Lesion

I keep forgetting to write about my last Magnetic resonance imaging (MRI) results probably because they are the good/bad type. Good that nothing in the brain has changed in two years! Still numerous lesion but no new ones. I have been to enough talks and seen enough charts and graphs to understand that in secondary progressive (SPMS) or let us just say a progression from relapsing remitting ms (RRMS) the lesion load stops gaining while disability levels go up based on Expanded Disability Status Scale (EDSS).

The baffling portion was the results from the spinal MRI. I did get a copy of the MRI scans and the radiologist’s initial reports. I spent a lot of time squinting blowing up the spine series pictures and scratching my head. In my previous MRI, the spine was full of lesions. They were obvious. No real techno knowledge needed they were obviously there.

This time I could not see them. The radiologist report said “no imaging findings of demyelinating disease in the cervical spine”. I am not imagining this woo hoo. However, if this is so then. …

That said I did spend a few days in a state of bliss where I allowed myself the belief that the MS was going away. That was in October. On December 1, I had an appointment with my Neurologist. We went over the MRI results. I like my neurologist she is one of those Dr.’s that is not afraid to admit an error or when she is as confused as I am LOL.

She told me that she had taken my brain MRI to the other neurologists and they all agreed that the lesions in my brain were MS lesions and with my medical history, I had MS. Umm I am thinking I thought this was settled a few years ago. When I asked about the spinal lesions not being there she thought that the original MRI might have been flawed something about artifacts. I just looked at her and said – but they were there, lots of them, in different series- how can that be? She admitted it made no sense and that was why she had taken my records to the other neurologists.

Therefore, I came home with the reaffirmation that yeah you still got MS dingbat. Bummer.

The next day I received an email from my neurologist . … since I was also mystified (wow, my neuro. is mystified) … cervical spine MRI images. … presented both of them at neuroradiology conference . … the lesions on the first MRI were real and not artifactual and the lesions disappeared on the second MRI . …

It then went on to say they agreed that spinal lesions generally do not disappear like brain lesions sometimes do but that once in awhile it happens like in my case.

I emailed her back after researching more and asked for clarification about how lesions are picked up on MRI:

“If I have this right there are 3 types of lesions. Active – seen using the contrast dye , in the process of healing lesions with high water content shown on MRI, and then missing/disappeared lesions. If spine lesions don’t usually show dye and the fatty myelin is replaced/fixed the MRI no longer measures high water content so does not show but some damage is still there from when myelin was missing but is not measurable?’

Response:

You’re correct as to the 3 types of lesions.

“so does not show but some damage is still there from when myelin was missing but is not measurable?” – that’s what we think.

I am going with Remylenation but I gotta wonder – maybe MS is the catch all when they can not figure anything else out.

I have gone from your faking it, your depressed, you have lupus, you do not have MS, you have MS, your RRMS, your SPMS, your lesions were fake, your lesions were real, your lesions are gone . … along with tests that showed I should not be walking, my eye sees better than it should . …

Good grief. I am glad I trust my neuro. And always being the work it while you can type I got my request to test for Lyme disease granted. It is the only differential that has not been ruled out – so what the heck!