Is Spinal Cord Ms Worse Than More Lesions In The Brain

Question

Asked by Debbie Dack

Is Spinal Cord Ms Worse Than More Lesions In The Brain

I went to my neuro today and got told i have mainly lesions in my spinal cord my mobility is affected my bladder+bowels my speech memory moods depression well everything really just need to know if the spinal cord MS is worse on the outcome or not been diagnosed 2 years suspected to have had it for 10 years any answers greatly received thankyou

Answer

Hi Debbie

I do apologize that your question has not been answered sooner. This must have been such a shock to hear such news. I cannot even begin to imagine all the emotions you must be feeling.

Let me first preface my answer with the fact that nobody has a crystal ball. Nobody can accurately determine your future with this disease. There are some trends, however, which I will share with you. Also know that I am not a doctor or medical professional and your doctor will be the one to give you the most guidance on this.

One of my fellow MS bloggers had asked my friend who is a neurologist a very similar question. I am going to give you the link to the question and answer session and I will cut and paste that particular question here to give to you.

In addition, I have also found this link where a doctor provides an answer to this question about spinal lesions and MS.

And here is the question and answer forum with Doctor Sethi.

"Q: I wanted to see if you would inquire with Dr. Sethi which disease modifying drugs he felt worked best for someone who has several Spinal Lesions after 5 years of MS with no previous DMD's. If they cannot tolerate interferon's what would be his next course of action?

A. Hello there. Thank you for asking that question. Spinal MS (a patient with MS who has predominantly MS involvement of the spinal cord, the brain is relatively spared) is at times associated with high morbidity and mortality rates. The reason is that all the tracts which carry nerve impulses to and from the brain are concentrated in a relatively small area in the spinal cord. So even a small strategically placed lesion in the spinal cord can cause significant neurological impairments. Patients with spinal MS present with slightly different clinical signs and symptoms. They may present with what is called transverse myelitis (this is an involvement of the spinal cord usually at the cervical or thoracic level). Transverse myelitis can be devastating because all the descending motor fibers from the brain and the ascending sensory tracks are packed in the small diameter of the spinal cord. So any involvement of the spinal cord has the potential to affect all these tracks. Depending upon the level of cord involvement patients may have either weakness of just the legs (paraparesis or paraplegia) or all the four limbs may be involved (quadriparesis or quadriplegia). Usually the bladder and bowel are involved too and patients may have complaints of urinary incontinence. Sexual dysfunction is also commonly reported.

Spinal MS is treated in much the same way with traditional disease modifying drug therapies such as interferons. If a patient cannot tolerate one particular interferon, it may still be worthwhile attempting therapy with another interferon (for example if you cannot tolerate interferon beta 1 b, interferon beta 1a may be tried). The other option for RRMS would be to use glatimer acetate (copaxone) or Nataluzimab. Nataluzimab can at times have very serious side-effects and potential complications. Hence there are strict criteria which determine which MS patient can receive this drug."

I do thank you for your question. Please let us know if you have any other questions for us. This is a very nice community and you will receieve a lot of support here.

Answered by Merely Me