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  • One Lesion on Brain - MS? Seizure? Something else?

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    Old 04-16-2012, 12:34 PM   #1
    shoesB
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    One Lesion on Brain - MS? Seizure? Something else?

    In March 2011, my fiancÚ had a weakness in his arm, and felt very light headed. I took him to the ER. They ran a CT scan - normal results. They decided to admit him so they can do an MRI. While waiting 2 days for the MRI, they ran a series of tests. Everything came out normal. After his MRI, the neurologist told him that he has a lesion (4.4cmx2.7cm) on his brain, and told him that he most likely has MS, but there are other possibilities. He then was put on a steroid (through an iv) and the doctor did a spinal tap - normal results. He was then referred to an MS specialist. The specialist put him on copaxone. He had a spinal MRI, which came back normal. During the last year he has been on copaxone, he still felt the weaknesses in his hand. In March 2012, they did another MRI, which was then compared to the original MRI, and there was still one lesion on his brain but this time it had a swelling. He went to see a neurosurgeon, and the neurosurgeon told him that these weaknesses were mini seizures, and that he might not have MS. He also recommended to do an MRI at Columbia, which was more advanced than the previous ones. Last week, my fiancÚ has a serious seizure, in which he passed out for about 5 minutes. They took him to the ER. His blood work was normal. They did an EEG and put him on Keppra. I am not convinced this is MS because MS is usually multiple lesions on the brain, and MS patients rarely get seizures like this. Today, we went to another neurologist. This neurologist told him that this is most likely a neoplasm, and wants to do the MRI at Columbia and then a biopsy. Any comments?

    Last edited by shoesB; 04-17-2012 at 10:54 AM. Reason: more to the story.......

     
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    Old 04-16-2012, 01:22 PM   #2
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    Re: One Lesion on Brain - MS? Seizure? Something else?

    Welcome.

    Usually MS would be diagnosed with 2 or more lesions, but it really depends on when it was "caught". A CT Scan should not show any abnormalities with MS because it does not "see" lesions. An MRI can show lesions.

    Seizures do happen with MS (about 5% of MSers). I went through a cycle of seizures. It could very well be that there is something else happening. A normal LP result is not strange for MSers because a negative LP occurs in 15% of MSers.

    If his seizures are MS related, they will probably cycle through. MS is not fatal. I have had MS since at least 14 years of age. Stay strong!
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    Old 04-16-2012, 03:44 PM   #3
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    Re: One Lesion on Brain - MS? Seizure? Something else?

    Hi and welcome to healthboards. You certainly are going through quite a bit, arent you? Im sorry....

    Your fiance seems to be in good hands so far. Columbia is a very good place to seek opinions. Jayhawk is accurate. Seizures DO take place in only 5% of MS patients, however lesions can be caused by any number of things. They can be from migranes, prior brain trauma, infections, etc. The fact that the LP was normal...normal for what? Do you know? They use cerebral spinal fluid to test for an awful lot of things...meningitis, PML, Obands....do you know what they were looking for? I have a normal LP myself...but I also have more than 50 lesions in my brain! Ive been tested and retested several times for all of the above and more- nothing ever shows up. 15% of MSers have normal LPs and do not show Obands.

    Its highly unusual to be put on Copaxone or any disease modifying drug for MS unless the MS specialist was very sure that he had MS. There appears to be something missing in this story. Maybe in his history and physical, more symptoms were discussed? Maybe he has had bouts of dizziness, heat sensitivity or other MS like symtoms? Something had to give the MS specailist a reason to prescribe Copaxone, because as Jayhawk also stated, the McDonald criteria for diagnosing MS depends on alot more than 1 lesion. See if you can gain more information from your fiance as to why he was put on Copaxone, if someone wasnt entirely sure it was MS...

    Last thought, Neurosurgeon vs. Neurologist....Neurosurgeons, cut. They do brain surgery...why did he see one? For one lesion? Again, something isnt adding up....if I were your boyfriend, I would be seeking the opinion of yet another MS specailist and being retested. If nothing else, for his own peace of mind. Its not good to get a diagnosis which is incorrect, but getting a MS diagnosis is one of the hardest diagnosis's to recieve...something told the first Specialist it was MS.....but a neurosurgeon isnt qualified to rule the possiblity out. See another MS specialist or at the very least a very good Neurologist who treats a bunch of MS patients...they sometimes have answers that others dont.

    I wish you both the best.....let us know what happens?
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    Old 04-17-2012, 10:56 AM   #4
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    Re: One Lesion on Brain - MS? Seizure? Something else?

    I added a few more details to my story... Thanks

     
    Old 04-17-2012, 01:46 PM   #5
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    Re: One Lesion on Brain - MS? Seizure? Something else?

    Neurosurgeons are not MS Specialists. When I went for my tests in 1982, the neurosurgeons were excited because they had the idea that surgery could fix me. After my test results, they lost interest and my neuro (MS Specialist) was permanently assigned to me. He suspected MS and had been my first doctor but the neurology department procedure required consultation from all the doctors (including the neurosurgeons).

    You mentioned Columbia. Is this in Columbia, Missouri or Columbia University?
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    Old 04-17-2012, 01:55 PM   #6
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    Re: One Lesion on Brain - MS? Seizure? Something else?

    Columbia University Medical Center

     
    Old 04-17-2012, 03:10 PM   #7
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    Re: One Lesion on Brain - MS? Seizure? Something else?

    Hi again. Your added details, changed how the story read. At this time, I still think you need to let Columbia (and I had assumed it was Columbia University, probably because I live in the area) do their thing. Its a great place to get more information and he will be in good hands.

    Please do keep us posted and if MS comes up again, know you have a place to come to and ask questions! But let us know what the MRI shows.

    I hope both of you stay well thru this...I realize how hard not knowing is.
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    Nikki
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