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Related Experiment Videos

Multiple sclerosis with caudate lesions on MRI.

S Hashiguchi1, N Ogasawara, H Mine

  • 1Department of Neurology, Takamatsu Red Cross Hospital, Kagawa.

Internal Medicine (Tokyo, Japan)
|May 4, 2001
PubMed
Summary

Multiple sclerosis (MS) can affect the basal ganglia, causing memory loss and abulia. This case highlights caudate nucleus lesions in MS, responsive to corticosteroid treatment.

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Area of Science:

  • Neurology
  • Neuroimaging
  • Neuroimmunology

Background:

  • Multiple sclerosis (MS) is a chronic inflammatory demyelinating disease of the central nervous system.
  • Cognitive impairment, including memory dysfunction, is a common manifestation of MS.
  • Lesions in MS typically occur in the white matter, but involvement of deep gray matter structures is increasingly recognized.

Observation:

  • A 31-year-old woman presented with somnolence and impaired recent memory.
  • Initial T2-weighted MRI showed high signal intensity lesions in the bilateral basal ganglia, thalamus, and brainstem.
  • Recurrence of memory dysfunction and emotional disturbance one year later revealed new lesions in the right caudate nucleus and left frontal white matter.

Findings:

  • The patient achieved remission with corticosteroid therapy for initial symptoms.
  • Subsequent relapse with cognitive and emotional symptoms correlated with new lesions, notably in the caudate nucleus.
  • Maintenance corticosteroid therapy prevented further recurrence, indicating disease control.

Implications:

  • This case demonstrates that lesions in the caudate nucleus can occur in multiple sclerosis.
  • Caudate nucleus lesions in MS may manifest as abulia and memory dysfunction.
  • The findings underscore the importance of considering deep gray matter involvement in MS diagnosis and management, particularly when cognitive symptoms are prominent.

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