Disappearing Brain Lesions

[hbananas]

Hi, all. I wanted to get this thread back out onto the forum.  I just put this in my journal so I wouldn't lose track of Quix's original post, not realizing anybody would add comments in there.  If it's important to me and important to ge97511, maybe it should be out there for discussion again.  hbananas

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Quix's answer to disappearing brain lesions
Nov 27, 2008 05:23PM - 2 comments - (Public)


Hi, Welcome to our Forum.  What an amazing thing to hear from the new neurologist!  Your basic question is a very good one and is asked here over and over again.  Can lesions disappear?  

ABSOLUTELY THEY CAN DISAPPEAR!!  You already got one way that they can disappear, but you misunderstood.  Old lesions can be reabsorbed by the body and leave tiny, blank spaces, in the brain.  These "black holes" may be invisible to the MRI.  It is not common that they are seen until there are so many of them that the entire brain appears to shrink.  So you don't often see them reported on MRIs.

The most common thing that happens, and IT HAPPENS ALL THE TIME, is that the body repairs the lesions, by remyelinating the nerves.  When this happens the lesions may get smaller in size or even disappear from the MRI altogether.  In fact, when they are following someone on therapy, one of the things the look for specifically is whether or not the lesions have reduced in number!!!  This is ver improtant for everyone to understand.  The studies on the drugs used to treat MS look for a reduction in the number of relapses, a stabilization in the progression of diability and a reduction in brain/spine lesions or, at least, for the number of lesions to stay the same.

It is wonderful that the lesions disappeared on your MRI!!  Does this mean that you never had MS to begin with?  No, it doesn't.  You have had repeated attacks, evidence of Optic Neuritis, and multiple lesions on MRI.  Do you have any permanent problems like weakness, spasticity, hyper reflexes, numbness, decreased vision,...anything?

You need to be DONE with this neurologist.  However, the MS Center at UCSF is one of the best!  It wouldn't hurt to be reevaluated by them.  But then, get your follow up by a different neuro close to home.  Why were you on all the different meds?  Did you have problems on them?

I wrote a little post on how MRI's show MS lesions.  I'll find it and bump it up so you can read it if you want.  I hope you stay with us so we can help you as you sort all this out.

Quix

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ge97511
Female
Member since Nov 2008  



, Nov 27, 2008 10:31PM
You just opened my eyes on something that really bothered me.  Back in September when I first presented in the ER with numbness in my limbs and head they did a CT.  When the doctor came back and gave me the results she said that my brain seemed to be atrophied (sp).  Basically it looked to be smaller that it should be for someone my age.  She even asked me if I was in special ed and if I was able to graduate High School.  No offense to anyone but that really upset me.  She went on to say that it was a congenial defect.

What BS!!!  She ended up admitting to the hospital and three days later after an MRI I was given my dx of MS.  But nobody ever came back to explain that my brain hadn't shrunk.

I'm so happy for places like this.  If it wasn't for the internet and this forum I would be more clue less than what I really am.
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Quixotic1
Female, 56 years
Washougal - WA
Member since Jul 2006
Mood: Quixotic1 Having seen Hither, I'll take Yon.
Journal Entry:   "I am a 56 year old female. Seven years ag..." [Read]
  



, Nov 27, 2008 11:54PM
GE - When the tiny lesions disappear and the brain collapses down around them it is the same as atrophying.  In the quote above I shouldn't have said, "the brain appears to shrink."  It actually does shrink by losing volume when cells die.

The brain really does shrink.  In fact atrophy (shrinking) of the brain and spinal cord is a very good pointer to a diagnosis of MS.

If the brain is too small from birth, like from an infection while still in the womb, the person is often developmentally delayed.  She should have known better than to make a diagnosis like that from a CT scan, which is pretty useless for picking up the lesions of MS.   When the brain atrophies from MS the changes in mental/physical abilities happen much more slowly.  What we notice are things like the cognitive fog, the memory and language problems.

What I am saying is that it is likely that you do have some brain shrinkage.  It is expected in MS.  Same with me.  In MS the brain atrophies faster than the normal aged-related atrophy everyone gets.

I'm glad you like this place.

Quix

[Heather3418]

I watched a documentary some years ago, where they were doing an MRI on a patient every 24 hours in a study.  It actually showed lesions appearing and disappearing from one 24 hour period to the next.  I swear this is true.  

This is one reason most of us old MS veterans say that MS is ALWAYS active, even if it does not produce any symptoms.  Lesions have also been known to appear one week and be gone the next.  I think it's amazing what medical science can learn by watching lesions over each 24 period.  It helps them to get a better understanding of now knowing that MS is active all the time.  Whether you are having symptoms or not.  Even huge lesions can disappear over time.   A lesion can reduce in size and remain inactive, while another area of the brain takes over.  This is one of the reasons we all scream, probable diagnosis - DMD's, positive diagnosis - DMD's.  Anything to try and slow this disease down.

Okay, I am stepping over my laymen's soap box now.  ... Thanks hb for bringing this important post back up.  It's so insightful...that's our Quizzle girl.  What would we do without her?  I shudder to think.  She may have been a peditrician, but has enough medical knowledge after years of studies, to know how to do vital research on the net about Multiple Sclerosis and other mimics diseases. She thens puts it all in laymen's terms, so that we all understand it.  Thanks to you, Quizzle for all you do and God Bless this entire Forum for all they do, as well.  What a group...

Heather

[doni54]

Thanks hbananas!  I had read this on your journal and it is full of good info.  That Quix, isn't she just the bomb!!!!!