This Is MS Multiple Sclerosis Knowledge & Support Community

Hi.
I had an MRI recently and the out come is... "The brain demonstrates area of FLAIR hyperintensity in the deep and subcortical white matter. There are no new lesions relative to previous examination."

It has been 2 years and 9 months between MRIs. Obviously, this is good news. The question is... how good? I mean, is this common or it is rare not to have gain anything new for that period of time?

History: Woke up with paralysis on the right side of face, arm and leg in January 2004. Went to hospital had an MRI. It showed nine lesions. For three months I was on Avenox prescribed by my Neuro. It made me very ill. FIRED my neuro and had my GP prescribe Minocycline. I was on Mino for year and moved to the ABX routine. I have been on the ABX for 11 months.

Hi Wilson,
I have 4 lesions only, of the upper spine. I have had them on each of my 4 MRI's over the past 12 years.
Regards,
Phil

Hi wilson, From my understanding of lesions, they are active or not. In other words, there is current inflammation or not. With the exception of the one lesion showing "hyperintensity," those other lesions might equate with "CPN WAS HERE" graffiti, hence the term "sclerosis" (aka scarring). It's possible that the key to understanding that one problem lesion is the word "deep." Besides protecting CAPers from too much herxing at once, one reason the protocols are long term is to allow for deeper and deeper tissue penetration.

Another reason the protocols are long term is that it takes time to aggravate the reticulate bodies (the active, reproducing phase of the Cpn life cycle) with the bacteriostatic antibiotics to the point that they enter the cryptic phase in order to protect themselves from the threat. That's where the flagyl comes in. It's bacteriocidal and effective in killing the Cpn off in the cryptic phase. With every flagyl pulse, there is winnowing down of the total Cpn cryptic phase population. Actually there is also some continuous killing going on of the reticulate bodies as well, but on a much smaller scale. I guess that's a case of the RBs being aggravated to death (weakened to the point of death) by the bacteriostatic abx. And, of course, the NAC is killing the elementary bodies (seed-like phase of the life cycle). Winnowing down and more winnowing down of all the phase populations over an extended period.

You're not a newbie to this, so you'll understand that I've recapped the process for other readers. Anyway, it never hurts to get someone else's version of the process. I'm not a medical type, so if I got anything wrong, please let me know.

Cypriane~caregiver and advocate in Dallas for husband with SPMS

Tim, it partly depends on the type of MS you have. With relapsing, remitting, lesions can completely go away, but there tends to be something new developing somewhere else. With my secondary progressive, my brain MRI looked like a mass of storm clouds in the first one, before starting abx treatment, in the second one the intensity of the storm had quietened down somewhat, in the third one, some of the peripheral lesions had gone. In all this, there were no new or enhanced lesions. This is not normal for progressive disease, where lesions don't disappear.

I would say that your results are very good news, so celebrate it!

Sarah

I really don't know what type of MS I have, RR or Progressive. I haven't been to a Neuro for over 2 years. Besides what was stated above about the latest MRI, it is noted that everything like ventricle, nasoparynx, and mastoid is normal (whatever that is??). Impression is "stable white matter lesions".

Also, what does it mean "demonstartes areas of FLAIR hyperintensity"?

thanks

FLAIR is "Fluid attenuation recovery" method. Its to do with the MRI machine, not your actual brain.

Basically, no new lesions is good news, whatever type of MS you have. With relapsing remitting, things are always waxing and waning, with secondary progressive, they just get worse, either new ones develop or existing ones get bigger. With primary progressive, which Phil has, things can happen much slower, but again things don't go away, but you can obviously also develop new ones.

People can have lesions in a part of the brain which does not affect them on the outside, so a lot of waxing and waning can be going on without the person's knowledge, which is where the idea that an MRI is not a useful guide as to your real condition comes from. My last MRI still, to my mind, looked horrendous, but it was a lot less intense and there was nothing new. I feel a lot better than it looks and I am still slowly improving.

Leaving your MRI to one side, how are you? That is what really matters at the end of the day.

Sarah