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General Questions and Answers For learning, sharing your experience, and exchanging information about Multiple Sclerosis. Please discuss medications in the Medications forum, and natural supplements in Tara's forum.

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Old 05-29-2012, 12:57 PM
kriscake kriscake is offline
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Lesions on spine vs brain... or both

I have a possible lesion on my brain that the neuro said might just be a shadow/ wrinkley bit on my brain and another small lesion BUT I do have a lesion on my spine. I'm somewhat confused here because as I talked to him one day, he changed his tone and said that spinal lesions are more serious than the brain lesions.

He went from discussing avonex to jumping up to rebif (said it was stonger form) and that I would need to be a bit more aggressive since lesions on the spine are more serious.

I was taken aback and pretty much lost the ability to ask any more questions when he said that. Bad move on my part really.

Is it true that spine vs brain lesions are worse? Should I find out exactly WHERE the lesion is on my spine and that will maybe give me some insight as to what area of my body will show signs of ms? or is all of it just one big shot in the dark?
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Old 05-29-2012, 04:08 PM
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SNOOPY SNOOPY is offline
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Spinal cord lesions can be more symptomatic than brain lesions. Symptoms for a spinal cord lesion can cause symptoms/problems from that point down.

I have numerous cervical (neck) spinal cord lesions and any symptoms I may have are from the cervical lesions. I have 4 brain lesions and are considered non-specific. The brain lesions have not been the problem.
1985 dx'd RRMS. 5/09/2013:Secondary Progressive without Progression. Never used DMDs. Low EDSS.
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Old 05-29-2012, 04:45 PM

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I feel extra limp reading this. I have a few tiny brain lesions and a giant spinal lesion. I'm told what Snoopy says - in the case of the spine, it's more of a roadblock than in the brain where there are lots of paths around it.

That said, I'm still doing well 2 years in and on Avonex. Be SURE your vitaminD levels are high enough. This can be your most effective DMD in addition to whatever else you choose.


[COLOR=black][FONT=Verdana]The queasiness at hearing "spinal lesion" will pass until you hear "Giant Spinal Lesion", but that will pass too[/FONT][/COLOR]

Look here for great info and be sure to Exercise regularly in whatever way you are able

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Old 05-29-2012, 05:18 PM
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CGMoonbeam CGMoonbeam is offline
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Yes, my neuro said that spinal lesions cause problems with walking, while more brain lesions cause more cognitive problems.
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Old 05-29-2012, 05:22 PM
Redwings Redwings is offline

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Hi kris:
I can appreciate why you're confused, because it appears that your neuro is giving you some imprecise and unclear messages. Once someone gets off track in their understanding of MS, the harder it is to get back on track.

The first is a pet peeve of mine, possibly because it actually starts with the loose terminology of some doctors themselves. MS lesions are not "lesions on the spine." The spine is part of the skeleton and is made of bone. MS is a disease of the central nervous system, not of bone. If you're referring to an MS lesion, you don't have a lesion "on your spine." You have a lesion [I]in your spinal cord[/I]. It's best for your understanding of the situation to not get into the habit of referring to an MS lesion as "on the spine."

It's the nature of spinal cord lesions to be symptomatic because there isn't redundancy in the spinal cord. There aren't nerve networks in the cord that can bypass damage, so a lesion is likely to cause some kind of a problem in the body. A cord lesion affects everything below it. If the lesion is lower in the cord (toward the feet), there is relatively less area that's potentially affected. But if a lesion is higher in the cord, say in the neck area, the entire body below that is potentially affected. That's why even a small cord lesion can cause serious problems.

In the brain, there is some redundancy, with many neural interconnections that can sometimes route nerve signals around a lesion. In that way, some lesions can be "silent," causing no noticeable symptoms. That doesn't mean that brain lesions are silent or harmless, but that a few might not cause problems.

The central nervous system is fairly well mapped, so it isn't just a shot in the dark about what functions can be affected by lesions in a known location. What [I]is[/I] just by chance is where lesions might form in any individual. The potential for rerouting of signals through the brain can make it more difficult to find the lesions that are the source of a symptom, but it isn't a crapshoot. The functions that are affected are still dictated by the physical network and what "circuit" the lesions are on.

The other thing you're not getting a clear message about is the medications you mentioned. Rebif isn't really a "jump up" over Avonex. The meds are the same drug, just administered differently. The more frequent, subcutaneous Rebif has shown to be only a few percentage points more effective than Avonex in studies. If you want to play a couple of percentage points, Rebif does seem to have the edge. But essentially, Rebif and Avonex perform about the same. Rebif isn't going to give you the kind of advantage your doctor has implied. You'll have to read several studies about the effectivity of the CRAB drugs, but when you do you'll find that they [I]all[/I] perform about the same. Once you've done your homework, you can ask better questions of your neuro and be more comfortable choosing a med for yourself.
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Old 05-30-2012, 12:11 AM
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meeegun meeegun is offline
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based off of this information, should i consider myself lucky that i have 5 spinal cord lesions (4 cervical, 1 at the conus), 6 if you count the one at the cervicomedullary junction, and almost no mobility impairment? i keep reading these posts about spinal cord lesions and i'm just wondering, did i dodge a major bullet here or is this common to have multiple lesions with minimal impairment?
dx: RRMS 9/8/11 copaxone 12/5/11
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Old 05-30-2012, 05:31 AM
Redwings Redwings is offline

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Small lesions obviously don't affect as many nerve fibers as do large lesions. Spinal cord nerve tracts contain a [I]lot[/I] of individual neurons carrying the same of similar information. One hundred malfunctioning cells out of ten thousand probably don't have a significant effect (remember, nerve cells die off normally every day, just like every other cell type in the body). Two thousand malfunctioning cells in the same place might.

The rest of it is just luck.
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Old 05-30-2012, 08:48 AM
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jifr jifr is offline
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Hi. I have cervical cord lesions at every level and at least 3 at the thoracic level. I have a "huge" lesion at C2 (according to the MS specialist) and an "extensive" one that crosses the entire AP cord at T7-T8 (according to my most recent MRI).

I have L'hermittes all of the time. Otherwise, 75-80% of my symptoms I associate with my cord lesions are "sensory" with some very minor motor dysfunction even though my cord lesions do have motor neuron involvement.

I, too, was told that MS that involved "cord" lesions was "worse". I thought I would be in a wheelchair by now (10 years after dx). I'm not.

So, while MS is not typical and no one presents that same - hopefully that's information you can put in your bucket of things you know.

Stay well.
Dx 4/02
Brain & spinal lesions
Current DMD: Betaseron (again)
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Old 05-30-2012, 08:25 PM
misspammy misspammy is offline
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Cervical Spinal Cord lesions

My largest is at c 5/6 and c7 and I have more. My MS specialist said I was a bit of an anomaly in that I have mostly spinal cord lesions and very few brain (corpus collasum) lesions. However I am totally ambulatory and am at 10 years+ with my diagnosis. So I think how fast this monster moves is just a crap shoot.
"And in the end, the love you take, is equal to the love you make"....the beatles..
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