Lesions without relapse

Hi there,

After having a second MRI scan I’ve been diagnosed with MS. The MRI showed four new lesions compared to the one I had six months ago but I from what I can think, I haven’t had a relapse during this time, leading to the question, is it possible to have new lesions without a relapse or I have just dismissed one as something else??

Likewise, can you have a relapse with no changes to lesions etc?

I have an appointment with the consultant again in a few weeks but was just wondering if anyone on here knew the answers :slight_smile:

I am absolutely no expert, but my understanding is that it is not unusual to have ‘silent lesions’ - particularly in the brain - that are definitely caused by MS damage but do not cause obvious corresponding symptoms, even if the same-sized lesion, less fortunately situated, would have caused mayhem. I think silent lesions are rarer in the cervical spine because the space in there is so tight that there aren’t many places for lesions to lurk without causing obvious trouble.

As for whether you can have a relapse without lesions, well, again I don’t really know, but don’t think that is so likely, although it does happen that small lesions are not always easily picked up by most MRI scanners.

As ever with these things, it is best to ask the views of you medical advisors who (unlike me) do know what they’re talking about.



Yes, I think Alison’s right. Silent lesions in the brain are quite common. You might find that lesions in the brain are causing such small symptoms that you’re not aware of them. Things like very early cognitive problems start like this I think. Or indeed that they have no symptoms at all.

Spinal lesions do tend to have symptoms of course.

Again, I would imagine Alison is correct about relapses without lesions. If a lesion is caused by inflammation in the CNS, and a relapse is caused by that inflammatory process, then you’d expect to have lesion(s) if you have a relapse. Even if it’s a repeat of symptoms that you have had before, there must have been some inflammatory activity to cause the relapse and therefore a lesion or scar would form as a result.

This is what the MS Trust say about lesions:


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I agree with Sue and Alison above, although I’m no expert. I was also diagnosed with ms like you after mri showed further active lesions (Enhanced by gadium) together with the older lesions. As far as I’m aware I didn’t have symptoms at the second mri.

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