Great comment!
Buried deep within posts and links to other posts is this one - Beginner's Guide to MS: What is a Lesion? - which addresses some of the questions you raise regarding "active" lesions and "black holes" in the brain. I'll go back and add this to the list of posts above.
It can be confusing to use the term "active" lesions when really we mean gadolinium-enhanced lesions or just "enhanced" lesions. As you describe, we can have active symptoms but not "active" lesions. Now that I think of it, the only time MRI showed enhanced lesions for me was during the diagnosis process.
Good point regarding getting on the MS drugs when they might be most effective early on. And I have read (can't remember where just now) that there is some thought that perhaps multiple sclerosis is really a large umbrella title for several different diseases with different causes. That would explain why we respond differently to the drugs from individual to individual. Different causes.
There was a time, not long ago at all, that neuromyelitis optica (NMO or Devic's disease) was considered a rare form of MS. Now it is recognized as a separate disease and even has a definitive blood test. People with Devic's actually do worse on the MS disease-modulating drugs.
You've brought up some great points. Thank you for starting this discussion!
OK. Different subject. So are you saying that it is obvious I NEED a teleprompter? 'Cause I basically turned my little digital camera on and talked. I do recall having to tape this particular segment more than once because I was stumbling on "demyelinating" - I had to stop and say that word about 10 times to get it to flow. 
OMG. You were absolutely great without a teleprompter. I was referring to all the media coverage deriding the use of teleprompters by high-profile speakers. I noticed at once that you were looking at us not down at a teleprompter which I find amazing. It is really difficult to give a presentation without reading from notes or a teleprompter. I did not know about Devic's diagnosis. Very interesting. Links are also great. Thanks again Lisa.
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Too short!
LOL. Some of these videos are very short by design. I think that I got MY personal diagnosis story down to about 6 minutes. It is supposed to go up on Tuesday which is the 10 yr anniversary of my going blind (optic neuritis). I tried to keep these short because there are 9 of them in total. Too much of Lisa might not be a good thing all at once, lol.