I found this an interesting read

Thanks Bob - I too found it very interesting. Teresa xx

Very nice paper, thanks for posting.

For everyone: the McDonald criteria have been updated since this was written, but it’s a very informative read nonetheless.

Karen x

One thing that I found interesting is the suggestion that amongst the small percentage of false negatives on brain MRIs, up to half of them are likely to be PPMSrs often with quite advanced disease.

Yep - PPMSers are less likely to have brain lesions and are less likely to have visible lesions in general. Also, MRI is far from perfect, especially when used with “standard” (i.e. pretty rubbish) settings. MRI of the spinal cord is very tricky too - and that’s where PPMSers are likely to have lesions. The other thing is that most neuros don’t bother to scan the whole spine and it’s possible to have only thoracic lesions, especially in the early years.

Over-reliance on MRI can be a real issue :frowning:


I found that a very interesting read too, especially since I am in limbo. I thought the connection with Lupus interesting and am going to requests the blood tests for this. Since reading your article I have typed in to google “Lupus and Spinal atrophy” and got lots of hits! Apparently it can cause partial transverse mylitis which gives the brown-sequard pattern (numbness one side weakness the other). This is what I was hit with 4 years ago and although am pretty well now I have been left with spasticity in right leg (ie the one that went weak). Also Lupus is in my family, my fathers 2 sisters had it and 2 of my female cousins. At the moment one neuro has diagnosed possible MS and the other radiation myleopathy! If i did have MS it would probably be PPMS as I have no brain lesions and only one spinal, a clear LP and only one side effected!