Can you have MS with no symptoms?

Finding of white matter spots (lesions) in the brain that are classic for multiple sclerosis without having symptoms can occur.   Not a surprising fact since many of people with MS have many old MRI spots when diagnosed.   A study of 456 patients in 5 countries examined people with these MRI changes.  Why do these people get an MRI scan?   Various reasons including headache (40%) and head trauma (8%).   Sixty-five percent of these individuals also had abnormal spinal fluid suggestive of MS.

By 5 years,  34% had their first relapse or progressive disability.   Those at higher risk for developing a MS relapse or disability were men, younger patients, and those with spinal cord disease.  Out of the 456 people with this “radiologically isolated syndrome,”  17% had been treated with an MS treatment.

As people approach age 50,  normally some white matter spots can form on the brain due to blockage of small blood vessels.   Smoking and high blood pressure can cause an increase in these MRI changes and can sometimes look similar to MS brain changes.  Therefore,  following patients over time with MRI scans is sometimes the best approach if not clear.  A young patient with classic MRI for MS and abnormal spinal fluid might consider early treatment with their healthcare provider.