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Q: Multiple Sclerosis Question
asked by: DoctorQuestion on January 13th, 2006
I had an MRI of the brain in 1996 with abnormal white matter lesions and another one in 2005 with even more white matter lesions and am now supposed to have a lumbar puncture next week. The only symptom I seem to have is some incoordination of my 4th and 5th fingers on my left hand which makes it very hard to do my job as a medical transcritionist, which is why I had the MRI of the brain in 2005. The first MRI was done for a severe headache I got postoperatively. I do not have high blood pressure nor migraine headaches. I am quite tired all the time but have thought it was from narcotic pain meds for the chronic back pain. What is wrong with me? What are these lesions. They are nonspecific and scattered in the white matter. Are these lesions going to replace healthy brain, cause dementia?


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Dr. Nikola Gjuzelov , MD
replied on January 18th, 2006
Multiple Sclerosis Answer A157
Although your medical examinations are not finished yet, white matter lesions in the brain direct us to a possible case of multiple sclerosis. Multiple sclerosisis an autoimmune disease where the immune system attacks its own structures (in this disease - the immune system attacks the myelin coverings of the nerve tracts in the brain). Lesions can appear any time, any place on the brain’s white matter (nerve tracts). Symptoms depend on the lesions’ localization. Symptoms become easier but do not disappear over timebecause lesions do repair, but not completely. Multiple sclerosis is a progressive disease because new lesions appear and the old ones don’t recover completely. A lumbar puncture is necessary for proper diagnosis because anty-myelin antibodies must first be detected in the spinal fluid. If multiple sclerosis is proved (and the antibodies are found), you would need therapy for slowing down the process( corticosteroids).


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