What is normal or average for MS lesions

[Lisa6659]

I am new to this site. I found it trying to find out what is normal or average for lesions. Can any one help me with this information.....

My MRI report states: there are approximately 40 to 50 supratentorial lesions and 5 posterior fossa lesions. At least a third to half are moderate in size, Most of these lesions are in the periventricular and deep white matter with a few in the juxtacortical location. Approximately 15 low T1 signal lesions are in the supratentorial brain and 3 in the posterior fossa.

A moderate-sized cord lesion is centrally located at the C3/4 level. A large confluent lesion extends along the left side of the cord from C3-C6/7. Two lesions are in the brainstem at the pontomedullary junction and other lesions in the cerebellar hemispheres.

[mshurts7199520]

hello I have ppms, and I suffer with a lot of fatigue. I used to be able to get up at a decent time, now I have to sleep for 13 -14 hrs a night. I feel so horrible. Used to once upon a time get up @ 8am now I can't even get up before 12:00pm a lot of days. the earliest will be between 10:30am-11am. Then there's the pain + I still feel tired. It never was quite this bad , I have no energy, it takes a lot out of me to do every little thing.

thanks
Julie

[jujuminx]

As previously stated, there is no normal and location matters more than quanity.

But to answer your question, I have 2-3 lesions that they can see in my spine.  The MRI of my spine was done on a 1.5 T so there are probably a lot more there that are not being captured.

Julie

[facingforward]

I can't tell you what is "normal" :) but I can identify with you in terms of having a lot of brain lesions and two or three spinal cord lesions.  The report for my 2003 MRI identified 60-70 T2 (hyperintense) brain lesions of which 15-20 were also T1 hypointense (low signal).  The lesions on my spinal cord are at C4/C5 and T2.  (My neurologist does MS research and has no doubt about my diagnosis of MS.)

If you want to see a scientific paper that looks at lesion sizes and numbers, use Google to search for
  
Distribution of lesion size in multiple sclerosis  Liqun

That paper summarizes MRI results for 13 patients diagnosed with Relapsing Remitting MS (RRMS) and 15 patients diagnosed with Secondary Progressive MS (SPMS).  

It reports lesion counts from 15 to 227 in the RRMS patients with an average of 75 lesions each in the RRMS group.  It also reports lesion counts from 25 to 272 in the SPMS patients with an average of 96 lesions each in the SPMS group.  

The counts for the paper include lesions less than 3 mm in diameter and may double count some of the larger lesions because the counts were taken separately on each slice of the MRI and totaled.  Anyway the paper illustrates that lesion counts can vary widely.  

The study classified small lesions as those with diameters less than 3.5 mm.  Lesions larger than that are probably considered moderate.  (On another site I read that the "average" brain lesion is 7 mm in nominal diameter.)

Periventricular and juxtacortical are locations strongly associated with MS.  I don't know about the other locations you mention.

To me, having a lot of lesions is truly concerning.  However, since medical science offers no way to reduce or eliminate existing lesions, I try not to dwell on the numbers.

I don't know anything about your personal circumstances.  Whenever possible, I try to pursue healthy eating and to exercise and recommend the same to others.  

Wishing you well.

[Wobbly]

hi there, when do you see the Neuro and get some answers?  Let us know when you do and how things are going with you.

take care
wobbly

[jensequitur]

Some people present with many lesions on their MRI.  It looks like you're one of those people.  Oddly enough, the number of lesions don't really indicate the course of your disease.  Sometimes people have lots of lesions, but few symptoms - or few lesions, and lots of symptoms.  

I don't have a lesion-counting neuro, so I don't really know how many I have.  Somewhere between 10 and 20, I think.  I have a variety of different symptoms, some cognitive, some physical, and some sensory.

With any luck, your neuro is treating your symptoms, rather than looking at your MRI for answers.

[Lulu54]

Hi Lisa and welcome.  There is no normal number when it comes to lesions.  What is so much more important than the number of lesions is WHERE those lesions are located.

this is like real estate - location, location, location really does matter.  You can have a whole slew of brain lesions and have few to none of them affect your daily functioning.  Spinal lesions are a different story - almost all of them affect us in one way or another.

When you get the opportunity I hope you will stop and share your story with us.

be well,
Lulu