Seems like a strange question to ask a doctor, but when you have been diagnosed with MS and you begin having regular MRI's, there are two questions you want answered right away.

1. Are there any active lesions?

2. How's the brain atrophy?

What is Brain Atrophy?

The short answer, In brain tissue, atrophy describes a loss of neurons (nerve cells) and connections between them. Of course everything we do is controlled by messages sent from the brain to the body's muscles and nerves.

I view it as evidence that my brain is shrinking because the brain can decrease in size as well as function. The neurons conduct and transmit signals throughout the body. Obviously it is of no little concern when you know your nerve cells are dying.

MS causes inflammation, myelin damage and lesions in the cerebral (brain) tissue, which are best revealed in MRI results.

What Constitutes a Good MRI Report?

I am very happy when my neurologist tells me that my brain atrophy is within the normal range. I realize it means my brain is still atrophying, but at least it is doing so at a slow and steady pace.

When you have MS, you have no choice, your brain IS going to atrophy. You can only take solace in the fact that it is not happening too quickly.

By the way the same atrophy takes place in the spinal chord.

YEARS OF GOOD MRI'S

I think I got spoiled. I had years of no real change in my MRI's. I was still injecting myself with Copaxone and it seemed to be working. Of course "working" is a relative term. Copaxone does not cure MS, but it does slow down the course or pace of the disease.

I hoped the MRI results would last forever, I suppose.

MY LATEST MRI RESULTS

My next to last MRI results showed a change. I developed a new, active lesion in the area of my spinal chord that controls leg movement. I was naturally concerned about the brain atrophy, but at least that remained in the normal range.

My latest MRI's showed NO changes. No new active lesions and brain atrophy still in the normal range.

I am expecting the same results when I do this year's MRI's since I have not had any new problems or symptoms to deal with.

SYMPTOMS OF BRAIN ATROPHY

People with MS can have brain atrophy with no real evidence that is happening except for the MRI results. However, there are some of us who do suffer some symptoms.

I can't say I suffer symptoms ALL the time, but I have noticed some problems that indicate brain atrophy.

• Expressive Asphasia
• Seizures
• Dementia

My symptom group is Expressive Asphasia.

At times during a flare-up, I become so fatigued that I am unable to move. Along with feeling paralyzed comes the inability to speak. I am thinking very clearly, but the words do not want to come out. I am totally alert, but cannot utter clear sentences.

When the attack begins. I am naturally asked by my family member if I am alright, I can get out the fact that I'm having a flare-up, but if the questioning continues, I am less and less able to answer.

For example,

"Do you want something to drink?"

I answer, "yeah"

"What do you want, water or soda?"

I want to answer, "ginger ale". Instead what comes out is, "um . . . um . . .

I don't know"

"Do you want ginger ale?" I'm asked.

I answer, "yes".

It drives me crazy when that type of interchange occurs. I think to myself, "why can't you answer, you know you want the ginger ale, just say it!"

Seems like whatever part of my brain which can allow me to verbally identify my choice is blocked, only yes or no wants to come out.

After a little while, even answering yes or no is not possible.

FAMILY ASSISTANCE

I'm glad those attacks only last 1-2 hours. It is disconcerting when it occurs. Thankfully it is only once or twice a year. I am able to get through it by reminding myself that it will be over soon and then I'll be back to normal.

My family member stays close by until the worst has passed. It calms me when I know someone is with me. I've had occasion when I've had to ride it out all by myself. I find those times are much scarier to endure.

SLOWING ATROPHY DOWN

I suppose if my atrophy begins to increase, I would ask to be put on IV steroids. Studies have shown it can slow down brain atrophy. The drug Betaseron supposedly slows down the atrophy as well.

Of course if I remain at my present level of deterioration, I won't have to consider doing anything at all, and that is just fine with me!