The Relationship Between Lesions and Disabilities
By: Nurse Kimberly
Most people living with relapsing multiple sclerosis know that annual MRIs are important, since they are the only way for a neurologist to see if there are lesions in the brain or spinal cord.1 However, what many people may not know is how MRI results can explain the different effects of MS and how MS may cause certain disabilities.
Some of my MS patients think the results of an MRI tell you one thing: whether or not you have new lesions. While that is the primary purpose of an MRI, MRIs can also give you a better understanding of where lesions are located and other key details.2
This is important because lesions in specific locations of the brain can cause specific symptoms or have effects on various systems in the body, so knowing the location of your lesions can help you and your healthcare provider set expectations for the future.2 While there are many examples of the relationship between lesions and disabilities, these three in particular are the most common among my patients.
This condition occurs when lesions are located along the optic nerve.3 Damage to the myelin along the optic pathway to the brain can cause blurred vision, double vision, reduced color vision, eye pain, a blind spot, or vision loss.2 These impairments are often temporary and can resolve on their own.2
These are often caused by lesions on the brain stem. Speech disorders (dysarthrias) including slurring and speech scanning—when the cadence of speech is affected—are often two issues that arise.4,5
This is caused by lesions in the cerebellum.6 Dysmetria is a coordination problem that involves a tendency to over or underestimate the amount of motion required to perform a task (eg, overreaching for an object).6
MS is an unpredictable disease, so even if you know the location of a lesion, no one can say definitively that it will affect you the same way it affects another person living with MS. However, knowing as much as you can about your lesions, and disease activity, is always beneficial.
Next time you’re going over MRI results with your healthcare provider, try to get as much knowledge as possible. Ask specific questions about your lesions, and take notes so you can do your own research after the appointment. You should always feel comfortable talking with your healthcare provider, no matter what the topic is. There are also some helpful tips from Live & Learn MS bloggers for anyone trying to better understand MS and improve the dialogue with their healthcare providers.
- Ask your healthcare provider about the location of your lesions to see how they relate to disabilities now or in the future.
- Optic neuritis, speech issues, and dysmetria are often caused by lesions found in specific areas of the brain.4,5,6
- It’s important to feel comfortable asking your healthcare team specific questions about lesions and disabilities.
References: 1. Zabad RK, Stewart R, Healey KM. Pattern recognition of the multiple sclerosis syndrome. Brain Sci.2017;7(10):138. doi:10.3390/brainsci7100138. 2. National Institutes of Health. National Institute of Neurological Disorders and Stroke. Multiple sclerosis: hope through research. 2017. https://www.ninds.nih.gov/Disorders/Patient-Caregiver-Education/Hope-Through-Research/Multiple-Sclerosis-Hope-Through-Research. Accessed April 18, 2018. 3. National Multiple Sclerosis Society. Vision problems. https://www.nationalmssociety.org/Symptoms-Diagnosis/MS-Symptoms/Vision-Problems. Accessed May 19, 2018. 4. National Institutes of Health. U.S. National Library of Medicine. Dysarthria. https://medlineplus.gov/ency/article/007470.htm. Accessed May 18, 2018. 5. National Insititute on Deafness and Other Communication Disorders (NIDCD). Speech problems. https://www.nationalmssociety.org/Symptoms-Diagnosis/MS-Symptoms/Speech-Disorders. Accessed May 21, 2018. 6. National Multiple Sclerosis Society (NMSS). Speech disorders. https://www.nationalmssociety.org/Symptoms-Diagnosis/MS-Symptoms/Speech-Disorders. Accessed May 19, 2018.