MS brain lesions occur from damage to the myelin sheath in your brain. Carefully managing and monitoring the condition can help you and your doctor understand if it’s progressing.

Nerve fibers in your brain and spinal cord are wrapped in a protective membrane known as the myelin sheath. This coating helps increase the speed at which signals travel along your nerves.

If you have multiple sclerosis (MS), overactive immune cells in your body trigger inflammation that damages myelin. When that happens, damaged areas known as plaques or lesions form on the brain or spinal cord.

Sticking with an effective treatment plan may limit or slow the development of lesions.

When lesions develop on your brain or spinal cord, they can disrupt the movement of signals along your nerves. This can cause a variety of symptoms.

For example, lesions may cause:

  • vision problems
  • muscle weakness, stiffness, and spasms
  • numbness or tingling in your face, trunk, arms, or legs
  • loss of coordination and balance
  • trouble controlling your bladder
  • persistent dizziness

Over time, MS can cause new lesions to form. Existing lesions may also grow larger, which might cause a relapse or an acute flare-up of symptoms. This happens when your symptoms get worse or new symptoms develop.

It’s also possible to develop lesions without noticeable symptoms. Only 1 in 10 lesions causes outward effects according to the National Institute of Neurological Disorders and Stroke (NINDS).

To help slow the progression of MS, many treatments are available. Early diagnosis and treatment might help prevent the development of new lesions.

To diagnose and monitor the progression of MS, your doctor will likely order imaging tests. These tests are called MRI scans. Doctors also use physical examinations to monitor the course of your MS.

MRI scans can be used to create pictures of your brain and spinal cord. This allows your doctor to check for new and changing lesions.

Tracking the development of lesions can help your doctor learn how your condition is progressing. If you have new or enlarged lesions, it’s a sign that the disease is active.

Monitoring lesions can also help your doctor learn how well your treatment plan is working. If you develop new symptoms or lesions, they might recommend changes to your treatment plan.

Your doctor can help you make decisions about your treatment options. They can also inform you about new therapies that might benefit you.

Many medications are available to treat MS. Some of those medications may help relieve your symptoms during a relapse or flare. Others decrease the risk of new lesions forming and help slow the disease progression.

The Food and Drug Administration (FDA) has approved more than a dozen disease-modifying therapies (DMTs) to help slow the formation of new lesions.

Most DMTs have been developed to treat relapsing forms of MS. However, some of them are used to treat other types of MS.

Many DMTs have shown promise for preventing new lesions. For example, the following medications may help stop lesions from developing:

  • interferon beta-1b (Betaseron)
  • ocrelizumab (Ocrevus)
  • interferon-beta 1a (Avonex, Extavia)
  • alemtuzumab (Lemtrada)
  • cladribine (Mavenclad)
  • teriflunomide (Aubagio)
  • fumaric acid
  • dimethyl fumarate (Tecfidera)
  • fingolimod (Gilenya)
  • natalizumab (Tysabri)
  • mitoxantrone
  • glatiramer acetate (Copaxone)

According to NINDS, clinical trials are underway to learn more about the potential benefits and risks of using these medications. Some of them are experimental, while others are FDA approved.

It might be possible to one day heal lesions in addition to slowing the growth of them.

Scientists are working to develop myelin repair strategies, or remyelination therapies, that might help regrow myelin.

For example, a small clinical trial published in 2017 found that clemastine fumarate might help promote myelin repair in people with optic nerve damage from MS. Clemastine fumarate is an over-the-counter (OTC) antihistamine that’s used to treat seasonal allergies.

More research is needed to assess the potential benefits and risks of using this medication to treat MS. Research is also underway to identify and test other potential strategies for promoting remyelination.

Lesions on the spine are also common in people with MS. This is because demyelination, which is what causes lesions, is a characteristic sign of MS. Demyelination occurs in the nerves of both the brain and the spine.

MS can cause lesions to develop on the brain and spinal cord, which may lead to a variety of symptoms. To help slow the development of lesions and manage symptoms they might cause, your doctor may prescribe one or more treatments.

Many experimental therapies are also being researched and developed to not only stop the development of new lesions but also to heal them.