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A 45-year-old female asked:

can ms lesions be just in spinal cord not brain or visa versa? also does ms always show up in spinal fluid?

4 doctor answers8 doctors weighed in
Dr. Anatoly Belilovsky
Pediatrics 35 years experience
MS lesions...: ...Can be anywhere in the nervous system, and do not have to show up as changes in the cerebrospinal fluid. The clinical course (stepwise deterioration with slow recovery between episodes) is t he hallmark of ms.
Dr. Bennett Machanic
Neurology 52 years experience
Yes: Although less common, can find cases at least initially spare brain & involve cord only but if so need to r/o NMO. Early on, spinal fluid may be negative or nonspecific. Serial MRI's may be more helpful
Dr. Olav Jaren
Neurology 19 years experience
Good questions: MS lesions may either be in the brain or the spinal cord, or in both. Sometimes, rarely, they are not found in either location. Evidence does not always appear in the spinal fluid. These are not perfect tests, but in most cases, they will help give the answer.
Dr. Andrew Reeves
Neurology 30 years experience
Yes: MS which only shows up in spinal cord can be Devic's syndrome, or spinal MS. Sometimes an antibody can confirm Devic's (70 percent have NMO antibody). No MS does not always show abnormalities in the spinal fluid (at least 10 percent are normal).

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Last updated Mar 16, 2021

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