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MS Lesions and progression

Ive been wondering about something and though some of you may be able to advise. Does having more lesions on your MRI indicate the progression of MS and increased disability? I do know MS is so unpredictable and no two people will be the same. May be a silly question but though Id ask. Thanks Heather        
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I've had RRMS for 10 years now, but all of a sudden the drugs I was using, Tysabri, IV steroids and Provigil for energy ,have quite working. I have started going downhill since May, with no definite relapse, just downhill. I don't show any new lesions In brain, neck or spine, so I really don't know what is going on.  Could I possibly be transitioning into SPMS?
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572651 tn?1530999357
the spinal lesions are the ones that almost always cause a problem - think of your spinal column as a super highway - the traffic is traveling along at super speed and suddenly there is a big pothole on the road.  It causes the traffic to jerk, slow down, creep over the pothole and has trouble getting back up to speed for the rest of the trip.  That is how I think of spinal lesions.

Brain lesions are different - they involve location, location and location.  There is a lot of real estate in the brain that is unused.  When a lesion is encountered that is causing a disruption in signal, the plasticity of the brain allows a new route to be developed.  

In the brain, the traffic can hit a road block and take the detour.  In the spinal column there is no way to detour and the traffic has to get through, some way if possible.  

Now I feel like I need to get down on the floor and play with some Matchbox cars!  LOL
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Avatar universal
Thanks Lulu for your reply. That makes perfect sense. My neurologist said where my lesions were located on my spinal cord would certainly explain my symptoms. They also said I had lesions on brain which were asymptomatic, Im guessing this means they could cause certain problems in some people but havent just yet with me? So some lesions can cause more problems in where they are located, for me those dreaded spinal cord lesions! Many thanks again. Heather  
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572651 tn?1530999357
hi Heather, there is nothing silly about your question and we hear variations of it quite often.  No, the number of lesions you have really means little.  What is important is where those lesions are located.  There is a lot of our brain that is not used and if that is where the lesions are, they won't make a difference.  

You can have one tiny lesion in the perfect spot to create lots of problems.

If there an increase in the number of lesions seen on MRI., it could mean your therapy is not working the best and you and your doctor have to talk about maybe making changes.

I hope this helps.
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