I wonder if some one can give advice please I have just had an MRI of brain and spine with and without contrast The brain, no change I had an MRI a year ago Multiple small white non specific hyper intensities that did not light up with contrast ( pretty much as last time although I didn’t have contrast) I was told they were vascular lesions although I have low blood pressure and I’m thin no diabetes The spine showed lesions in C2 C3 C5 T6 T8 T10 T11 T12 none of these enhanced with contrast So What I’m asking is, If they don’t show up with contrast does this mean they are not active lesions? because the fact of the matter is I literally feel like I’m dying I don’t have an appointment to see the Neurologist for 6mths When I staggered into his office on 20th December he told me it would be impossible for me to have MS without any lesions in the spine (he agreed to the spinal MRI to shut me up
also I forgot enhancement in both optic nerves particularly in the immediate retrobulbar component (which I’m guessing is optic neuritis)
A lesion is a lesion. No idea why With Contrast would be less specific than one without the Gadolinium injection.
Whilst many of them have pseudo-Deity delusions, Neurologists can be provoked into action. Having had (with hindsight) PPMS since 2016, yet only diagnosed in early 2021, my MS Consultant set a 12-month follow-up for Mar’22. However, I was concerned enough after about 6 months that my decline was significant enough to bring things forward. Had a hell of a job persuading them and eventually threatened them with the N-word (Negligence). Bring on another MRI with contrast (head, C & T-spine), lumbar puncture, MRI lumbar + Ortho consult.
I’m still not on any meds apart from baclofen & vitamins but at least they’re playing ball now. You should shake them up a bit too if you feel they’ve underestimated your progress. 
Hi thanks for the reply The first MRI of my head was not through a Neurologist it was through the stroke clinic who sent me to see the neurologist feeling there was something more going on He was utterly dismissive asked why I was even there
If he was dismissive, I recommend you diarise the conversation and send it back to him/her. If they feel they are being misrepresented or being bcked into a corner, you’ll suddenly get their attention.
I’m preparing a negligence claim against my NHS Trust. In 2019 I saw the same MS Consultant who diagnosed me in 2021. In 2019 he didn’t even order a Head scan (I’d never had one, ever) and put me on happy pills which I stopped after 3 days because they turned me into a zombie. His laziness / dismissiveness cost me a potential 2 years of DMT’s. Don’t fall into the same trap!
I’ve actually been horrifically sick for a year I waited 6mths to see him I walked into his office and he said I’m DR … we don’t have much time I could barely walk I was in his office 10 minutes
Defintely write to him. Explain that you were dissatisfied with being “granted” only 10 minutes when in fact you felt so ill you could not really resist and request another appointment quickly, to complete your assessment as you feel there were things that had been missed. Write to him or via his Med Sec for his attention.
The trail starts here.
Well, I’m glad you talked a spinal MRI out of the neurologist, however reluctant he seemed. Those results should get his attention. Time to push for an early appointment, I think. You have new information now, and that’s what gets things moving.
I don’t know much about it, but my understanding, such as it is, is in line with yours: that active inflammatory lesions look different from old ones when the scan is done with contrast.
Just to add:
Go back to your GP and report, in writing, your dissatisfaction and ask that they book you an URGENT follow-up with the Neuro guy, for the reasons you’ve explained. GP will have had a copy of ypur report. Doing it this way means the Neuro can’t fob you off without fobbing your GP off at the same time.