I am one woman with MS that DOES have a lesion in my spine. It is high in the thoracic region. It is very common with MS to have lesions in both the brain and the spinal cord, but is not necessarily a "must have" to get a diagnosis of Multiple Sclerosis.
All the lesions that they are attributing to me having MS or in the spine. Just like lesions in the head, though, they have to exclude whether they are from arthritis, stroke or circulation problems, tumor, infection, transverse myelitis, ADEM, etc. etc. Also, to further complicate things, people can develop lesions due to two or more ongoing medical problems. So, that is where the diagnosis get really hairy. I have multiple lesions in the spine. I also have WMA in the brain. For the last six years, they have been attributing my WMLs to migraine and have read my scan as normal (and never even mentioned the WMLs) and read my initial lesion as all different diagnosis from normal, artifact (even though it has been on more than one MRIs--unbelievable) to a birth defect to nothing to worry about, etc., etc. You get the picture. So, a person can have two or more different disease processes and a physician will not diagnose the MS disease because they say that the lesions are from various sources and not the disease of MS itself. However, MS means multiple sclerosis--more than one lesion in the central nervous system. So, technically, it is like having MS lesions and symptoms as a secondary disease process rather than the primary disease. At least, that is the way I understand it.
However, when there are lesions in the spine it is often easier to diagnose MS than with lesions just in the brain as brain lesions can have so many other sources as compared to spinal lesions. Also, spinal lesions often tend to show more motor problems early on then brain lesions. Which could also make observation and diagnosis more definitive. I am not a doctor; but, I hope that I have this correct and that this helps. Good luck!
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