Multiple Sclerosis Brain Lesions

Dick:
Our question is from Carl in California. Carl asks, “Does the number of lesions and their locations – brain or spinal cord – seem to predict the course of MS? What if many of these lesions haven’t caused any symptoms that I’m aware of?”
Dr. Phillips:
In general, the fewer lesions that a person has at the beginning of the disease, the longer it may take to develop the next evidence of the disease. The more lesions that a person has, the sooner perhaps, or the more certain, the subsequent development of the disease will be. With regard to the actual location, interestingly enough, whereas you might think that the specific location of plaques, or lesions, would predict the specific problems that you would have with MS. Well, the answer is sometimes yes and sometimes no. In general, what you can say is that the more that you have, the higher the degree of total cumulative abnormality, the more problems in general that you are going to have. An exception to that might be problems in the spinal cord, so a lesion in the spinal cord is very likely to cause either sensation abnormalities or strength abnormalities at a level in your body below that level affected by the plaque in the spinal cord. So with spinal cord lesions, there is a little bit more specific localization of the neurological symptoms associated with that.

Dick:
Would a greater number of lesions, Doctor, be an even stronger indicator to emphasize early intervention, early treatment?
Dr. Phillips:
Yeah, I think I would say it’s an even stronger indicator. But frankly, I think that even very few lesions represent a plenty strong indicator for me. But certainly, the more you have, the more imperative.
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One Comment on “Multiple Sclerosis Brain Lesions”

  • Orla wrote on 27 September, 2010, 12:03

    hi Doc, 
    Can you give an indication of what is considered “a lot” of lesions and what is “a few”.  I have lesions on the brain and on the spinal cord but there are more on the brain.
    thanks

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