How much does brain atrophy play in the diagnosis of the type of MS you have?

[ge97511]

I'm just wondering how much brain atrophy play in the diagnosis of the type of MS you have.  When I first started having symptoms I went into the ER and they did a CT.  The neurologist came and said that my brain was too small for someone my age and then went on to ask if I was in special ed/graduated hs.  She said it was brain atrophy and that it was probably congenial.  I believed her then but then I started reading stuff in the health pages and on the web and now understand it's MS related.

I've been too I have RRMS but it makes me wonder if they have the right dx.  It's because I'm getting worse and from what questions that first neurologist asked it tells me that there was significant damage.

Any and all comments would be greatly appreciated.

Thank you for reading.

[doni54]

Thanks T!!  Gosh, everytime I see you've posted, it makes me smile!!  I miss you so very much.

You are always in my thoughts and prayers, sweetie!!

Take care,
doni

[young at heart]

TO ALL,

YES, WHEN ORIGINALLY DX'D WITH MS IT WAS BASED ON BRAIN ATROPHY,MORE PRONOUNCED FOR AGE( THE DX WASN'T JUST BASED ON THIS)

BRAIN ATROPHY IN MS CAN BE AN EARLY PRECUSOR DEPENDING ON ITS LOCATION AND I STRESS LOCATION.

ATROPHY CAN OCCUR IN THE GREY MATTER AND THE WHITE MATTER IN MS.MANY MS SPECIALIST ARE FINALLY RECONIZING THAT LESIONS IN MS ARE NOT JUST ISOLATED TO THE WHITE MATTER ANY MORE.

ATROPHY DEPENDING ON IT'S LOCATION,CAN CREATE DISABILITIES.

WHEN FIRST DX'D,THE ATROPHY PEAKED MY INTEREST SO I DID DO A VERY IN DEPTH RESEARCH ON ATROPHY AND MS AND HOW IT EFFECTED US.

WHEN I HAVE MORE TIME AND MY VISION DECIDES TO COOPERATE I WILL POST THIS LENGTHY IMFORMATION,IT'S IN TERMS WE CAN ALL UNDERSTAND.

THIS IS A VERY GOOD TOPIC,MANY DRS. OVER LOOK THIS ASPECT BUT IT CAN IMPACT OUR DAILY LIVES FROM VISUAL,COGNITIVE,BALANCE AND SO FORTH,REGARDLESS TO THE DEGREE OF ATROPHY,IT DOES HAVE AN IMPACT ON US.

HUGS

T-LYNN

[doni54]

Okay, I'm gonna try to give this a shot.  These are some of the facts of the stages of MS.  Jen is exactly right about the SPMS and brain atrophy.  

From what I read today, the neuro's go by how long you've been having symptoms, what symptoms you are dealing with, what symptoms come and go and which stay around all the time.  I haven't read that the amount of lesions have anything to do with the stage of MS, for example PPMS shows more in the spinal cord than in the brain.

Approximately 50% of patients with RRMS convert to Secondary Progressive Multiple Sclerosis (SPMS) within 10 years of disease onset. After 30 years, this figure rises to 90%.

At any one time, the Relapsing-Remitting form of the disease accounts around 55% of all people with multiple sclerosis.

SPMS is characterised by a steady progression of clinical neurological damage with or without superimposed relapses and minor remissions and plateaux.

People who develop SPMS will have previously experienced a period of Relapsing/Remitting Multiple Sclerosis (RRMS) which may have lasted anything from two to forty years or more. Any superimposed relapses and remissions there are, tend to tail off over time.

Secondary Progressive Multiple Sclerosis tends to be associated with lower levels of inflammatory lesion formation than in RRMS but the total burden of disease continues to progress. This is thought to be caused by higher levels of AXONAL LOSS.

At any one time, the Secondary Progressive form of the disease accounts around 30% of all people with multiple sclerosis.

PPMS is characterised by a gradual progression of the disease from its onset with no superimposed relapses and remissions at all. There may be periods of a leveling off of disease activity and there may be good and bad days or weeks.

PPMS differs from Relapsing/Remitting and Secondary Progressive in that onset is typically in the late thirties or early forties, men are as likely women to develop it and initial disease activity is often in the spinal cord and not in the brain.

Primary Progressive MS often migrates into the brain, but is less likely to damage brain areas than relapsing/remitting or secondary progressive - for example, people with Primary Progressive are less likely to develop cognitive problems.

PPMS is the sub-type of MS that is least likely to show inflammatory (gadolinium enhancing) lesions on MRI scans.

The Primary Progressive form of the disease affects between 10 and 15% of all people with multiple sclerosis.

__________

Hope this helps a little, wish I could find more info on this for you.  I really miss Quix, I'm sure she could tell you without having to research this!!!!

Have a good weekend.

doni

[jensequitur]

Brain atrophy is a sign of SPMS, and of long-term disease activity.  They used to believe that old lesions collapsed, creating brain atrophy.  Now I think they're discovering that white matter atrophies, whether lesions are formed or not.  So the brain, spinal cord (cervical) and optic nerve can atrophy, and the rate of atrophy can tell the doctor how long your disease has been active.

One of our moderators, Quixotic1, has been scheduled for an OCT (optical coherence tomography) test to check the optic nerve.  It measures the thickness of the nerve, and compares it to normal healthy optic nerves.  It's a non-invasive, quick test to measure how much atrophy has occured in your white matter.

[doni54]

Hi ge,

I've been trying to research this myself.  I found that article on cog issues yesterday, and what I'm trying to learn is if any of the cog issues with MS can be reversed by some of these brain exercises I've been reading about.

I don't know much about the brain atrophy, but I think I remember that one of our members, YOUNG AT HEART, was dx because of the brain atrophy.  I hope I am remembering this right, anyway.

I had looked for a more descriptive article about the dx of different stages of MS, but so far I haven't found what I was looking for.  I will try again, today, and see what I can find.

Have you talked to your neuro about your suspicions?  I don't see where it would hurt for you to tell him that you feel that your MS is progressing and just point blank ask him how they determine what stage of MS you are in when you are dx.

Take care,
doni