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Abnormal brain scans in multiple sclerosis.

S L Cohan, J Fermaglich, T L Auth

    Journal of Neurology, Neurosurgery, and Psychiatry
    |February 1, 1975
    PubMed
    Summary
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    A young man with a family history of multiple sclerosis (MS) experienced neurological symptoms and an abnormal brain scan during an acute exacerbation. The findings suggest MS should be considered in diagnosing positive brain scans in young adults.

    Area of Science:

    • Neurology
    • Neuroimmunology

    Background:

    • Multiple sclerosis (MS) is a chronic, demyelinating disease of the central nervous system.
    • Genetic predisposition, such as a family history, can increase the risk of developing MS.

    Observation:

    • A 25-year-old male with a family history of MS presented with transient neurological deficits.
    • The patient developed acute optic neuritis accompanied by an abnormal brain scan without clear clinical correlation.
    • Cerebral arteriography was normal, and the brain scan normalized post-episode, suggesting transient blood-brain barrier disruption.

    Findings:

    • Elevated cerebrospinal fluid (CSF) gamma globulin levels were noted.
    • Abnormal brain scans in this case correlated with acute exacerbations of demyelinating disease.
    • The transient nature of the brain scan abnormalities suggests a temporary breakdown and restoration of the blood-brain barrier.

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    Implications:

    • This case highlights the importance of considering multiple sclerosis in the differential diagnosis of positive brain scans in young adults.
    • Abnormal brain imaging during acute phases may be a key diagnostic indicator for demyelinating conditions.
    • Understanding the transient nature of brain scan findings can aid in the diagnosis and management of MS exacerbations.