Hello everyone. Sometimes I feel like I ask the same questions in different ways in an attempt to better understand what's going on with this MS. Here's my question. Does nerve damage occur ONLY when there are lesions in the brain or spinal cord or is nerve damage part of the package with MS regardless?
I hope everyone is as well as they can be!
Damage only occurs in the Central Nervous System (the brain and the spine) in MS. None of the nerve outside of that CNS are damaged. Since the brain and the spine direct all of the body, of course you are going to have symptoms in your arms, legs, hands, feet, etc. But there is no damage to those nerves. Only the nerves that tells that parts what to do.
Does that answer your question, dearheart? If not, let me know.
Forgot to add, damage is taking place even where a lesion cannot be seen. These are called silent lesions. We just don't have the means, YET to see all the damage that MS is doing....I believe that seeing the lesions and identifying them is only PART of the whole picture.
CNS nerve damage in MS is caused by lesions. That's a given. Sometimes the lesions heal well enough so they can't be detected by MRI or other medical means, but this doesn't mean the patient is not experiencing problems because of them. Sometimes they are active, not healed, but medical technology cannot yet find these lesions, particularly if they are in the brain's gray matter.
If a patient's MRIs reveal clear lesions in brain and/or spine of the type typical for MS, getting a diagnosis can be relatively easy. In all other cases it's not. Many have obvious lesions but not typical, and these people often get shoved aside as cases of microvascular disease. Or migraine (even though migraines can cause tiny brain lesions). Or people are labeled as smokers, obese, and a bunch of other stuff whose connection to brain abnormalites is extremely questionable, if not outright wrong.
And although it's at least technically possible to diagnose MS with no detectable lesions (see McDonald Criteria), that almost never happens in the real world. If anyone here has had an MS diagnosis without MRI lesions, pleaase speak up.
One day, 'ess,' my precious friend; techonology will catch up and I think we will all be SHOCKED when the "invisible" damage from MS can actually be seen.
I've had you on my mind more than usual this week ess. It was almost one year ago since you and I got a chance to meet. I will never forget the kindness you showed me during one of the most difficult times of my life. I will treasure you in my heart and my life, forever. I love you.
At my last Dr visit I was asked to particate in a study that is developing new lab tests to diagnose and follow the course of MS. I agreed as they only wanted some of my blood. Hopefully soon MS could be diagnosed with a blood test only.
So if a person has an MRI and it shows the numerous lesions in the brain and spine appear to be shrinking (because of medication) it does not mean there is no damage going on where those lesions are or in other places in the brain and spine? Is this right? Did I understand that correctly? Ess, you amaze me with what you know! Maybe you should get your PHD if you don't already have one. I learn more on this site than I do in the Dr.s office.
Thank you, Christina. To answer your question with one word: Yes. You understood correctly. Research neurology shows that lesions seen on MRI are not the whole picture in MS. Some might be healing, however imperfectly, and some might not be visible using today's technology. Also, some seemingly atypical lesions may well be MS.
With some rare exceptions, there's no scientifc way to point to a given lesion and say, 'That's causing such-and-such.' Conversely, saying that no VISIBLE lesions means no MS is wrong as well. For many years good neuros have understood that the MRI is not the whole shooting match by any means, although some neuros act as if it is. Remember, MRIs have been around only about 20? years, but MS has been documented for centuries.
Our Health Pages explain this much better than I have. Please go there and select only one or two topics at a time to study. Taken as a whole they can be a lot to understand, but individually they are clear and valid.
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