of symptoms "Could mean that a lesion is active but not necessarily.....the only TRUE Definiye way to tell if you are having an "Active" exacerbation...Or as you had put it, and Active Lesion is to have an MRI w/ and w/out contrast.

    This would show an Enhancement of the particular lesion or lesions after the contrast was administered. If you look up at the top right of the page you will see a "Health Pages" section. click on it and it will explain this much better than I have...LOL

     I certainly hope that you start to feel better soon. yes, I would make sure and write down all the questions you want to ask adn then when they are aswered.joy down a couple words next to it so that you will remember what the Dr said in regards to your question....Hope that makes sense :)

    Please keep us posted,
Have a Great Weekend!
~Tonya
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739070_tn?1338607002
Hi,
The suggestion to look in our Health Pages is a good one. There are several pages dealing with lesions and one about steroids among the others.

Avery quick synopsis is "active" or new lesion will only show up as enhancing the first 30-45 days of their formation. If the lesion is there it is already active since the lesions indicate areas of demylenation.

Also, lesions do not "match" up with symptoms. Sometimes the lesions are not visible as yet on the MRI.

Steroids are given when the symptoms flare up and are causing too much loss of function or bring a quicker resolution to symptoms as in optic neuritis. Steroids do not change the course of the disease they simply calm down the symptoms.

Hope this a better clarification for you. The best clarification can be found in the Health Pages:

http://www.medhelp.org/health_pages/Multiple-Sclerosis/Lesions-vs-Symptoms/show/61?cid=36

http://www.medhelp.org/health_pages/Multiple-Sclerosis/How-MRIs-Show-Lesions-in-MS/show/23?cid=36

Click on these links for the best info.

Ren
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559187_tn?1330786456
I just wanted to add on to what Ren and mentioned earlier about when doctor's decide to use steroids.

Steroids are no walk in the park and taking them can help reslove the relapse a little quicker, but steroids can also cause other problems like high blood pressure and increased sugar levels.  So, when a decision is made to take them it is made on the matter of whether your function level is severely affected as Ren already stated.  

For example, I recently had a relapse and the protocol is to do an MRI to see if there are new lesions.  My MRI did not show new lesions but my baseline functioning was significantly affected so my neuro made the decision to put me on steroids.  There were other factors going on like results of my blood works showing an eleveated sed rate or inflammation as well.  So, we don't necessarily have to have a new lesion before steroids are considered.  

Every doctor has his/her own internal policy on when to do steroids so don't be too confused.  Hope this was helpful information.  

Take care.

Julie
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