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Diagnoses question about CIS

Hi all how many of you were first diagnosed with a CIS…my main symptom was a foot drop had 2 brain and 1 spinal MRI which showed lesions in several different areas!..what I’m confused about is if I’ve got lesions in more than one area how can they have happened at the same time but just have me one major symptom…it makes no real difference to the outcome as neuro put me on avonex as he felt attack was so severe and likely to have another one and this hopefully lessens the chance,…but just can’t really understand that one and be interested if anyone could shed some light on it…thanks Emma x

Hi Emma

I was diagnosed with CIS at first with several lesions in the brain. My symptoms were slurred speech, droopy mouth and right hand weakness (I couldn’t write properly, it was like spider scrawl). Nevertheless it was considered just the one attack so I was told to go home and try not to worry about it as, by the time I had the MRI and lumbar puncture, I was showing signs of recovering on my own. As if you can go home and not worry about it!!

Three months later I was back in hospital, numb from the waist down, with the hug and barely able to walk. I suppose I should be glad I was diagnosed quickly and was not in limbo for long and at least, like yourself, I got onto DMDs very quickly as both relapses were significant. I’m on Rebif and have only had one mild relapse since. That was four years ago but I’m having lots of troublesome symptoms at the moment which is a bit worrying. I’m doing my best to ignore them although I have alerted my nurse so she can put it on my notes. She did say if they get worse I could have steroids but I’m not that keen to have them so I’ll try to rest as much as possible and see what happens. In the meantime I’m driving 200 metres to work as I can’t walk it at the moment

I suppose they put it down as one attack if you only seek medical help at the time. The other lesions must have occurred over time but perhaps didn’t cause symptoms severe enough for us to seek help. Looking back there were odd things that make me wonder now but I’m not one to rush to the doctor every time I’m a little bit wobbly as I’m clumsy anyway. I also had a dizzy spell a week before the slurred speech started but just put it down to coming down with a virus. We do tend to explain away odd little things and it’s not until they merge into one huge problem that we begin to think there may be something more going on. Even when I was in hospital the first time having tests, if I walked down the corridor I was bouncing off the walls and thinking it was odd but I never thought to mention it because I didn’t realise it was significant. If the doctors had given me any kind of clue what they suspected I could have given them loads more help :wink:

Tracey

Hi Emma (& Tracey),

Each attack can - and often does - cause multiple lesions.

It’s not “one lesion = one attack”. Therefore you can halve multiple lesions - and in different places, too - but all considered to be stemming from the same attack.

Not ALL lesions cause any symptoms at all. The brain, in particular, is very good at finding ways round things, so it is possible for someone to have quite a number of lesions, without noticing many/any ill effects. But conversely, if you’re unlucky, just one in a crucial place could wreak major havoc!

In general, spinal cord lesions tend to be more problematic, because it’s a narrow pathway, so if there’s damage, there isn’t really the same potential for re-routing things, to avoid the worst effects. Your brain might be able to find different ways of doing things, but your spinal cord doesn’t have the same flexibility.

Tina

Hi Tracy and Tina for your replies…and that’s really helpful information Tina I was a bit confused by it all really but that really simplified it and answered some questions I wax unsure of…if would be nice if the health professionals explained some of these things to you as it makes it all a bit easier to understand…so thanks muchly Emma x