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One lesion on spinal cord... MS?

Posted: Fri Sep 27, 2013 10:32 am
by staceo
Hi All,

Two back doctors have told me to see a neurologist because to 3 things:

1. a 9mm lesion in spinal cord - C5 in my MRI
2. Hoffmann's reflex - positive
3. Hyperreflexia

From my perspective, I have no bladder or bowl problems but I do have leg and arm pain (was told I have fibromyalgia 2 years ago) and have Hashimoto's (thyroid) which is an autoimmune. I have chronic allergies & asthma, blurred vision, some cognitive issues and some numbness in my feet and face. My question is, don't most people with MS have two or more lesions? If not MS, what else could this be? My ortho said it was not caused my an injury so....

I do have an appt. with a Neurologist in a few weeks but in the mean time I'm stressing out.

Any feedback would be greatly appreciated.

Re: One lesion on spinal cord... MS?

Posted: Fri Sep 27, 2013 3:16 pm
by jimmylegs
hi and welcome to the forum :) vitamin b12 deficiency is one well known cause of spinal lesions. it should be looked at when doing differential dx for ms.

Re: One lesion on spinal cord... MS?

Posted: Sat Sep 28, 2013 10:12 pm
by staceo
I've checked my b12 and it's in the low normal range. Do you really think that could be the cause of the lesion? Also, what I want know is, can you have MS with just ONE spinal lesion. Don't most people have several?

Re: One lesion on spinal cord... MS?

Posted: Sun Sep 29, 2013 12:32 pm
by jimmylegs
b12 would be a definite possibility. you have a number of comorbidities that suggest the possible involvement of more than one nutrient.

given the allergies, asthma, vision and cognitive issues, hashimoto's and fibro, I would be taking a long hard look at a few essential nutrients.

with ms and the mri, they're usually looking for a characteristic pattern of lesions involving the brain and spine. it is uncommon but not unheard of to see brain lesions in b12 deficiency. cervical lesions do fit the characteristic pattern of spinal cord lesions seen in b12 deficiency.

curious if you have a copy of your latest b12 results on file?

Re: One lesion on spinal cord... MS?

Posted: Sun Sep 29, 2013 1:38 pm
by lyndacarol
staceo wrote:Hi All,

Two back doctors have told me to see a neurologist because to 3 things:

1. a 9mm lesion in spinal cord - C5 in my MRI
2. Hoffmann's reflex - positive
3. Hyperreflexia

From my perspective, I have no bladder or bowl problems but I do have leg and arm pain (was told I have fibromyalgia 2 years ago) and have Hashimoto's (thyroid) which is an autoimmune. I have chronic allergies & asthma, blurred vision, some cognitive issues and some numbness in my feet and face. My question is, don't most people with MS have two or more lesions? If not MS, what else could this be? My ortho said it was not caused my an injury so....

I do have an appt. with a Neurologist in a few weeks but in the mean time I'm stressing out.

Any feedback would be greatly appreciated.
Welcome to ThisIsMS, staceo.

Since you stated that "any feedback" would be appreciated, I will offer my thoughts:

People diagnosed with one autoimmune disease are often diagnosed with a second or even a third autoimmune disease. Hashimoto's and fibromyalgia (I think asthma, too) are in the list of over 100 autoimmune diseases – http://www.aarda.org – MS is also in that group.

To your question… Some people with MS symptoms and diagnosis have NO lesions. After death and autopsy, many people who had no MS symptoms/diagnosis during their lifetimes have been found with many lesions! I am not convinced that lesions play much of a role in MS at all.

In preparation for your appointment with a neurologist in a few weeks, this description of a neurological exam might be helpful to you. It will give you an idea of what to expect and encourage you to take a list of symptoms to the appointment:

http://peripheralneuropathycenter.uchic ... #bloodtest



I think the section on blood tests is especially important for you to discuss with your neurologist:

Blood tests

Blood tests are commonly employed to check for vitamin deficiencies, toxic elements and evidence of an abnormal immune response.
Depending on your individual situation, your doctor may request certain laboratory tests to identify potentially treatable causes for neuropathy. These include tests for:

Vitamin B12 and folate levels (Jimmylegs recommends magnesium, zinc, and copper also.)
Thyroid, liver and kidney functions (especially thyroid recommended by Kathryn Simpson in her book The MS Solution)
Vasculitis evaluation
Oral glucose tolerance test (I suggest a "fasting blood insulin test" also.)
Antibodies to nerve components (e.g., anti-MAG antibody)
Antibodies related to celiac disease (I think testing for celiac/gluten intolerance is also important.)
Lyme disease (Bartman, among other TIMS members, urge this test be done.)
HIV/AIDS
Hepatitis C and B

Re: One lesion on spinal cord... MS?

Posted: Sun Sep 29, 2013 5:20 pm
by grandsons4
Continuing with the B12 connection (note that initial vitamin B12 level was normal):

Sub-acute combined degeneration with an initially normal level of vitamin B12: a case report
Abstract
Introduction
The neurological manifestation of vitamin B12 deficiency can occur as a result of peripheral nerve pathology or lateral and posterior column involvement, also known as “sub-acute combined degeneration”. This case report demonstrates an unusual presentation of SCD with normal B12 level.
Case presentation
A 39-year-old man was referred to the outpatient neurology clinic with a two month history of distal upper extremities numbness and fine motor movement difficulties. Initial vitamin B12 level was normal. A repeat MR imaging of the cervical and thoracic spine showed extensive posterior cervical cord flame-shaped lesions. His repeat vitamin B12 level was 41 pg/ml (normal; 200 pg/ml). He received monthly injections of vitamin B12. After six months his symptoms were resolved and his repeat spinal MRI showed resolution of the previous lesions.
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2769328/
The full article may be found at the posted website.

Re: One lesion on spinal cord... MS?

Posted: Thu Oct 10, 2013 6:50 pm
by staceo
Just had another MRI of my brain. I now have a 3mm lesion in my frontal lobe that was not there 3 years ago. So now, I in spinal cord and 1 in frontal lobe, plus some neurological symptoms. I wasn't scared before but now I'm starting to get concerned that this is indeed MS.

My question is, what is the rule about dx? Something about space and time + symptoms. Does anyone know?

Re: One lesion on spinal cord... MS?

Posted: Thu Oct 10, 2013 10:44 pm
by NHE
staceo wrote:Just had another MRI of my brain. I now have a 3mm lesion in my frontal lobe that was not there 3 years ago. So now, I in spinal cord and 1 in frontal lobe, plus some neurological symptoms. I wasn't scared before but now I'm starting to get concerned that this is indeed MS.

My question is, what is the rule about dx? Something about space and time + symptoms. Does anyone know?
The page linked below talks about the diagnostic criteria for MS.

http://www.mult-sclerosis.org/DiagnosticCriteria.html

Note: The McDonald Criteria for diagnosing MS were revised in 2010. You can read about that below.

http://www.ncbi.nlm.nih.gov/pmc/article ... 9-0292.pdf