Tips From a Doctor: Understanding Silent Activity
- by Dr. Travis
- May 13, 2019
Dr. Travis is a paid spokesperson for Teva Neuroscience, Inc.
In MS, the immune system attacks myelin which is a protective sheath that covers nerves (axons). This can lead to communication problems between the brain and the rest of the body. Messages from the brain and spinal cord going to other parts of the body can be delayed and may have trouble reaching their destination, which causes the symptoms of MS. These symptoms can include a variety of physical, emotional, and cognitive changes.
MS is a particularly challenging condition because signs and symptoms of MS can vary widely and depend on the amount of nerve damage that has occurred as well as which nerves are affected. Part of the reason for this is because MS may be “clinically silent.” This means that some people with MS show no increase in symptoms, but can continue to show signs of disease activity within the CNS on magnetic resonance imaging (MRI). However, these same people can experience long periods of time without worsening. These variations in disease activity show how MS may affect each individual differently.
Lesions are areas of damage and inflammation that can be viewed and tracked using brain MRI, one of the most important inventions of the 21st century. Disease activity can be assessed from changes in the size or number of lesions. “Clinically silent” MS activity can be viewed on brain MRI scans. If a “silent” lesion appears, it can act as a warning sign - a way for your doctor to check on your MS and let you know in real time if your MS is under control.
I always remind patients to ask their neurologists if there is “clinically silent” MS activity on their brain MRI to ensure they are getting the most out of their visit. If you have “clinically silent” MS activity or have a lesion that has never produced symptoms, it might be helpful to keep a journal to track these lesions for your own records.
Your MRI results are a starting point—a way to monitor your MS over time. The time that you and your neurologist spend together discussing your symptoms, performing a physical exam, and comparing how you are doing today to how you were doing weeks, months or even years ago is also very important.
Remember to keep up with your MRI scans and neurologist visits. If you visit your neurologist regularly, you’ll find “clinically silent” MS activity is nothing to be feared.
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Take care of yourself!
Lori Hendin Travis, MD