Hi, and Welcome to our family. I've meant to add my thoughts to your post for a few days, but have been noodlebrained and otherwise distracted.
I was so blown away by the bizarre notion that one would contemplate surgically removing lesions as described in your MRI, that I went back and studied the three MRIs very closely.
In May you had a lesion in the left frontal lobe that enhanced.
In August you had a moderate-sized lesion in the left side (parietal) lobe. This extended from the part of the white matter just below the junction with the gray matter to the gray matter itself. The report is not clear whether this extended "into" the actual gray matter. It also showed an increase in signal right around the ventricles. One such lesion (focus) on the left showed enhancement. It sounds like this one was also seen on the May MRI and was enhanced both times. (I can't be sure of this, tho). There was also a lesion in the R frontal lobe. This is tiny (often when considering MS they don't "count" lesions less than 3mm), but the wording suggests that they saw this one in May also.
November - Nothing new, nothing changed. No enhancement seen.
Now, I am not an expert on interpeting MRI reports and NO DIAGNOSIS should ever be made from a report! Only from analysis of the actual images.
But, there was concern about the second lesion, possibly because of it's location across the subcortical-cortical junction. In my reading lesions of this location are disagreed on by MS MRI experts. Some think it suggests more of a malignancy. Others disagree. Maybe this was why someone said something about removing it.
Of some confusion is whether there was still enhancement of a left periventricular lesion. That is a long time to stay enhancing. Typical duration of the enhancement (lighting up with contrast) is 4 to 6 weeks, occasionally 2 months, rarely as long as 6 months. That might have set them back.
Bravo to you for firing any doctor that says that an enhancing lesion is part of the aging process.
Okay, a few more comment:
One O-Band on the LP. This doesn't qualify for a positive result because a number of people with other neuro problems and some without known problems will have an O-Band here or there. In reality, even one O-Band is abnormal and points toward MS, but is not great evidence.
Your ABR (BAER) is abnormal. Again, subtle findings that point toward MS, I think. I don't know much about interpreting the BAER. It is abnormal when there is demyelination in the brainstem.
VEP - Delayed P100 - The cutoff is sometimes called at 115msec. A significant delay is evidence of prior optic neuritis. It doesn't matter if you have never had symptoms of optic neuritis. It can occur subclinically (without symptoms) and with minor symptoms.
Where the heck is the MRI of your spine?? If MS is in the differential diagnosis and the MRI of the brain is not diagnostic, then the recommendation is that the spinal cord be imaged. This should be done on the highest resolution MRI machine available. The brain is pretty easy to image on most 1.5T or 3T, but the spinal cord is very difficult.
My answers to your questions will agree with Lulu's, but I'll give them anyway.
#1 - No, you would NEVER plan to remove an MS lesion. Perhaps the location of the lesion made someone think that a tumor was a possibility. I would get a second and a third opinion before undergoing surgery. But, It sounds like it is not still growing.
#2 - The radiologists are supposed to note the size, number, and locations of all lesions. They do not always do this.
#3 - MS frequently disturbs the balance. It may be very subtle. Also, pain from your Achilles tendonitis can throw off your balance, from your body's attempt to protect itself from pain. I have an Achilles tendonitis from my abnormal gait due to spasticity. By limping I have strained the tendon.
#4 - Yes, you have to have symptoms to have MS. Symptoms are the very basis of the MS diagnosis. But, we know that MRI lesions can predate symptoms by quite a long time - possiby years.
#5 - You can have tons of lesions. If they are in a quiet part of the brain then you may have no symptoms. 90% of the brain is neurologically quiet - meaning we have no idea what it does. You can have silent spinal cord lesions, but they are less common. Most of the spinal cord is made up of nerves that have known purpose.
You might want to read one of our Health Pages that discusses this:
http://www.medhelp.org/health_pages/Multiple-Sclerosis/Lesions-vs-Symptoms/show/61?cid=36
Welcome again, I hope this helps.
Quix