Bilateral

[Katefrs]

Are lesions in ms always bilateral? I had discussion with someone yesterday who said they are.

Kate

[Katefrs]

Now I am getting even more lost ....

[JemmAus]

So Bob, it's almost opinion?

[COBOB]

It's like reading tea leaves.  Heck, MRIs are not even real images.  It is a computer generated image by listening to how loud the protons scream as they spin around in a magnetic field.  More like bat sonar than an xray.

Bob

[Katefrs]

Hey Mary hope you got to work on time xx lol

[JemmAus]

I'm always confused. I still can't understand how they can tell the difference between ischemic lesions and demyelinating ones, and howcome two different radiologists can look at one set of MRI scans of my brain and reach two different conclusions!

Let alone how 5+ neurologists can disagree on the same thing......*sigh*........

[Lulu54]

I'm always learning - this is the same error I made about 3 years ago.  Maybe it will stick in my brain this time?   :-)

However, the lesions  are not always bilateral, most of mine are unilateral.  The symptoms are rarely bilateral.  

Confused?  I am.
Lulu

[twopack]

Didn't realize it was you this morning Kate.  My apologies.  I was on my way out to an appointment and hurried through posting an answer (as much as I can).

Sounds like you will be looking for that second opinion.  There are lots of options.  It may be a stroke or MS or something else.  You deserve someone who will investigate fully and then give you the best possible answer.  Symptoms in otherwise healthy, active people don't appear for no reason.

Now I'm going to be late for work if I don't get moving.  

Mary

[Katefrs]

the lesions on my MRI have shown up in the left parietal lobe in the subcortical position and another in the left temporal lobe.
symptoms are facial numbness (without  numbness) on right side and right sided hand weakness with a tendency of the hand to "lock up" if left in one position for a period of time. After the last incident my right leg felt little weak too as if I had been lying on it.
consultant neuro stated from the mri lesion sites that he is 100% sure it is not MS and dismissed the symptoms as part of a stroke.  I am a midwife and no one i know that has had a stroke has ever reported symptoms like mine. I had one episode in Sept and another in Jan this year of the same type but january was more severe. I suffer from migraine but didnt have a migraine during either of these attacks.

kate

[COBOB]

When doctors see unilateral lesions, they begin to think "Ischemic disease" and "migraine."   MS MRI lesions tend to show up in both hemispheres of the brain.  Since MRI lesions do not map to symptoms, bilateral MRI lesions and unilateral symptoms are not unusual.

If you look at the Atlas of MRI Images, you will see bilateral lesions on a good portion of the images.

Bob.

[twopack]

There have been many discussions here about the nature of both lesions and symptoms. There is a difference between bilateral and symmetrical.

Here's a quote from the Health Page titles Lesions vs. Symptoms
http://www.medhelp.org/health_pages/Multiple-Sclerosis/Lesions-vs-Symptoms/show/61?cid=36

MS "tends" to cause lesions within a characteristic pattern in the brain.  But this just means that, when you look at a large number of people with MS and plot all of their lesions, the majority of lesions will fall into this pattern.   This pattern is generally symmetrical side to side, but not a perfect mirror-image.  Any one person or any person with just a few lesions may have them occur in any white matter location. . Even people with a "characteristic pattern of lesions" will have some that don't fall into the perfect "zones."

Symptoms are more complex.  It makes a difference if the disease is early or late stage, if symptoms are sensory or motor, what type of MS it is and if the lesions are in the brain or spinal cord.

We even manage to keep Quix guessing about explaining this one (even though she makes it so much more understandable!).  Make sure you read through the entire topic I'm linking to so you see how confusing it can be.  In MS, anything is possible.
http://www.medhelp.org/posts/Multiple-Sclerosis/What-Kinds-of-Symptoms-Dont-Sound-Like-MS/show/856407

Welcome to the forum.  Please share more of your experience if you feel comfortable.

Mary

[essdipity]

Have to disagree. Symptoms don't necessarily reflect lesions, so MRIs will often show lesions on both sides. This is a good time to dust off old and not so old discussions and health pages on this topic.

What would be rare is to have the exact symptoms on both sides, in exactly the same places at exactly the same times. That would actually point away from MS. But to have, say, left arm weakness and right foot drop would not be at all unusual.

Have to run now, busy day ahead, but I hope others will fill in here and comment.

ess

[Lulu54]

Hi Kate - the lesions in MS are rarely Bi-lateral (appearing on both sides).  Lesions are usually unilateral.  That is why symptoms usually appear on one side of the body but not both.  Eg: foot drop on one side but not both, upper limb weakness on one side but not both, optic neuritis in one eye, but not both, etc..  

If they were bilateral we would get matching symptoms on both sides.

It sounds like the person who had this discussion with you could use a primer in MS.  
Lulu