What is the likely location of an MS lesion causing paresthesia and neuralgia on the dorsal right forearm and ring finger?

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From the Guidelines

The likely location of an MS lesion causing paresthesia and neuralgia on the dorsal right forearm and ring finger is in the cervical spinal cord.

Key Points

  • MS lesions typically develop in specific white matter regions, including the periventricular and juxtacortical white matter, the corpus callosum, infratentorial areas, and the spinal cord 1.
  • The cervical segment of the spinal cord is a common location for MS lesions, and lesions in this area can cause symptoms in the arm and hand 1.
  • Imaging of the whole spinal cord is recommended to define dissemination in space, particularly in patients who do not fulfill brain MRI criteria for dissemination in space 1.
  • T2-weighted sequences are sensitive for detecting spinal cord lesions, and high-resolution imaging is required due to the small cross-sectional area of the spinal cord 1.
  • The dorsal right forearm and ring finger are innervated by the C7 and C8 nerve roots, which are located in the cervical spinal cord, making this a likely location for the MS lesion causing these symptoms.

From the Research

MS Lesion Location

The location of an MS lesion causing paresthesia and neuralgia on the dorsal right forearm and ring finger is likely to be in the central nervous system, specifically in the spinal cord or brainstem.

  • The spinal cord is a common location for MS lesions, and lesions in this area can cause a range of symptoms, including paresthesia and neuralgia, depending on the specific location and extent of the lesion 2.
  • The brainstem, particularly the pons, is also a potential location for MS lesions that can cause facial pain and other symptoms, including trigeminal neuralgia 3, 4.

Specific Lesion Locations

Some specific lesion locations that may be associated with paresthesia and neuralgia on the dorsal right forearm and ring finger include:

  • The periventricular region, which is a common location for MS lesions and can cause a range of symptoms, including sensory disturbances 5, 6, 2.
  • The posterior columns of the spinal cord, which can cause paresthesia and other sensory symptoms if damaged by an MS lesion 2.
  • The dorsal root entry zone, which is the area where sensory nerves enter the spinal cord and can be affected by MS lesions, causing paresthesia and neuralgia 2.

Lesion Symptom Mapping

Voxel-based lesion symptom mapping analysis has been used to study the relationship between lesion location and symptoms in MS patients, including chronic pain 2.

  • This type of analysis can help identify specific lesion locations that are associated with particular symptoms, such as paresthesia and neuralgia.
  • The results of these studies can provide valuable insights into the pathophysiology of MS and the development of symptoms, and can inform the diagnosis and treatment of MS patients 2.

References

Guideline

Guideline Directed Topic Overview

Dr.Oracle Medical Advisory Board & Editors, 2025

Research

A voxel-based lesion symptom mapping analysis of chronic pain in multiple sclerosis.

Neurological sciences : official journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology, 2021

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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