Multiple Sclerosis (MS) Support Group

Focal area of what?

Focal means not diffuse, so a defined focal area. MS lesions get lighter until they disappear on an MRI, remylenation makes the lesion nolonger bright enough for the MRI to meassure. It may have been an old lesion that is in the process of healing. It keeps getting less bright while it is healing. PP MS people often report diffuse areas of hyperintensities on their MRI's. A large area of hyperintensity on their spine not discrete area(dot like-focal area) like RRMS people report.

The spine mri says: the vertebrae reveal normal signal intensity without edema or fracture. there is no prevertevral soft tissue swelling. there is disc bulging at c5/6. At this level there is a faint focal area of imcreased signalintensity on the t2 and stir imagis in the spinal cord posteriorly. there is no abnormal contrast enhancingmass identified. there is reversal of normal lordosis.


IMpression:faint focal area of increased signal intensity in the spinal cord posteriorly, which could represent an area of demylination. clinical correlation required.

so does this mean they are not certain?

Thats what it sounds like....I read a book on how MRI's worked and in the very first chapter they said the MRI diagnosis nothing it is only used to confirm or dispute clinical observation.

Your MRI is always uncertain , pending the clinical observation.

Yhe combination of the disc buldge at that level makes clinical observation more necessary. Lesion form, they heal. Fduring the forming or healing part they may be faint and not a "true lesion"

The book I read identified a term DWM-dirty white matter on an MRI where lesions tend to form in the future. That would be a diffuse area. Focal would be a discrete are and more likely a lesion that formed and then began to heal...but it could just be "noise" on the MRI showing something not there and clinical correlation is needed to determine the accuracy of the MRI reading there.

Clinical observation ALWAYS superseded what is measured on an MRI. The MRI only disputes or supports conical observation.
Your doc is god, not the MRI.

do you know what symptoms a lesion at that level would be, and with the disk bulge can ms cause that? sorry to bother you if i am just tell me.

Can't tell you but can give you many links about the spine. One might give you some answers to yo9ur questions. They ar many...it will require a few replies for me to find them all.

http://www.medhelp.org/health_page...

http://www.makoa.org/scimap.htm

http://www.wisegeek.com/what-are-o...

And...And one really good site I am looking for..if I find that one I will post it also..

http://www.spine-health.com/condit...

http://www.dailystrength.org/c/Mul...#addcomment_anchor

I hasd a really good article on this, I am so disappointed i can't find it. A person who is always critical of those siteas actually replied it was good. I preened with pride when she did tha, now I cant find it :(

Here is a partial post I am copying from NickAtNite. If I ever find that really good site I will make sure I din't lose it!!!.

http://www.patientslikeme.com/foru...

SPINAL COLUMN

C1: blood supply to the head, pituitary gland, scalp, bones of the face, inner and middle ear, sympathetic nervous system, eyes, ears

C2: eyes, optic nerves, auditory nerves, sinuses, mastoid bones, tongue, forehead, heart

C3: cheeks, outer ear, face, bones, teeth, trifacial nerve, lungs

C4: nose, lips, mouth, Eustachian tube, mucus membranes, lungs

C5: vocal cords, neck glands, pharynx

C6: neck muscles, shoulders, tonsils

C7: thyroid gland, bursa in the shoulders, elbows, ulnar nerve

T1: arms from the elbows down, including hands, arms, wrists and fingers; esophagus and trachea, heart

T2: heart, including its valves and covering coronary arteries; lungs bronchial tubes

T3: lungs, bronchial tubes, pleura, chest, breast, heart

T4: gallbladder, common duct, heart, lungs, bronchial tubes

T5: liver, solar plexus, circulation (general), heart, esophagus, stomach

T6: stomach, esophagus, peritoneum, liver, duodenum

T7: kidneys, appendix, testes, ovaries, uterus, adrenal cortex, spleen, pancreas, large intestine

T8: spleen, stomach, liver, pancreas, gallbladder, adrenal cortex, small intestine, pyloric valve

T9: adrenal cortex, pancreas, spleen, gallbladder, ovaries, uterus, small intestine

T10: kidneys, appendix, testes, ovaries, uterus, adrenal cortex, spleen, pancreas, large intestine

T11: kidneys, ureters, large intestine, urinary bladder, adrenal medulla, adrenal cortex, uterus, ovaries, ileocecal valve

T12: small intestine, lymph circulation, large intestine, urinary bladder, uterus, kidneys, ileocecal valve

L1: large intestine, inguinal rings, uterus

L2: appendix, abdomen, upper leg, urinary bladder

L3: sex organs, uterus, bladder, knee, prostate, large intestine

L4: prostate gland, muscles of the lower back, sciatic nerve

L5: lower legs, ankles, feet, prostate

Sacrum: hip bones, buttocks, rectum, sex organs, genitalia, urinary bladder, ureter, prostate

Sacral Plexus: Forms the sciatic as well as other nerves that go to muscles, joints and other structures of the legs, knees, ankles, feet and toes

Coccyx: rectum, anus

Found tjhat really good site and it was of brain not spinal column. The above is the best I could do. remeber a lesion in the spine affects everything below it.

Is it possible, that it isnt a lesion and its the disk bulging, or are they pretty much different?

I don't think the focal area can be disc bulging. I wrote what I said. I believe it is an old lesion healing or just an "artifact" the MRI measured incorrectly and it has to be confirmed by clinical observation of symptoms. That what makes the disk bulging significant. Disc bulging happens normally as we age, but sometimes the disc bulge can impinge on the nervous column causing symptoms typical of MS but are from the disc bulge. Tingling in the extremities would be the big on that could be caused by both MS & the disc bulge.

I think the disc bulge is significant in confirming with clinical correlation.

I have a C5/C6 lesion and it affected me by not being able to use my right arm during a relapse. And you know what, from that chart I had a lot of vocal issues in the past & I wonder if it really does affect the vocal,tonsils neck area. Its C1/C2 that is the most scary.