Look up the "clinco-radiographic paradox" in MS that explains everything. But basically:

1. Not all lesions cause symptoms especially in the brain
2. Many lesions are smaller than conventional MRI can detect
3. Most symptomatic lesions are in the spinal cord
4. MRI lesions are not reflective of all facets that MS is ie. Many microscopic changes to nerve axons etc not just inflammation seen in lesions and those things are not shown by MRI.

As a result, you cant always match symptoms with an individual specific lesions. Its possible to have new symptoms without new lesions and new lesions without symptoms.

Lesions aren't what causes symptoms, it's nerves. Lesions are tools to dx, it's what they can see, but there is damage that goes on beneath the surface. As progressive, we still get intermittent and ongoing symptoms without new lesions. If it were new lesions causing symptoms, we'd be good instead of progressing. Some spontaneous symptoms may be pseudo exacerbations, related to things like stress, heat and illness. Demyelination is ongoing, signals miss, skip and reroute if possible. Rerouting is easier in the brain, which is why spinal damage is more often debilitating, plus its connectivity to the arms and legs can be interrupted. If I were to guess, that's why some people experience inability to walk, then walking ability returns...the nerve pathway finds a way to reroute. Hope this helps.

Yes they are specialist but I disagree with mine I feel like I am living constant exacerbation everyday...my bladder,bowels, fatigue, numbness, cognitive, retention the words leave me and now I am starting to have trouble pronouncing words I know very well, so how the lesions are today with all of these symptoms daily coralate how? They don't understand all of it and a guessing game as to why and which medication may or may not work for me!

You need to rest and stay stress free. Your body is telling you to sit down, smell the air and relax.

@A MyMSTeam Member
Hun that is very good information and very very helpful. From time to time I get all Hazy and confused. I have had the lemtrada treatment 1 month ago and thought things might ease up a little. But all last week and this week i feel the same as before I started the lemtrada treatment if not worse. It's very confusing it must be a short cercuit Trying to reroute I just can't get my head round it. All the best Hun xxxx.

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