Can Vascular Changes mean A Flare Is Coming?

[sweetmimzim3]

I originally posted this for Quix and realized it was a pretty old post, so I'm starting a new question for anyone that could help me. Thanks in advance...

I had a minor neurological event in 1991 (fatigue and left leg weakness) my GP told me he didnt think I had an auto-immune disorder and sent me on my way. In 2002 I had a Major Neurological event. The Neurologists all said probable MS, but I didnt have any new activity in 3 years, no diagnosis. I recently December 2011 went to a New Neurologist in a different state who performed an MRI and she said there was vascular changes that were new compared to 2006 MRI. She couldnt diagnose me either with MS. She said it was probably Acute Demyenating Ensythro Mylitis (SP?) caused from a virus. I cant except that opinion due to the fact it occurs primarily in prepubescent children. Can the vascular changes be the "higher blood supply to the area to fight the attack" you explained above in your article (Quix article on lesions)? I am not experiencing any NEW neurological changes. Can this mean I am possibly going to have an event soon? I am going to seek a different opinion, of course.

[Sidesteps]

I don't know the answer to the question: I am not sure anyone knows because they aren't fully sure what causes MS.

It seems you are asking if they can tell by MRI if you are going to have a flare.  I haven't found any literature stating that. In fact, it's difficult to even "catch" a new lesion, a slim window of an opportunity; so I don't think they can pick up on an attack.

I think Quix meant by vascular changes in her article is the blood brain barrier being broken in an event (flare) which is shown by the GAD and enhancing lesions.

One thing that I noticed about your lesions is that it sounded like they grew in size and not in number. I am not a doctor but I that is atypical in MS where we typically see an increase in number varying lesion size.

I'd be asking my doctor "what could causes lesions to grow in size and not in number?"  Maybe that is what she means by vascular changes the lesions grew in size but not number. I'm not sure. I'd clarify that with her.  It also never hurts to have another specialist take a look at all the tests.

Did they do a thoracic spine MRI? What other tests have they done on you?

[sweetmimzim3]

I have done some reading about vascular changes in MS and came upon this article. http://radiology.rsna.org/content/231/3/645.long

Here is a possible answer to my question "Can vascular changes mean a flare is coming?"
Adams et al (9) described lymphocytic infiltration of vein walls without adjacent parenchymal inflammation, suggesting that MS represents a form of vasculitis that could precede lesion development.

[sweetmimzim3]

By major Neurological event I mean...right hand weakness and tremors, head tremors with neck weakness, feeling like I had no left foot, over/under shooting objects when grabbing, couldnt remember collegues names or come up with a word for ordinary objects, had troubles signing my own name, lightning bolt feelings up the back of my head, bladder control issues, major changes in bowel muscle (weak), unbelievable fatigue and falling into REM sleep very quickly with vidid dreams and could hardly wake up. I called it my coma sleep. Difficulty swallowing, would take 3 tries to swallow. Unbelievable irritability occompanied with dizziness. Heat intolerance I would become extremely confused and disoriented when hot. I would get out of the shower before washing. I would do things out of order such as brushing teeth before applying toothpaste or try to put on my shoe before my sock. The list actually goes on and on....
I have read alot on ADEM and I didnt have a virus before all this came on either. I also read that most people with ADEM go on to be re-diagnosed with MS...so who knows?

[Sidesteps]

Can you tell us some more information? What do you mean by Major Neurological event?  What happened?

I don't really know the answer to your question.

Vascular changes usually indicate normal aging processes or through smoking.

ADEM: http://www.answers.com/topic/cerebrospinal-fluid-csf-analysis

Isn't really just related to children. I have to admit, I wondered if I had ADEM when I started to feel improvement (I didn't know the name but wondered if it was a virus that caused my issues.) I never had a virus prior to getting my symptoms so I don't fit that category.

Based on the article, you also can have recurrent ADEM but it seems to follow a totally different pattern of behavior over MS. Some believe they are in a similiar disease umbrella.

Rather interesting read. I hope it helps you.

[sweetmimzim3]

I forgot to mention my test results..2002 had 2 lesions 1mm in size on brain and one on spine found thru nerve conduction testing. Spinal tap was clear. 2005 the lesions were 6mm in size, but no new ones. 2011 MRI showed only new vascular changes but no new lesions and nerve conduction test was identical to 2002.