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    Lesion on Spinal Cord Only?

    I was curious can the ms lesion be on the spinal cord only and not on the brain? I have basically ruled everything else out and I'm just now (hopefully going to get an mri of spine) and was curious does anyone have a lesion on the spinal cord alone and is dx with ms?

    I have not got a spinal tap yet but if lesions do come back on the spinal cord I plan to. I currently have a positive romberg sign, balance issues (keep getting pulled to the right) and can not walk a straight line to save my life.

    I've had tons of symptoms that point to ms and the docs have been ruling everything out - all my blood tests come back normal for everything.

    Can x-rays show anything that is relevant to MS? Just curious. I had an xray yesterday and of course I had damage because of an accident I was in years ago but it still doesn't explain the positive romberg sign and other balance issues.

    After removing all the ruled out conditions - only thing that remains is - there has to be a lesion on the spinal cord. I do not believe I have had a mri of the spine only.

    I had a neuro tell me several years ago that it looked like my spinal cord was being pulled downward (too straight) based on a cervical mri but he never requested a full mri of my spine. I know part of this could be due to some of my back issues but not the positive romberg sign. Recently, spine doc said no that wasn't the case. I don't know if any of you had a similar experience/result or if it is even related.

    I feel like that song "Like a record baby, right round, round, round

    Thanks in advance.
    ~Brittan~ Over 15 years w/ symptoms & Recently diagnosed w/ Chiari 1 Malformation - it has a lot of similar symptoms to MS. Easy to dx by MRI. See videos CM info - how to dx via MRI: https://youtu.be/I0f9e3pU6to CM symptoms: https://youtu.be/YyF3HVgHpCs FB group: Chiari Is For Real

    #2
    Hi Brittan,

    Multiple Sclerosis is a disease of the Central Nervous System(CNS), this includes the brain, spinal cord and optic nerves. Lesions can show up in any or all of those areas.

    I had a neuro tell me several years ago that it looked like my spinal cord was being pulled downward (too straight) based on a cervical mri but he never requested a full mri of my spine.
    The cervical MRI you had would have shown Lesions if there were any.

    The most common spine MRI for MS is the Cervical Spine (neck) although some will have the T-spine done.

    At the time I was diagnosed with MS I had clear MRIs. My Neurologist said based on my symptoms and exam MS was affecting the spinal cord. He was correct. To this day I have only 2 or 3 brain lesions but at one point I had numerous (too many to count) c-spine lesions.

    Can x-rays show anything that is relevant to MS?
    No.
    Diagnosed 1984
    “Lightworkers aren’t here to avoid the darkness…they are here to transform the darkness through the illuminating power of love.” Muses from a mystic

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      #3
      How in the world did they dx you w/out lesions? The lesions is the only thing holding my docs back from diagnosing me.

      I just found that there is Spinal MS - it can effect just the spine. My question is can the lesions only show up if it is in a flare? Can just a regular mri pick up on the lesions in the spine? I've heard the contrast shows active lesions but wasn't sure about the regular mri.

      Here is what I just found on MS lesions: Brain vs. Cervical vs. Spine

      "The lesions caused by multiple sclerosis can occur anywhere within the central nervous system which includes the brain, the spinal cord, and the optic nerves. Approximately 55-75 percent of patients with MS will have spinal cord lesions at some time during the course of their disease. If a patient does have lesions in the spinal cord, he/she may be said to have Spinal MS. A smaller number of MS patients, approximately 20%, may have only spinal lesions and not brain lesions. (see emedicine.medscape.com) I am an example of one of those 20% of MS patients who only have spinal lesions.

      Spinal MS occurs more commonly with lesions in the cervical spine (the neck area) in approximately 67% of cases. Lesions in this area often affect the corticospinal tract. Neurological signs which indicate lesions in the corticospinal tract include the Babinski Sign and the Hoffmann Sign. Additional indicators of lesions in the upper spine include the l’Hermittes phenomenon and the Romberg Sign. At one time or another, I have shown each of these signs of neurological involvement/interference due to MS lesions."

      See more at: http://www.healthcentral.com/multipl...137908/spinal/

      So, It still has a window of possibly having spinal ms w/out the other lesions in cervical spine or brain.

      Just want to be clear on the odds ... it's slim but it never stopped me before from getting the least likely things ... lol.

      I read this from another forum about MS and mri / dx procedure:

      "I am an MRI tech so I see MS all the time on patients. Usually physicians will order a plan brain MRI first due to insurance issues and so forth, and since the plaques show up alot in the brain. However, I've seen docs order everything from full spine and brain (which is what i had), to combinations of brain/cervical spine and alot of thoracic/cervical spine combinations. If the MRI of the brain is negative showing no evidence of demyelinating disease, neurologist will then order usually a cervical/thoracic MRI combination to check for plaques or demyelination within the actual spinal cord. If these are all negative, your neurologist or doctor may order a lumbar puncture or spinal tap to look for what they call oligoclonal bands. Doctors are not going to order the whole series usually at first if they can confirm a diagnosis off a single study since MRI's are very expensive 1000-2000 dollars per scan depending on whether or not contrast was used. Contrast is usually used to look for enhancement of these so called plaques. MS can be diagnosed without contrast but once confirmed, is usually followed up with contrast exams periodically to check the progression of the disease. (plaques will always show up on certain sequences). The plaques will "highlight" or enhance on images after the injection if they are considered active, whereas non-active plaques will not generally enhance. Therefore your doctor can monitor your treatments effectiveness with MRI. Hope this helps."

      Read more: http://www.healthboards.com/boards/m...#ixzz3e6sVfv9q


      If the mri does come back normal maybe I should do the spinal tap??? But I've heard varying things about this saying it only pick up when symptoms are active but others say the opposite.

      Tell you the truth I am getting tired. I am running out of options to what this can be. If it's not ms then I have no clue what it could be and I think my docs are with me.
      ~Brittan~ Over 15 years w/ symptoms & Recently diagnosed w/ Chiari 1 Malformation - it has a lot of similar symptoms to MS. Easy to dx by MRI. See videos CM info - how to dx via MRI: https://youtu.be/I0f9e3pU6to CM symptoms: https://youtu.be/YyF3HVgHpCs FB group: Chiari Is For Real

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        #4
        Hi Brittan,

        My question is can the lesions only show up if it is in a flare? Can just a regular mri pick up on the lesions in the spine? I've heard the contrast shows active lesions but wasn't sure about the regular mri.
        A MRI without contrast (dye) will show an anomaly (lesion), if there is any. Contrast will "light up" or enhance a lesion if it is currently active (inflammation). If a MRI without contrast (dye) is clear (no lesions) then a MRI with contrast will also be clear (normal).

        Lesions are part of this disease. A person with MS will always have some lesions.

        If the mri does come back normal maybe I should do the spinal tap??? But I've heard varying things about this saying it only pick up when symptoms are active but others say the opposite.
        Only you and your Dr. can decide if a LP would be a good idea. It's quite invasive and may or may not give you any answers.

        When I was diagnosed with MS the MRI was fairly new, there were 2 MRI machines in the entire State. I underwent quite a bit of testing (x-rays, blood work, MRI, VEP, LP, Myelogram, EEG). The only test that came back positive was the LP (5 o-bands).

        During the diagnostic process I was in a severe exacerbation. My Neurologist told me, due to the condition I was in there was a better chance of the LP showing "something."

        How in the world did they dx you w/out lesions?
        Well, the LP cinched my diagnosis but I was in pretty bad shape. At 24 years old I had Lhermittes, hand tremors, bilateral leg weakness, pins/needles/buzzing/vibrations from the waist down, fatigue, and almost complete loss of mobility.

        I have heard the term, spinal MS, but I have never asked my Neurologist if spinal MS is a proper term.
        Diagnosed 1984
        “Lightworkers aren’t here to avoid the darkness…they are here to transform the darkness through the illuminating power of love.” Muses from a mystic

        Comment


          #5
          Thanks for clarifying about the MRIs.

          Well, the LP cinched my diagnosis but I was in pretty bad shape. At 24 years old I had Lhermittes, hand tremors, bilateral leg weakness, pins/needles/buzzing/vibrations from the waist down, fatigue, and almost complete loss of mobility.
          I have had my symptoms since I was 22 years old and like you I have all those symptoms. I feel like I am going to collapse. I try to keep staying motivated to get a dx but it is so exhausting (on top of the extreme fatigue) and causes my symptoms to flare and then I just don't want to move. If I could stay in bed all day I would but I have kids and that's not an option. Right now I am feeling the love from the MS hug - I can feel it getting worse. It's been giving me a light hug for the past week and since I went to the docs yesterday - I will pay severely.

          I forget if I initially got a mri of my spine when I was 22 or not. I remember mri of cervical and brain. So who know if there is something or not.

          Is there anything other condition you've heard of (that is not common) that is similar to MS? Because I already went through the grind with Lupus, Sjogern's, Lyme's, a bunch of things and nothing. I know I heard there are many other illnesses that mimic MS but I have yet to find a complete list or a decent size list at that. The web seems to restate the same illnesses over and over.

          I pray the mri does come back with ms lesions because then I can finally rest. I am already taking it day by day and can only treat the symptoms anyways but at least I'll know what it's capabilities are with regards to how it can effect me further. (I can dream ... lol.)
          ~Brittan~ Over 15 years w/ symptoms & Recently diagnosed w/ Chiari 1 Malformation - it has a lot of similar symptoms to MS. Easy to dx by MRI. See videos CM info - how to dx via MRI: https://youtu.be/I0f9e3pU6to CM symptoms: https://youtu.be/YyF3HVgHpCs FB group: Chiari Is For Real

          Comment


            #6
            Originally posted by Brittan View Post
            Here is what I just found on MS lesions: Brain vs. Cervical vs. Spine
            Hi Brittan:

            It sounds like you've misinterpreted something somewhere. Cervical IS the spine, so it's not cervical vs. spine.

            The spine is referred to in three regions, from the top down:
            cervical (including the neck)
            thoracic
            lumbar

            Since you've had cervical MRIs, you've already had MRIs of part of your spine -- your upper spine. Relating that to the article you quoted: "Spinal MS occurs more commonly with lesions in the cervical spine (the neck area) in approximately 67% of cases."

            So it sounds like you'd like to know if lesions can occur in the lower parts of the spinal cord. Yes, they can, accounting for the other 33% of cases. Those lesions would be almost exclusively in the thoracic cord. The spinal cord ends before the spine ends, and the lumbar cord is basically only a nub. It would be extremely rare for MS lesions to be found only in the lumbar cord, and a lesion that far down wouldn't be responsible for a positive Romberg sign or an MS hug.

            Originally posted by Brittan View Post
            Can x-rays show anything that is relevant to MS? Just curious. I had an xray yesterday and of course I had damage because of an accident I was in years ago but it still doesn't explain the positive romberg sign and other balance issues.
            Xrays don't show anything related to MS. Xrays aren't sensitive enough to pick up small areas of soft tissue damage

            The damage from your accident might possibly explain the positive Romberg sign and the balance issues if damage also occurred in the corresponding areas of the spinal cord. It depends on where the damage is, and when the symptoms showed up relative to the accident (you haven't said anything about the timing). It would be unusual for neurologists to overlook that possibility, but stranger things have happened.

            Originally posted by Brittan View Post
            After removing all the ruled out conditions - only thing that remains is - there has to be a lesion on the spinal cord. I do not believe I have had a mri of the spine only.
            You've had MRIs of the upper (cervical) spine. It sounds like you're waiting to have an MRI of your lower spine.

            Originally posted by Brittan View Post
            I had a neuro tell me several years ago that it looked like my spinal cord was being pulled downward (too straight) based on a cervical mri but he never requested a full mri of my spine. I know part of this could be due to some of my back issues but not the positive romberg sign. Recently, spine doc said no that wasn't the case.
            Again, it would be unusual for spinal cord damage from your accident or some other condition to be overlooked or downplayed, but subtleties are sometimes missed. It also makes me wonder if something like a mild Chiari malformation is being overlooked.

            That's really a stretch. But when things don't make sense, it's time to go back and look at all of the possibilities again.

            You said you've had symptoms for 15 years. With MS, lesions would be expected to show up during that time. The longer a person goes without lesions, the smaller the chance that the condition is MS.

            So in comparison, which makes more -- or less -- sense: an unusual case of MS that hasn't shown lesions for 15 years, or spinal trauma causing subtle spinal cord damage that isn't showing up on an MRI? Which makes more -- or less -- sense: an unusual case of MS that hasn't shown lesions for 15 years, or an accident causing subtle brain trauma that isn't showing up on an MRI?

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