Do MS patients always 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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Are there always lesions with MS?

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 you have MS without demyelination?

Now, new study findings have identified a subtype of MS—myelocortical MS (MCMS)—that has neuronal loss but no demyelination of the brain's white matter.
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Can MS lesions be missed on MRI?

MRIs are not a 100 percent positive in the diagnosis of MS. In 5 percent of the people showing clinical MS disease activity, lesions were not visible on the MRI. However, if follow-up MRI studies continue to show no lesions, the MS diagnosis should be reconsidered.
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Can MS symptoms 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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MS with No Lesions - National MS Society



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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Can MS lesions go away?

Can Lesions Heal Once They Appear? “Absolutely,” says Dr. Hua. “It's not specific to MS, but in any process where there's some sort of brain injury, there will always be healing, as well.
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Can you have normal MRI with MS?

Normal brain MRI is found in only 5% of MS patients using modern techniques. Half of such patients in one series consisted of patients with primary progressive disease, the majority of whom were severely disabled. In relapsing remitting disease normal imaging was associated with early or mild disease.
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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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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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How accurate is an MRI for diagnosing MS?

The first important role for MRI in the diagnosis of MS allows for an early diagnosis of MS for CIS patients using the IP diagnostic criteria, including MRI for dissemination in space (DIS) and time (DIT). The sensitivity of diagnosing MS within the first year after a single attack is 94%, with a specificity of 83%.
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What can be mistaken for MS?

Conditions That Can Seem Like MS
  • Epstein-Barr Virus.
  • Vitamin B12 Deficiency.
  • Diabetes.
  • Nerve Damage.
  • Eye Problems.
  • Stroke.
  • Lupus and Other Autoimmune Diseases.
  • Parkinson's Disease.
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What mimics multiple sclerosis?

These include fibromyalgia and vitamin B12 deficiency, muscular dystrophy (MD), amyotrophic lateral sclerosis (ALS or Lou Gehrig's disease), migraine, hypo-thyroidism, hypertension, Beçhets, Arnold-Chiari deformity, and mitochondrial disorders, although your neurologist can usually rule them out quite easily.
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How many lesions are needed for MS diagnosis?

According to updates made in 2017, MS can be diagnosed based on these findings: two attacks or symptom flare-ups (lasting at least 24 hours with 30 days between attacks), plus two lesions. two attacks, one lesion, and evidence of dissemination in space (or a different attack in a different part of the nervous system)
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What does MS look like on brain 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 you see MS lesions on a CT scan?

An acute MS lesion may enhance and appear simply as an enhancing white matter lesion on CT scans, but the appearance is highly nonspecific. When a highly active MS lesion is observed to enhance and possibly exerts mass effect, it can be termed tumefactive (due to the potential for misidentification as a tumor).
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How many lesions is alot for MS?

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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Can you have MS for years without knowing?

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 makes multiple sclerosis worse?

Having a chronic disease like MS can establish a new source of stress. But stress can stem from other sources too, including work, personal relationships, or financial worries. Too much stress may worsen your MS symptoms.
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Can you have an MS relapse without new lesions?

In summary, people with progressive MS can and do have attacks (relapses), albeit infrequently, and develop new spots (or lesions) on MRI. Both relapses and new lesions are types of disease activity.
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How does a neurologist diagnose MS?

Your neurologist will look for abnormalities, changes or weakness in your vision, eye movements, hand or leg strength, balance and co-ordination, speech and reflexes. These may show whether your nerves are damaged in a way that might suggest MS.
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Why is multiple sclerosis not diagnosed initially?

Unfortunately, multiple sclerosis (MS) is much more complex and can take months, or even longer, to accurately diagnosis. There is no single test that will tell you if you have MS. Doctors arrive at a diagnosis based on a combination of your symptoms and the results of several different tests.
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Can you have MS and not have lesions on the brain?

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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Can small brain lesions disappear?

In an increasingly recognized subset of patients however, the imaged lesions spontaneously resolve. While poorly understood, these 'disappearing' lesions may in fact be the consequence of seizures, rather than the cause.
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Can multiple sclerosis be reversed?

Disease modifying treatments (DMTs) may be able to reverse the symptoms caused by MS for some people with relapsing MS. This is according to new research published in the Journal of Neurology. This is the first study that has measured whether people's long-term symptoms improve following treatment.
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