Editor’s note: “Need to Know” is a series inspired by common forum questions and comments from readers. Have a comment or question about MS? Visit our forum. This week’s question is inspired by two forum topics about silent inflammation from August 2019. Have an experience you want to share? Leave a comment here or at the original forum topics.
I have been in remission for a few years now and — knock on wood — I hope that continues for a long time. Like, forever!
My annual MRI showed no changes in my lesions to indicate new activity. As a result, my neurologist put me on a new maintenance plan. My orders? Maintain good health habits, follow my current therapy protocol, get an MRI every other year, and call if new symptoms appear suddenly and don’t resolve.
I wondered why I needed to get an MRI if I wasn’t exhibiting outward symptoms. However, two MS terms — silent inflammation and smoldering lesions — explain why.
Lesion activity in MS
When we think of inflammation, we think of swelling, redness, warmth, pain — hallmarks of acute inflammation. If you break an ankle or develop an earache, you’re going to have acute inflammation, which is temporary and even beneficial to the healing process.
However, overactive inflammatory responses caused by MS result in lesions (plaques or scarring) on the tissue of the central nervous system. Chronic, MS-related inflammation releases immune cells that mistakenly attack the myelin coating of our nerves. Overactive inflammatory responses interfere with signal conduction between the brain and other areas of the body.
MS inflammation is acute during an active flare. But it can also be chronic during and between flares, resulting in muscle spasms, slow speech, and other neurological dysfunctions that define life with MS.
Chronic inflammation is noticeable and can be felt, but silent inflammation can go unnoticed for years. Silent inflammation occurs in the background and is prompted by underlying and emergent conditions of which we are often unaware. Silent inflammation is rarely accompanied by outward symptoms.
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