How many lesions are typical in MS?

For the diagnosis of multiple sclerosis, there should be at least one typical multiple sclerosis lesion in at least two characteristic regions [periventricular (abutting the lateral ventricles), juxtacortical/cortical, infratentorial, spinal cord] to support dissemination in space (Thompson et al., 2018).
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What is the average number of lesions in MS?

Unless you have a trained eye, you will miss it." Bakshi concluded: "Patients who have a more severe form of MS have a median number of three [hyperintense T1 lesions]; the relapsing-remitting patients have only one."
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How many MS lesions is a lot?

According to the team, patients with a combination of more than 13 lesions, with a maximal lesion diameter greater than 0.75 cm, and lesions perpendicular to the corpus callosum, had a 19 times greater chance of progressing to MS during the following year.
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How often do lesions appear in MS?

We know from MRI studies that new lesions (abnormal areas in the brain or spinal cord) occur about 5 to10 times as often as people with MS have new symptoms; that is, much of the disease occurs 'under the radar scope'.
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Where are lesions most common in MS?

Lesions may be observed anywhere in the CNS white matter, including the supratentorium, infratentorium, and spinal cord; however, more typical locations for MS lesions include the periventricular white matter, brainstem, cerebellum, and spinal cord.
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Types of MS Lesions - National MS Society



How quickly do MS lesions develop?

Most symptoms develop abruptly, within hours or days. These attacks or relapses of MS typically reach their peak within a few days at most and then resolve slowly over the next several days or weeks so that a typical relapse will be symptomatic for about eight weeks from onset to recovery.
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Do MS lesions disappear?

Conclusions: Brainstem lesions in MS patients can disappear on subsequent imaging. Disappearing MRI lesions may delay the diagnosis. These results suggest that more weight should be given to the reported clinical brainstem events, especially in the initial diagnosis of MS.
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Do all MS patients have lesions?

Lesions are usually the most telling symptom of an MS diagnosis. According to the National MS Society, only about 5 percent of people with MS do not show lesions on MRI at the time of diagnosis. MRI uses strong magnetic and radio waves to produce detailed pictures of the brain and spinal cord.
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Can MS stay mild?

After the first round of symptoms, multiple sclerosis can stay mild without causing major problems for decades, a 30-year British study indicates.
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How long do MS lesions enhance?

The course of enhancement is transient and usually is shorter than 6 months; rarely it may persist for a longer time. The appreciation of the evolution of MS-enhanced lesions aids in both identifying new MS lesions and distinguishing these lesions from other pathologic entities.
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How common are white matter lesions?

White-matter lesions

They are highly frequent in the elderly population. In people aged 60–70 years the prevalence is about 87%, whereas the prevalence at the age of 80–90 years even approaches 100% (de Leeuw et al., 2001; Launer, 2004).
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What percentage of MS patients have brain lesions?

About 5 percent of people who are confirmed to have MS do not initially have brain lesions evidenced by MRI. However, the longer a person goes without brain or spinal cord lesions on MRI, the more important it becomes to look for other possible diagnoses.
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Do MS lesions shrink?

Lesion accrual in multiple sclerosis (MS) is an important and clinically relevant measure, used extensively as an imaging trial endpoint. However, lesions may also shrink or disappear entirely due to atrophy.
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Do MS lesions grow?

Over time, MS can cause new lesions to form. Existing lesions may also grow larger, which might cause a relapse or an acute flare-up of symptoms. This happens when your symptoms get worse or new symptoms develop. It's also possible to develop lesions without noticeable symptoms.
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What is considered a small lesion?

Throughout this report we use the term small lesion to refer to white matter lesions in multiple sclerosis, seen on MRI, that are no larger than 3.5 mm in diameter.
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Can MS progress without new lesions?

After a certain amount of time, “You look and see that you're not having the same kind of relapses, there are no new MRI lesions, but there are certain symptoms that are gradually getting worse,” Shephard says of her gradual change to secondary-progressive MS.
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What is the mildest form of MS?

There's no cure for multiple sclerosis, but benign MS is the mildest form of the condition.
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Can MS go into remission forever?

A remission can last for weeks, months, or, in some cases, years. But remission doesn't mean you no longer have MS. MS medications can help reduce the chances of developing new symptoms, but you still have MS. Symptoms will likely return at some point.
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Can you have MS for 20 years and not know it?

Benign MS can't be identified at the time of initial diagnosis; it can take as long as 15 years to diagnose. The course of MS is unpredictable, and having benign MS doesn't mean that it can't progress into a more severe form of MS.
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What does early MS look like on MRI?

MS activity appears on an MRI scan as either bright or dark spots. Typical MS lesions tend to be oval or frame shaped. MS lesions can appear in both the brain's white and gray matter. Healthcare professionals may use a chemical contrast dye called gadolinium to improve the brightness of MRI scan images.
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Can MS come and go?

MS symptoms can come and go and change over time. They can be mild, or more severe. The symptoms of MS are caused by your immune system attacking the nerves in your brain or spinal cord by mistake. These nerves control lots of different parts of your body.
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Can you feel lesions on your brain?

Lesions are a type of damage to to the brain. Brain lesions may not produce any symptoms at first. As lesions worsen over time, though, symptoms become more noticeable.
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Can stress cause more MS lesions?

Are there triggers for developing new lesions? Prior studies suggested that MS lesions occur more of- ten after a stressful life event. Other studies showed that people with MS had fewer attacks (also called exacerba- tions) when they coped well with their stress.
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Does white matter lesions mean MS?

DIFFERENTIAL RADIOLOGICAL DIAGNOSIS OF WHITE MATTER LESIONS. White matter T2 hyperintensities in the brain are not specific to MS and are seen in a number of other disorders. They can even be seen in otherwise normal individuals, particularly with increasing age.
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How often is MS missed on MRI?

MRI is considered the best test to help diagnose MS. However, 5% of people with MS do not have abnormalities detected on MRI; thus, a "negative" scan does not completely rule out MS. In addition, some common changes of aging may look like MS on a MRI.
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