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Based on the available search results, there isn't enough specific information to definitively answer whether smoldering MS can occur exclusively in the spinal cord without brain lesions. The research discussed primarily focuses on smoldering lesions detected in the brain through specific MRI techniques called Show Full Answer

Based on the available search results, there isn't enough specific information to definitively answer whether smoldering MS can occur exclusively in the spinal cord without brain lesions. The research discussed primarily focuses on smoldering lesions detected in the brain through specific MRI techniques called susceptibility weighted imaging.

These smoldering lesions are characterized by dark boundaries or "paramagnetic rims" that are visible on brain MRI scans, showing areas where the immune system is actively attacking nerves. What we do know is that smoldering MS represents ongoing disease activity that can occur even during periods of remission. It can cause subtle disability progression that might be hard to notice in routine doctor visits. If you have concerns about disease progression despite only having spinal cord lesions, it's important to discuss this with your healthcare provider, who can evaluate your specific situation and possibly recommend appropriate imaging techniques.

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What Is Smoldering MS? Inflammation May Linger During Remission