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Does size matter?
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Does size matter?

I have been diagnosed with MS for just over a year now but only recently did a neurologist (not my normal MS neurologist) explain what was found during my initial MRI.  Apparently I have smattering of small lesions.  None over 3 mm and only 1 in an area consistent with MS.  She explained that normally MS lesions are larger than 3 mm.  Just wondering if others have heard this?
Tags: lesions, MRI
8 Comments Post a Comment
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1232907_tn?1367475337
I have been dealing with these symptoms since 07, (still no real dx)I have seen many doctors in many different fields and I have come to realize just how totally, completely clueless they are when you dont fit into the box of "normal" criteria. If the treatment is helping and you feel better dont listen to them. ((HUGS))
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Avatar_f_tn
never fall for the "normal" description.  That indicates a lazy neurologist who doesn't keep up.  None of mine are "normal" size per criteria but they do cause their problems!  
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Avatar_f_tn
I'm not saying that small lesions are not part of MS, because I think they are. But many neuros don't, and their opinions seem to count more than mine do :-)

For diagnostic purposes, a great many neuros discount lesions smaller than 3 mm.. These have been attributed to microvascular ischemia, migraines (especially the 'pinpoint' size), unidentified bright objects, artifacts, and for all I know, PMS.

Some years ago we had a number of members here who had every sign of MS except the requisite lesion size, and they were denied a diagnosis. In my decidedly untrained opinion, insisting on such an exact definition defies logic and abdicates responsibility to use common sense shaped by medical knowledge.

As we say here almost every day, every case is different.

ess
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Yes, every case is different, and mine are small and many but with CIS documentation by my eye doctor, they are real.  I too questioned my neuro about the size and he assured me they were indeed MS lesions.

We don't know what all your doctor used to diagnose with, other things than MRI, as MRi by itself is not a Dx, MS dx is a clinical thing.  It is often based on many things, not just what is found on the MRI.

But ess is right, opinion waxes and wanes even among the neurologists, depending on which conference they attend and who follows things closely!

We all have different opinions depending on our neurologists and you will find that we often change those too!

Hoping we have not confused you further!
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check your inbox!
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3205586_tn?1362846585
I have a punctuate lesion on top of my other lesions...and I recall reading a piece of research that suggested punctuate lesions can cause a load of issues, especially those in the anterior parts of the brain.
I think size might matter for some folks, but it should not swing your doctors view of your illness. If you are sick, you are sick. Small lesion or not.
I have to say, esdipity, you are right on!
SarahL as usual has great insight, too.
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572651_tn?1333939396
This is like real estate - what is important is the location.  A minute lesion can create so much more and greater problems than a huge lesion if it is in the 'right' spot.  I'm glad you neuro wasn't hung up on size....
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3205586_tn?1362846585
Well put!
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